Sahyun Sung, Ji-Won Kwon, Soo-Bin Lee, Eun Hwa Kim, Inkyung Jung, Seong-Hwan Moon, Kyung-Soo Suk, Hak-Sun Kim, Si Young Park, Byung Ho Lee
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The infection rate was analyzed by dividing patients into 4 groups as follows: patients who underwent neither acupuncture nor ESI (unexposed group), patients who underwent acupuncture only (acupuncture group), patients who underwent ESI only (ESI group), and patients who underwent both acupuncture and ESI (combined group). Cox regression analysis was performed to identify risk factors for postoperative spinal infection.</p><p><strong>Results: </strong>A total of 207,806 patients were included in this study. The postoperative infection rate among all patients was 4.29%. The infection rates in the unexposed, acupuncture, ESI, and combined groups were 4.17% (4,342 of 104,106 patients), 3.90% (340 of 8,726 patients), 4.48% (3,761 of 83,882 patients), and 4.26% (473 of 11,092 patients), respectively. Increasing age, male sex, and ESI were demonstrated to be risk factors for postoperative spinal infection. ESI was no longer a risk factor when patients who received acupuncture or ESI within 2 weeks of spinal surgery were excluded. Preoperative acupuncture was not associated with postoperative spinal infection.</p><p><strong>Conclusions: </strong>Acupuncture and ESI performed >2 weeks prior to spinal surgery did not increase the risk of postoperative infection.</p><p><strong>Level of evidence: </strong>Prognostic Level III. 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引用次数: 0
摘要
背景：针灸和硬膜外类固醇注射（ESI）是腰椎退行性疾病患者经常采用的治疗方法。本研究旨在探讨术前针灸和ESI作为选择性腰椎融合术后感染的风险因素：方法：使用全国性数据库，通过诊断和手术代码识别 2010 年至 2019 年期间因退行性腰椎病接受脊柱融合术的年龄大于 50 岁的患者。确定了术后 90 天内脊柱感染的发生率。使用程序代码确定了脊柱手术前 90 天内接受过针灸和/或 ESI 的患者。通过将患者分为以下四组来分析感染率：既未接受针灸也未接受 ESI 的患者（未暴露组）、仅接受针灸的患者（针灸组）、仅接受 ESI 的患者（ESI 组）以及同时接受针灸和 ESI 的患者（合并组）。结果显示，共有 207 806 名患者接受了针灸治疗：本研究共纳入 207 806 名患者。所有患者的术后感染率为 4.29%。未暴露组、针灸组、ESI 组和合并组的感染率分别为 4.17%（104106 位患者中的 4342 位）、3.90%（8726 位患者中的 340 位）、4.48%（83882 位患者中的 3761 位）和 4.26%（11092 位患者中的 473 位）。年龄增长、男性和 ESI 被证明是术后脊柱感染的风险因素。如果排除脊柱手术后两周内接受针灸或 ESI 的患者，ESI 不再是风险因素。术前针灸与术后脊柱感染无关：结论：脊柱手术前2周内进行针灸和ESI不会增加术后感染的风险：预后III级。有关证据等级的完整描述，请参阅 "作者须知"。
Effect of Preoperative Acupuncture and Epidural Steroid Injection on Early Postoperative Infection After Lumbar Spinal Fusion.
Background: Acupuncture and epidural steroid injection (ESI) are frequently performed in patients with degenerative lumbar disease. The purpose of this study was to explore preoperative acupuncture and ESI as risk factors for postoperative infection after elective lumbar fusion.
Methods: Patients >50 years of age who underwent spinal fusion due to degenerative lumbar disease from 2010 to 2019 were identified by diagnostic and procedural codes using a nationwide database. The incidence of spinal infection within 90 days after surgery was identified. Patients who underwent acupuncture and/or ESI within 90 days prior to spinal surgery were identified using procedural codes. The infection rate was analyzed by dividing patients into 4 groups as follows: patients who underwent neither acupuncture nor ESI (unexposed group), patients who underwent acupuncture only (acupuncture group), patients who underwent ESI only (ESI group), and patients who underwent both acupuncture and ESI (combined group). Cox regression analysis was performed to identify risk factors for postoperative spinal infection.
Results: A total of 207,806 patients were included in this study. The postoperative infection rate among all patients was 4.29%. The infection rates in the unexposed, acupuncture, ESI, and combined groups were 4.17% (4,342 of 104,106 patients), 3.90% (340 of 8,726 patients), 4.48% (3,761 of 83,882 patients), and 4.26% (473 of 11,092 patients), respectively. Increasing age, male sex, and ESI were demonstrated to be risk factors for postoperative spinal infection. ESI was no longer a risk factor when patients who received acupuncture or ESI within 2 weeks of spinal surgery were excluded. Preoperative acupuncture was not associated with postoperative spinal infection.
Conclusions: Acupuncture and ESI performed >2 weeks prior to spinal surgery did not increase the risk of postoperative infection.
Level of evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
期刊介绍：
The Journal of Bone & Joint Surgery (JBJS) has been the most valued source of information for orthopaedic surgeons and researchers for over 125 years and is the gold standard in peer-reviewed scientific information in the field. A core journal and essential reading for general as well as specialist orthopaedic surgeons worldwide, The Journal publishes evidence-based research to enhance the quality of care for orthopaedic patients. Standards of excellence and high quality are maintained in everything we do, from the science of the content published to the customer service we provide. JBJS is an independent, non-profit journal.
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