P13。融合长度在成人脊柱侧凸手术中作为预后的预测因子

IF 2.5 Q3 Medicine

North American Spine Society Journal Pub Date : 2025-07-01 DOI:10.1016/j.xnsj.2025.100637

Morteza Sadeh MD, PhD , Hadeel M Mansour MD , Yousaf Ilyas BS , Nauman Chaudhry MD

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引用次数: 0

摘要

背景：成人退行性脊柱侧凸手术常伴有多种并发症，如神经功能缺损、失血、急性感染和死亡。融合是矫正脊柱畸形的主要手术方法。然而，融合的长度可以是可变的，短融合(<；3)节段缩短手术时间，而较长的融合（=3节段）已被发现与某些类型并发症的增加有关。目的：文献缺乏融合长度与术后预后的关系。为了解决这一差距，我们的研究旨在比较短融合和长融合的结果。研究设计/设置在2013-2023年期间对接受融合手术治疗退行性脊柱侧凸的患者进行srs查询。共有60名患者被纳入研究。根据融合长度将患者分为两组。患者samplesshort融合（3个级别），每组30例患者。采用卡方检验和两两分析对两组患者的术后结果进行评估和比较，如神经功能缺损、围手术期失血、翻修手术、急性伤口感染、植入物并发症和死亡率。方法/结果：短融合组和长融合组在神经功能缺损、复发率、死亡率、术后伤口感染或种植体并发症方面无显著差异；然而，短融合组的失血量明显低于长融合组，平均为367.5，而长融合组为951。结论：短融合和长融合在神经功能缺损、感染、重返手术室和死亡率方面具有可比性。然而，短融合的失血率明显低于长融合，突出了其在高风险患者人群中的优势。FDA器械/药物状态本摘要不讨论或包括任何适用的器械或药物。

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P13. Fusion lengths in adult scoliosis surgery as a predictor of outcome

BACKGROUND CONTEXT

Surgery for degenerative adult scoliosis is often associated with multiple complications such as neurological deficits, blood loss, acute infections, and death. Fusion is the primary surgical approach to correct spinal deformity. However, the length of the fusion can be variable, with short fusions (< 3) levels minimizing operative time while longer fusion (=3 levels) has been found to be associated with an increase in certain type of complications.

PURPOSE

The literature is lacking on the association of fusion length with post-operative outcomes. To address this gap, our study aims to compare the outcomes of short vs long fusion.

STUDY DESIGN/SETTING

SRS was queried from 2013-2023 for patients undergoing fusion surgery for degenerative scoliosis. A total of 60 patients were included in the study. Patients were categorized into two groups based on fusion length.

PATIENT SAMPLE

Short fusion (3 levels), with 30 patients in each group.

OUTCOME MEASURES

Post-operative outcomes such as neurological deficits, perioperative blood loss, revision surgery, acute wound infection, implant complications, and mortality rates were assessed and compared across the two groups using chi square tests and pairwise analysis.

METHODS

N/A

RESULTS

No significant differences were observed between short and long-fusion groups in terms of neurological deficits, return to surgery, mortality, postoperative wound infections, or implant complications; however, blood loss was significantly lower in the short-fusion group with a mean of 367.5 compared to 951 in the long fusion group.

CONCLUSIONS

Short and long fusions shared comparable outcomes for neurological deficits, infections, return to OR, and mortality rates. However, short fusions showed significantly lower rates of blood loss than long fusions, highlighting its advantages in high risk in high-risk patient populations.