Alejandro Perez-Albela, Manjot Singh, Jinseong Kim, Maria Jensen, Gregory Snigur, Alan H Daniels, Bryce A Basques
{"title":"开放与内镜下腰椎间盘切除术：2618例手术患者的倾向匹配分析。","authors":"Alejandro Perez-Albela, Manjot Singh, Jinseong Kim, Maria Jensen, Gregory Snigur, Alan H Daniels, Bryce A Basques","doi":"10.1097/BRS.0000000000005404","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To compare intraoperative complications, 90-day medical complications, and 2-year surgical reoperation rates between endoscopic discectomy (ED) and open discectomy (OD).</p><p><strong>Summary of background data: </strong>Symptomatic lumbar disc herniation is common, with discectomy serving as a common surgical intervention. Previous studies comparing ED and OD show inconsistent findings regarding complications and long-term outcomes, often limited by small sample sizes and study heterogeneity.</p><p><strong>Methods: </strong>Patients undergoing ED (CPT-62380) and OD (CPT-63030) from 2010-2022 were identified using PearlDiver database. Propensity score matching (1:1) controlled for age, gender, and Charlson Comorbidity Index (CCI). Outcomes included intraoperative complications such as dural tears and nerve injuries; 90-day medical complications including deep vein thrombosis (DVT), surgical site infections (SSI), dura repair, and urinary tract infections (UTI); and 2-year reoperations. Statistical analyses utilized chi-square tests, t-tests, and multivariate logistic regression adjusting for comorbidities. Odds ratios (OR) with 95% confidence intervals were reported.</p><p><strong>Results: </strong>A total of 2,618 patients were identified and examined (1,309 ED, 1,309 OD). On multivariate analysis, ED was associated with a significantly lower risk of dural tears (0.15% vs. 1.15%, OR: 0.179, P=0.006), surgical site infections (0.08% vs. 1.15%, OR: 0.082, P=0.001), wound complications (0.38% vs. 1.07%, OR: 0.342, P=0.023), and dura repair (0.08% vs. 0.69%, OR: 0.091, P=0.021). ED was also associated with lower odds of persistent pain (2.22% vs 2.83%, OR: 0.665, P=0.048). No significant differences were observed in nerve injuries, DVT, UTI, or readmissions.</p><p><strong>Conclusion: </strong>ED is associated with fewer dural tears, surgical site infections, wound complications, and dura repairs, along with lower odds of persistent pain compared to OD. Rates of DVT, UTI, and reoperations were not significantly different between groups.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Open versus Endoscopic Lumbar Discectomy: A Propensity-Matched Analysis of 2,618 Surgical Patients.\",\"authors\":\"Alejandro Perez-Albela, Manjot Singh, Jinseong Kim, Maria Jensen, Gregory Snigur, Alan H Daniels, Bryce A Basques\",\"doi\":\"10.1097/BRS.0000000000005404\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To compare intraoperative complications, 90-day medical complications, and 2-year surgical reoperation rates between endoscopic discectomy (ED) and open discectomy (OD).</p><p><strong>Summary of background data: </strong>Symptomatic lumbar disc herniation is common, with discectomy serving as a common surgical intervention. Previous studies comparing ED and OD show inconsistent findings regarding complications and long-term outcomes, often limited by small sample sizes and study heterogeneity.</p><p><strong>Methods: </strong>Patients undergoing ED (CPT-62380) and OD (CPT-63030) from 2010-2022 were identified using PearlDiver database. Propensity score matching (1:1) controlled for age, gender, and Charlson Comorbidity Index (CCI). Outcomes included intraoperative complications such as dural tears and nerve injuries; 90-day medical complications including deep vein thrombosis (DVT), surgical site infections (SSI), dura repair, and urinary tract infections (UTI); and 2-year reoperations. Statistical analyses utilized chi-square tests, t-tests, and multivariate logistic regression adjusting for comorbidities. Odds ratios (OR) with 95% confidence intervals were reported.</p><p><strong>Results: </strong>A total of 2,618 patients were identified and examined (1,309 ED, 1,309 OD). On multivariate analysis, ED was associated with a significantly lower risk of dural tears (0.15% vs. 1.15%, OR: 0.179, P=0.006), surgical site infections (0.08% vs. 1.15%, OR: 0.082, P=0.001), wound complications (0.38% vs. 1.07%, OR: 0.342, P=0.023), and dura repair (0.08% vs. 0.69%, OR: 0.091, P=0.021). ED was also associated with lower odds of persistent pain (2.22% vs 2.83%, OR: 0.665, P=0.048). No significant differences were observed in nerve injuries, DVT, UTI, or readmissions.</p><p><strong>Conclusion: </strong>ED is associated with fewer dural tears, surgical site infections, wound complications, and dura repairs, along with lower odds of persistent pain compared to OD. Rates of DVT, UTI, and reoperations were not significantly different between groups.</p>\",\"PeriodicalId\":22193,\"journal\":{\"name\":\"Spine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-07-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BRS.0000000000005404\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BRS.0000000000005404","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Open versus Endoscopic Lumbar Discectomy: A Propensity-Matched Analysis of 2,618 Surgical Patients.
Study design: Retrospective cohort study.
Objective: To compare intraoperative complications, 90-day medical complications, and 2-year surgical reoperation rates between endoscopic discectomy (ED) and open discectomy (OD).
Summary of background data: Symptomatic lumbar disc herniation is common, with discectomy serving as a common surgical intervention. Previous studies comparing ED and OD show inconsistent findings regarding complications and long-term outcomes, often limited by small sample sizes and study heterogeneity.
Methods: Patients undergoing ED (CPT-62380) and OD (CPT-63030) from 2010-2022 were identified using PearlDiver database. Propensity score matching (1:1) controlled for age, gender, and Charlson Comorbidity Index (CCI). Outcomes included intraoperative complications such as dural tears and nerve injuries; 90-day medical complications including deep vein thrombosis (DVT), surgical site infections (SSI), dura repair, and urinary tract infections (UTI); and 2-year reoperations. Statistical analyses utilized chi-square tests, t-tests, and multivariate logistic regression adjusting for comorbidities. Odds ratios (OR) with 95% confidence intervals were reported.
Results: A total of 2,618 patients were identified and examined (1,309 ED, 1,309 OD). On multivariate analysis, ED was associated with a significantly lower risk of dural tears (0.15% vs. 1.15%, OR: 0.179, P=0.006), surgical site infections (0.08% vs. 1.15%, OR: 0.082, P=0.001), wound complications (0.38% vs. 1.07%, OR: 0.342, P=0.023), and dura repair (0.08% vs. 0.69%, OR: 0.091, P=0.021). ED was also associated with lower odds of persistent pain (2.22% vs 2.83%, OR: 0.665, P=0.048). No significant differences were observed in nerve injuries, DVT, UTI, or readmissions.
Conclusion: ED is associated with fewer dural tears, surgical site infections, wound complications, and dura repairs, along with lower odds of persistent pain compared to OD. Rates of DVT, UTI, and reoperations were not significantly different between groups.
期刊介绍：
Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store.
Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
