Risk factors for postoperative ileus after corrective spinal surgery: association with reduction in the retrocrural space area.

IF 2.9 2区医学 Q2 CLINICAL NEUROLOGY

Journal of neurosurgery. Spine Pub Date : 2024-11-01 DOI:10.3171/2024.7.SPINE24163

Shuhei Ohyama, Toshiaki Kotani, Tsuyoshi Sakuma, Yasushi Iijima, Yosuke Ogata, Shuhei Iwata, Tsutomu Akazawa, Kazuhide Inage, Yasuhiro Shiga, Shohei Minami, Seiji Ohtori

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引用次数: 0

Abstract

Objective: The objective of this study was to determine whether a reduction in the retrocrural space (RCS) area is a risk factor for postoperative ileus (POI) in patients with adult spinal deformity (ASD) treated with spinal corrective surgery.

Methods: In total, 100 patients (mean age 67.5 ± 8.3 years, 9 males and 91 females) with ASD treated with spinal corrective surgery were included in this study. Spinal parameters, including thoracolumbar kyphosis (TLK), and RCS area were measured pre- and postoperatively. The change (Δ) in spinal parameters was calculated. The percent change between pre- and postoperative RCS areas was calculated as ΔRCS. Patients were identified as having POI if they exhibited both gastrointestinal symptoms and radiographic findings. Each parameter was compared between patients with and without POI. Multivariable logistic regression analysis was performed with development of POI as the dependent variable.

Results: The incidence of POI was 11.0%. The RCS area was significantly smaller in the POI group than in the non-POI group (p < 0.001). Multivariable logistic regression analysis revealed that ΔTLK and ΔRCS were risk factors for POI (p = 0.029 and p = 0.033, respectively).

Conclusions: A reduction in the RCS area is a risk factor for the development of POI after corrective spinal surgery in patients with ASD. Overcorrection of the thoracolumbar junction should be avoided to prevent POI.

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脊柱矫正手术后出现术后回肠瘘的风险因素：与腓肠肌后间隙面积缩小有关。

研究目的本研究旨在确定在接受脊柱矫正手术治疗的成人脊柱畸形（ASD）患者中，腓骨后间隙（RCS）面积的缩小是否是导致术后回肠梗阻（POI）的风险因素：本研究共纳入 100 名接受脊柱矫正手术治疗的 ASD 患者（平均年龄为 67.5 ± 8.3 岁，男性 9 人，女性 91 人）。术前和术后测量了脊柱参数，包括胸腰椎畸形（TLK）和RCS面积。计算脊柱参数的变化（Δ）。术前和术后 RCS 面积变化的百分比计算为 ΔRCS。如果患者同时表现出胃肠道症状和放射学检查结果，则被确定为 POI 患者。对患有和未患有 POI 的患者的各项参数进行比较。以发生 POI 为因变量进行多变量逻辑回归分析：POI发生率为11.0%。POI 组的 RCS 面积明显小于非 POI 组（p < 0.001）。多变量逻辑回归分析显示，ΔTLK 和 ΔRCS 是 POI 的风险因素（分别为 p = 0.029 和 p = 0.033）：结论：RCS面积缩小是ASD患者在脊柱矫正手术后发生POI的风险因素。应避免过度矫正胸腰交界处，以防止 POI 的发生。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of neurosurgery. Spine 医学-临床神经学

CiteScore

5.10

自引率

10.70%

发文量

396

审稿时长

6 months

期刊介绍： Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.