{"title":"成人脊柱畸形手术的发病率和死亡率使用日本骨科协会国家注册/日本脊柱外科学会和相关研究数据库（JOANR/JSSR-DB）。","authors":"Takumi Takeuchi, Hideyuki Arima, Tomoyuki Asada, Satoru Demura, Toru Doi, Akira Matsumura, Hiroki Oba, Ryo Sugawara, Satoshi Suzuki, Shinji Takahashi, Haruki Ueda, Yu Yamato, Kei Watanabe, Naobumi Hosogane","doi":"10.22603/ssrr.2024-0289","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The study investigated the complications of adult spinal deformity (ASD) surgery in Japan in 2022 using the Japanese Orthopedic Association National Registry/Japanese Society for Spine Surgery and Related Research Database (JOANR/JSSR-DB).</p><p><strong>Methods: </strong>Among the 158,407 patients registered in JOANR/JSSR-DB, 4,822 patients aged ≥19 years (1,115 males [23.1%], 3,707 females [76.9%]) were included in this study. Diagnoses were scoliosis in 1,961 patients (40.7%), kyphosis in 1,613 patients (33.4%), and kyphoscoliosis in 1,248 patients (25.9%). Intra-operative and postoperative/systemic complications (within 30 days) were investigated.</p><p><strong>Results: </strong>The age distribution was 468 (9.7%) aged 19-39, 855 (17.7%) aged 40-64, 1,779 (36.9%) aged 65-74, and 1,720 (35.7%) individuals aged ≥75 years, with 72.6% of the total population aged ≥65 years. The total complication rate was 11.8% (567 patients), with 6.2% in patients aged 19-39 years, 12.6% in patients aged 40-64 years, 11.6% in patients aged 65-74 years, and 13.0% in patients aged ≥75 years, whose rate was significantly higher (p<0.001). Intra-operative complications occurred in 215 patients (4.5%). Dural tear in 110 patients (2.3%), massive bleeding (>2,000 ml) in 54 (1.1%), implant-related complications in 14 (0.3%), and intra-operative nerve injury in 10 patients (0.2%). Postoperative complications occurred in 266 patients (5.5%). Lower extremity paralysis in 99 patients (2.0%), surgical site infection in 55 (1.1%), vertebral body or endplate injury in 25 (0.5%), epidural hematoma in 18 (0.4%), and weakness of the iliopsoas muscle due to lateral lumbar interbody fusion in 21 patients (0.4%). Systemic complications occurred in 162 patients (3.4%) with urinary tract infection in 29 (0.6%) and postoperative delirium in 26 (0.5%).</p><p><strong>Conclusions: </strong>While the 11.8% total complication rate was lower than previous reports, rates were higher in patients aged ≥75, indicating the need for careful perioperative management in elderly patients.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 4","pages":"426-435"},"PeriodicalIF":1.2000,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330372/pdf/","citationCount":"0","resultStr":"{\"title\":\"Morbidity and Mortality of Adult Spinal Deformity Surgery Using the Japanese Orthopedic Association National Registry/Japanese Society for Spine Surgery and Related Research Database (JOANR/JSSR-DB).\",\"authors\":\"Takumi Takeuchi, Hideyuki Arima, Tomoyuki Asada, Satoru Demura, Toru Doi, Akira Matsumura, Hiroki Oba, Ryo Sugawara, Satoshi Suzuki, Shinji Takahashi, Haruki Ueda, Yu Yamato, Kei Watanabe, Naobumi Hosogane\",\"doi\":\"10.22603/ssrr.2024-0289\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The study investigated the complications of adult spinal deformity (ASD) surgery in Japan in 2022 using the Japanese Orthopedic Association National Registry/Japanese Society for Spine Surgery and Related Research Database (JOANR/JSSR-DB).</p><p><strong>Methods: </strong>Among the 158,407 patients registered in JOANR/JSSR-DB, 4,822 patients aged ≥19 years (1,115 males [23.1%], 3,707 females [76.9%]) were included in this study. Diagnoses were scoliosis in 1,961 patients (40.7%), kyphosis in 1,613 patients (33.4%), and kyphoscoliosis in 1,248 patients (25.9%). Intra-operative and postoperative/systemic complications (within 30 days) were investigated.