腰椎融合手术的并发症、费用、死亡率和住院时间的比较分析:机器人辅助与导航引导入路。

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY
David Maman, Amir Abu Elhija, Assil Mahamid, Lior Laver, Eyal Behrbalk
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引用次数: 0

摘要

导读:导航和机器人技术成为传统徒手脊柱融合技术的替代方案。他们的目的是提高围手术期和术后的结果,但其有效性仍然受到现有文献中小队列规模的限制。我们的研究比较了导航和机器人技术在腰椎融合手术中的并发症、成本和死亡率。方法:本研究采用全国住院病人样本数据。NIS每年捕获约700万未加权录取。该数据集跨越2016年至2019年,包括58270名患者。排除包括非选择性入院、入院前手术和报告住院费用为0美元的病例。使用ICD-10代码验证合并症和并发症。采用趋势识别、统计分析等分析技术,显著性阈值为p。结果:导航引导手术占主导地位(2016年为86.7%,2019年为77.1%),机器人辅助手术稳步增长。两者的死亡率都很低。与机器人辅助手术相比,导航引导手术的费用更低,失血贫血、急性肾损伤和输血的风险也更低。与机器人辅助手术相比,导航引导手术显示单节段腰椎椎体关节融合和腰骶关节融合的并发症风险显著降低。此外,机器人辅助手术在失血性贫血、急性肾损伤和输血方面的风险更高,风险比为1.24至1.72倍。结论:本研究突出了腰椎融合手术的变化趋势,强调需要量身定制的入路和细致入微的临床考虑来改善患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative analysis of complications, costs, mortality, and length of stay in lumbar fusion surgery: robotic-assisted versus navigation-guided approaches.

Introduction: Navigation and robotic technologies emerge as alternatives to conventional freehand techniques for spine fusion. They aim to enhance perioperative and postoperative outcomes, yet their effectiveness remains limited by small cohort sizes in existing literature. Our study compares navigation and robotic technologies in lumbar fusion surgery across complications, costs, and mortality.

Methods: This study employed data from the Nationwide Inpatient Sample. The NIS annually captures approximately 7 million unweighted admissions. The dataset spanned 2016 to 2019, comprising 58,270 patients. Exclusions included non-elective admissions, pre-admission surgeries, and cases reporting $0 hospital costs. Validation of comorbidities and complications was conducted using ICD-10 codes. Analytical techniques, such as trend identification and statistical analyses, were applied with a significance threshold of p  < 0.05. Demographic and clinical characteristics, surgery types, and outcomes were assessed.

Results: Navigation-guided surgeries dominated (86.7% in 2016, 77.1% in 2019), while Robotic-assisted surgeries increased steadily. Both showed minimal mortality rates. Navigation-guided surgeries had lower charges, lower risks of blood loss anemia, acute kidney injury, and blood transfusion compared to Robotic-assisted surgeries. Navigation-guided surgeries showed significantly lower risks of complications in one level lumbar fusion of vertebral joint and fusion of lumbosacral joint compared to Robotic-Assisted procedures. Additionally, Robotic-Assisted surgeries present higher risks across blood loss anemia, acute kidney injury, and blood transfusion, with risk ratios ranging from 1.24 to 1.72 times higher.

Conclusion: This study highlights shifting trends in lumbar fusion surgeries, underscoring the need for tailored approaches and nuanced clinical considerations to improve patient outcomes.

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来源期刊
European Spine Journal
European Spine Journal 医学-临床神经学
CiteScore
4.80
自引率
10.70%
发文量
373
审稿时长
2-4 weeks
期刊介绍: "European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts. Official publication of EUROSPINE, The Spine Society of Europe
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