Minimally Invasive vs. Open Surgery for Lumbar Spinal Stenosis in Patients with Diabetes - A Canadian Spine Outcomes and Research Network Study.
Minimally Invasive vs. Open Surgery for Lumbar Spinal Stenosis in Patients with Diabetes - A Canadian Spine Outcomes and Research Network Study.
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DOI：
10.1177/21925682211042576
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发表时间：
2023-07
影响因子：
2.4
通讯作者：
Attabib, Najmedden
中科院分区：
文献类型：
--
作者：
Hathi, Kalpesh;Bigney, Erin;Richardson, Eden;Alugo, Tolu;El-Mughayyar, Dana;Vandewint, Amanda;Manson, Neil;Abraham, Edward;Small, Chris;Thomas, Kenneth;Fisher, Charles G.;Rampersaud, Y. Raja;Hall, Hamilton;McIntosh, Greg;Johnson, Michael G.;Bailey, Christopher S.;Weber, Michael H.;Paquet, Jerome;Kingwell, Stephen;Nataraj, Andrew;Finkelstein, Joel;Kelly, Adrienne;Attabib, Najmedden
关键词：
回顾性队列。比较微创手术（MIS）与开放手术（OPEN）治疗糖尿病患者腰椎管狭窄症（LSS）的结局。纳入加拿大脊柱结局和研究网络（CSORN）数据库中接受单纯脊柱减压或融合治疗LSS的糖尿病患者。比较了2个队列的MIS与OPEN结局：（1）接受单纯减压术的糖尿病患者（N = 116; MIS n = 58和OPEN n = 58），（2）接受减压融合术的糖尿病患者（N = 108; MIS n = 54和OPEN n = 54）。在基线、术后6-18周和1年时比较改良的奥斯韦斯特里功能障碍指数（mODI）和背部和腿部疼痛。比较了1年时达到最小临床重要差异（MCID）或最小疼痛/残疾的患者数量。MIS入路的失血量更少（单纯减压差异100 mL，P = .002;融合差异244 mL，P < .001），住院时间（LOS）更短（单纯减压差异1.2天，P = .008;融合差异1.2天，P = .026）。与OPEN减压融合术相比，MIS发生不良事件（AE）的患者较少（差异为13例患者，P = 0.007）。与OPEN相比，MIS减压融合组的1年mODI（差异14.5，95% CI [7.5，21.0]，P <0.001）和背痛（差异1.6，95% CI [0.6，2.7]，P = 0.002）较低。MIS减压融合组中更多患者在1年时的mODI（MIS 75.9% vs OPEN 53.7%，P = 0.028）和背痛（MIS 85.2% vs OPEN 70.4%，P = 0.017）超过MCID。对于因LSS接受减压融合术的糖尿病患者，MIS入路与更有利的结局相关。
Retrospective cohort. To compare outcomes of minimally invasive surgery (MIS) vs open surgery (OPEN) for lumbar spinal stenosis (LSS) in patients with diabetes. Patients with diabetes who underwent spinal decompression alone or with fusion for LSS within the Canadian Spine Outcomes and Research Network (CSORN) database were included. MIS vs OPEN outcomes were compared for 2 cohorts: (1) patients with diabetes who underwent decompression alone (N = 116; MIS n = 58 and OPEN n = 58), (2) patients with diabetes who underwent decompression with fusion (N = 108; MIS n = 54 and OPEN n = 54). Modified Oswestry Disability Index (mODI) and back and leg pain were compared at baseline, 6–18 weeks, and 1-year post-operation. The number of patients meeting minimum clinically important difference (MCID) or minimum pain/disability at 1-year was compared. MIS approaches had less blood loss (decompression alone difference 100 mL, P = .002; with fusion difference 244 mL, P < .001) and shorter length of stay (LOS) (decompression alone difference 1.2 days, P = .008; with fusion difference 1.2 days, P = .026). MIS compared to OPEN decompression with fusion had less patients experiencing adverse events (AEs) (difference 13 patients, P = .007). The MIS decompression with fusion group had lower 1-year mODI (difference 14.5, 95% CI [7.5, 21.0], P < .001) and back pain (difference 1.6, 95% CI [.6, 2.7], P = .002) compared to OPEN. More patients in the MIS decompression with fusion group exceeded MCID at 1-year for mODI (MIS 75.9% vs OPEN 53.7%, P = .028) and back pain (MIS 85.2% vs OPEN 70.4%, P = .017). MIS approaches were associated with more favorable outcomes for patients with diabetes undergoing decompression with fusion for LSS.
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影响因子：
4.5
作者：
Kalichman, Leonid;Cole, Robert;Kim, David H.;Li, Ling;Suri, Pradeep;Guermazi, Ali;Hunter, David J.
通讯作者：
Hunter, David J.
影响因子：
5.3
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影响因子：
2.4
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Park Y;Seok SO;Lee SB;Ha JW
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Ha JW
影响因子：
3.2
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通讯作者：
Irrgang, JJ
影响因子：
3.7
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Lee, Chang Kyu;Choi, Sun Kyu;Kim, Insoo
通讯作者：
Kim, Insoo