Surgical complications associated with spinal decompression surgery in a Japanese cohort
Surgical complications associated with spinal decompression surgery in a Japanese cohort
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DOI：
10.1016/j.jocn.2015.06.029
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发表时间：
2016-04-01
影响因子：
2
通讯作者：
Taniguchi, Makoto
中科院分区：
文献类型：
--
作者：
Takai, Keisuke;Matsumoto, Takahiro;Taniguchi, Makoto
本研究的目的是在日本队列中确定与颈椎、胸椎和腰椎椎管狭窄症脊柱手术相关的围手术期并发症的危险因素。纳入了2008年至2012年间接受脊柱手术的椎管狭窄患者。回顾性收集首次手术后30天内的神经系统和/或手术部位并发症，并计算并发症发生率。使用单变量和多变量logistic回归分析，确定并发症的危险因素。共有364例患者接受了407例脊柱手术。在进行的407例手术中，236例为颈椎手术，28例为胸椎手术，143例为腰椎手术。黄韧带骨化是胸椎管狭窄患者中最常见的诊断（85%），而脊柱退行性狭窄和椎间盘突出是颈椎和腰椎管狭窄患者中最常见的两种诊断。椎板成形术和椎板切除术是最常进行的两种手术。胸椎管狭窄患者的并发症发生率（36%）高于颈椎管狭窄患者（16%）或腰椎管狭窄患者（13%，p = 0.013）。多变量分析后，只有胸椎管狭窄（比值比2.87）仍然是手术并发症的独立危险因素。本研究的新结果是，在日本队列中，脊柱狭窄水平对脊柱手术后并发症有显著影响。这一结果可以解释为，挑战性骨化病变是东亚胸椎管狭窄的常见原因。(C)2015爱思唯尔有限公司版权所有。
The aim of the present study was to identify risk factors for perioperative complications associated with spinal surgery for cervical, thoracic, and lumber spinal stenosis in a Japanese cohort. Patients with spinal stenosis who underwent spinal surgery between 2008 and 2012 were included. Neurological and/or surgical site complications within 30 days of index surgery were retrospectively collected, and the rates of complications were calculated. Using univariate and multivariate logistic regression analyses, risk factors for complications were identified. A total of 364 patients underwent 407 spinal surgeries. Of the 407 surgeries performed, 236 were cervical, 28 were thoracic, and 143 were lumbar surgeries. Ossification of the ligamentum flavum was the most common diagnosis in patients with thoracic stenosis (85%), whereas spinal degenerative stenosis and disc herniation were the two most common diagnoses in patients with cervical and lumbar stenosis. Laminoplasty and laminectomy alone were the two most frequently performed procedures. The rate of complications was greater in patients with thoracic stenosis (36%) than in those with cervical (16%) or lumbar stenosis (13%, p = 0.013). After a multivariate analysis, only thoracic stenosis (odds ratio 2.87) remained an independent risk factor for surgical complications. The novel result of the present study was that the level of stenosis in the spine had a significant impact on complications after spinal surgery in a Japanese cohort. The result can be explained by the fact that challenging ossified lesions are a common cause of thoracic stenosis in eastern Asia. (C) 2015 Elsevier Ltd. All rights reserved.