开放与微创脊柱手术治疗单节段退行性腰椎滑脱:AO脊柱整体横断面研究。

IF 3.6 2区 医学 Q1 CLINICAL NEUROLOGY
Neurospine Pub Date : 2025-03-01 Epub Date: 2025-03-31 DOI:10.14245/ns.2448902.451
Luca Ambrosio, Sathish Muthu, Samuel K Cho, Micheal S Virk, Juan P Cabrera, Patrick C Hsieh, Andreas K Demetriades, Stipe Ćorluka, S Tim Yoon, Gianluca Vadalà
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引用次数: 0

摘要

目的:本研究旨在评估使用开放手术与微创手术(MIS)治疗单节段L4-5退行性腰椎滑脱(DLS)的全球趋势。方法:于2023年7月至9月对AO Spine会员进行AO Spine知识论坛退行性横断面在线调查。参与者提出了3例L4-5级1级DLS的临床病例,每个病例都有不同程度的狭窄和不稳定。该调查捕获了外科医生的人口统计数据和对开放与MIS方法的偏好。统计分析包括卡方检验和逻辑回归,以探讨手术选择与外科医生人口统计学之间的关系。结果:共有943名外科医生回复,其中479名完成调查。开放手术是所有3例患者(分别为58.8%、57.3%和42.4%)的首选入路,特别是涉及中央和双侧椎间孔狭窄的病例。MIS是第二常见的选择,特别是单侧椎间孔狭窄伴轻度不稳定(38.8%)。外科医生的偏好因地区、年龄和奖学金培训而有显著差异,年轻和接受过奖学金培训的外科医生更倾向于MIS。结论:该研究强调了开放式手术治疗DLS的持续优势,特别是在复杂的病例中,尽管越来越多的人接受MIS。手术偏好的显著区域和人口差异表明需要量身定制的指南和标准化的培训方案来优化患者的结果。未来的研究应关注这些方法的长期疗效以及不断发展的技术对手术决策的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Open Versus Minimally Invasive Spine Surgery in the Treatment of Single-Level Degenerative Lumbar Spondylolisthesis: An AO Spine Global Cross-Sectional Study.

Objective: This study aims to assess global trends in the use of open surgery versus minimally invasive surgery (MIS) for the treatment of single-level L4-5 degenerative lumbar spondylolisthesis (DLS).

Methods: A cross-sectional online survey issued by the AO Spine Knowledge Forum Degenerative was conducted among AO Spine members between July and September 2023. Participants were presented with 3 clinical cases of L4-5 grade 1 DLS, each with varying degrees of stenosis and instability. The survey captured surgeon demographics and preferences for open versus MIS approaches. Statistical analysis, including chi-square tests and logistic regression, was performed to explore associations between surgical choices and surgeon demographics.

Results: A total of 943 surgeons responded, with 479 completing the survey. Open surgery was the preferred approach in all 3 cases (58.8%, 57.3%, and 42.4%, respectively), particularly in cases involving central and bilateral foraminal stenosis. MIS was the second most common choice, particularly for unilateral foraminal stenosis with mild instability (38.8%). Surgeons' preferences varied significantly by region, age, and fellowship training, with younger and fellowship-trained surgeons more likely to prefer MIS.

Conclusion: The study highlights the continued predominance of open surgery for DLS, especially in complex cases, despite the growing acceptance of MIS. Significant regional and demographic variations in surgical preferences suggest the need for tailored guidelines and standardized training protocols to optimize patient outcomes. Future research should focus on the long-term efficacy of these approaches and the impact of evolving technologies on surgical decision-making.

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来源期刊
Neurospine
Neurospine Multiple-
CiteScore
5.80
自引率
18.80%
发文量
93
审稿时长
10 weeks
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