Gemma S Krautzel, Steve Balsis, Alexandra Foote, Mark S Eskander
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Archival records from the National Surgical Quality Improvement Program database were retrieved and analyzed. We identified 7160 patients in the clinic population who underwent elective cervical, thoracic, or lumbar spine surgery. The records contained diagnoses of each of the 5 thrombotic complications made by a board-certified physician applying American Medical Association assessment procedures.</p><p><strong>Results: </strong>Findings indicated that the incidence of overall thrombotic complications was relatively low, with only 0.92% of patients (66 of 7160) having any complication. The complication rates differed by type and surgical region of the spine, such that thoracic procedures resulted in a greater percentage of complications (<i>χ</i> <sup>2</sup>(1) = 14.83, <i>P</i> < 0.001) than cervical or lumbar procedures. 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引用次数: 0
摘要
背景：过去的研究已经检查了颈椎、腰椎和胸椎手术的个体并发症发生率，但通常只关注脊柱的一个区域，使得跨脊柱区域的比较很困难。本研究的目的是分析5种血栓性并发症的发生率，包括肺栓塞、深静脉血栓形成、心肌梗死、心脏骤停和中风/脑血管意外，这些手术针对脊柱的不同区域，包括颈椎、胸椎和腰椎。方法：我们在一个相对较大的样本中对这5种血栓性并发症进行了横断面临床分析。从国家外科质量改进计划数据库中检索并分析档案记录。我们在临床人群中确定了7160例接受择期颈椎、胸椎或腰椎手术的患者。这些记录包含了5种血栓性并发症的诊断，每一种都是由一名委员会认证的医生根据美国医学会的评估程序做出的。结果：研究结果显示，总体血栓性并发症发生率较低，7160例患者中有66例（0.92%）有任何并发症。并发症发生率因脊柱类型和手术区域的不同而不同，例如胸椎手术导致的并发症比例高于颈椎或腰椎手术（χ 2(1) = 14.83, P < 0.001）。肺栓塞在胸椎手术中发生的可能性更高，而在颈椎和腰椎手术中发生的可能性相对较低（χ 2(1) = 16.43, P < 0.001）。结论：胸外科手术对血栓并发症的风险最大。在胸外科手术中可能发生的血栓性并发症中，肺栓塞是最常见的。临床相关性：这些发现强调了外科医生在脊柱特定区域进行手术时需要特别注意某些并发症的风险。证据等级：4；
Higher Incidence of Thrombotic Complications in Thoracic Spine Surgery.
Background: Past studies have examined individual complication rates for cervical, lumbar, and thoracic spine surgery but have typically focused on just 1 region of the spine, making comparisons across spine regions difficult. The purpose of the present study was to analyze the incidence of 5 thrombotic complications, including pulmonary embolism, deep vein thrombosis, myocardial infarction, cardiac arrest, and stroke/cerebrovascular accident, across surgical procedures that target different regions of the spine, including cervical, thoracic, and lumbar.
Methods: We conducted a cross-sectional clinical analysis of these 5 thrombotic complications in a relatively large sample. Archival records from the National Surgical Quality Improvement Program database were retrieved and analyzed. We identified 7160 patients in the clinic population who underwent elective cervical, thoracic, or lumbar spine surgery. The records contained diagnoses of each of the 5 thrombotic complications made by a board-certified physician applying American Medical Association assessment procedures.
Results: Findings indicated that the incidence of overall thrombotic complications was relatively low, with only 0.92% of patients (66 of 7160) having any complication. The complication rates differed by type and surgical region of the spine, such that thoracic procedures resulted in a greater percentage of complications (χ2(1) = 14.83, P < 0.001) than cervical or lumbar procedures. Pulmonary embolism in particular occurred with greater likelihood in thoracic procedures and relatively lower likelihood in cervical and lumbar procedures (χ2(1) = 16.43, P < 0.001).
Conclusions: Thoracic surgeries pose the greatest risk for thrombotic complications. Of the thrombotic complications that may occur during thoracic surgeries, pulmonary embolism is the most common.
Clinical relevance: These findings highlight the need for surgeons to pay particular attention to the risk of certain complications when performing surgeries in specific regions of the spine.
期刊介绍：
The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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