</p><p><strong>Results: </strong>The age distribution was 468 (9.7%) aged 19-39, 855 (17.7%) aged 40-64, 1,779 (36.9%) aged 65-74, and 1,720 (35.7%) individuals aged ≥75 years, with 72.6% of the total population aged ≥65 years. The total complication rate was 11.8% (567 patients), with 6.2% in patients aged 19-39 years, 12.6% in patients aged 40-64 years, 11.6% in patients aged 65-74 years, and 13.0% in patients aged ≥75 years, whose rate was significantly higher (p<0.001). Intra-operative complications occurred in 215 patients (4.5%). Dural tear in 110 patients (2.3%), massive bleeding (>2,000 ml) in 54 (1.1%), implant-related complications in 14 (0.3%), and intra-operative nerve injury in 10 patients (0.2%). Postoperative complications occurred in 266 patients (5.5%). Lower extremity paralysis in 99 patients (2.0%), surgical site infection in 55 (1.1%), vertebral body or endplate injury in 25 (0.5%), epidural hematoma in 18 (0.4%), and weakness of the iliopsoas muscle due to lateral lumbar interbody fusion in 21 patients (0.4%). Systemic complications occurred in 162 patients (3.4%) with urinary tract infection in 29 (0.6%) and postoperative delirium in 26 (0.5%).</p><p><strong>Conclusions: </strong>While the 11.8% total complication rate was lower than previous reports, rates were higher in patients aged ≥75, indicating the need for careful perioperative management in elderly patients.</p>\",\"PeriodicalId\":22253,\"journal\":{\"name\":\"Spine Surgery and Related Research\",\"volume\":\"9 4\",\"pages\":\"426-435\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-02-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330372/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine Surgery and Related Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.22603/ssrr.2024-0289\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/27 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine Surgery and Related Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22603/ssrr.2024-0289","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/27 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Morbidity and Mortality of Adult Spinal Deformity Surgery Using the Japanese Orthopedic Association National Registry/Japanese Society for Spine Surgery and Related Research Database (JOANR/JSSR-DB).
Introduction: The study investigated the complications of adult spinal deformity (ASD) surgery in Japan in 2022 using the Japanese Orthopedic Association National Registry/Japanese Society for Spine Surgery and Related Research Database (JOANR/JSSR-DB).
Methods: Among the 158,407 patients registered in JOANR/JSSR-DB, 4,822 patients aged ≥19 years (1,115 males [23.1%], 3,707 females [76.9%]) were included in this study. Diagnoses were scoliosis in 1,961 patients (40.7%), kyphosis in 1,613 patients (33.4%), and kyphoscoliosis in 1,248 patients (25.9%). Intra-operative and postoperative/systemic complications (within 30 days) were investigated.
Results: The age distribution was 468 (9.7%) aged 19-39, 855 (17.7%) aged 40-64, 1,779 (36.9%) aged 65-74, and 1,720 (35.7%) individuals aged ≥75 years, with 72.6% of the total population aged ≥65 years. The total complication rate was 11.8% (567 patients), with 6.2% in patients aged 19-39 years, 12.6% in patients aged 40-64 years, 11.6% in patients aged 65-74 years, and 13.0% in patients aged ≥75 years, whose rate was significantly higher (p<0.001). Intra-operative complications occurred in 215 patients (4.5%). Dural tear in 110 patients (2.3%), massive bleeding (>2,000 ml) in 54 (1.1%), implant-related complications in 14 (0.3%), and intra-operative nerve injury in 10 patients (0.2%). Postoperative complications occurred in 266 patients (5.5%). Lower extremity paralysis in 99 patients (2.0%), surgical site infection in 55 (1.1%), vertebral body or endplate injury in 25 (0.5%), epidural hematoma in 18 (0.4%), and weakness of the iliopsoas muscle due to lateral lumbar interbody fusion in 21 patients (0.4%). Systemic complications occurred in 162 patients (3.4%) with urinary tract infection in 29 (0.6%) and postoperative delirium in 26 (0.5%).
Conclusions: While the 11.8% total complication rate was lower than previous reports, rates were higher in patients aged ≥75, indicating the need for careful perioperative management in elderly patients.
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