帕金森病患者脊柱畸形手术后的结果:倾向匹配分析

IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY
Austin H. Carroll , James Fookes , Alejandro Quinonez , Christopher P. Bellaire , Brian McCormick , Lancelot Benn , Jonathan P. Japa , Kevin Yoon , Fred Mo , Mark Ehioghae , Addisu Mesfin
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引用次数: 0

摘要

成人脊柱畸形仍然是一个复杂的挑战,据报道,术后医疗和手术并发症发生率约为40%。帕金森病(PD)患者特别容易发生继发于体位畸形、肌肉僵硬和运动迟缓的肌肉骨骼疾病,与一般人群相比,脊柱畸形的风险增加。在这一高危人群中,研究多层次脊柱畸形手术结果的文献很少。采用PearlDiver数据库对诊断为帕金森病的脊柱畸形患者进行多级别后路脊柱融合术。PD患者按年龄、Charlson合并症指数(CCI)和Elixhauser合并症指数(ECI)与对照组按1:1的比例进行倾向匹配。在90天评估医疗并发症和手术部位感染率(SSI)。术后2年评估手术翻修率。倾向匹配后,共有2776例患者符合标准,PD组1388例,对照组1388例。PD患者术后2年的手术翻修率明显较高,术后90天并发症的风险增加。90天内各组感染率无显著差异。与年龄和合并症匹配的对照组相比,接受多节段后路脊柱融合术矫正脊柱畸形的帕金森病患者出现并发症和手术翻修的风险增加。非手术治疗应在手术治疗前用尽,需要进一步研究以优化这一高危患者群体的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes after spinal deformity surgery in patients with Parkinson’s Disease: a propensity matched analysis
Adult spinal deformity remains a complex challenge with medical and surgical complication rates post-operatively reported to be around 40 %. Patients with Parkinson’s Disease (PD) are particularly susceptible to musculoskeletal disease secondary to postural deformity, muscle rigidity, and bradykinesia and have an increased risk of spinal deformity compared to the general population. There is a paucity of literature investigating the outcomes of multi-level spinal deformity surgery in this at-risk population. Patients undergoing multi-level posterior spinal fusion for spinal deformity with a diagnosis of Parkinson’s Disease were identified using the PearlDiver database. Patients with PD were propensity-matched in a 1:1 ratio to a control group by age, Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI). Medical complications and rates of surgical site infection (SSI) were assessed at 90 days. Surgical revision rates were assessed at 2 years. A total of 2776 patients met criteria with 1,388 patients in the PD group and 1,388 in the control group after propensity matching. Patients with PD had a significantly higher rate of surgical revision at 2 years and an increased risk of 90-day medical complications post-operatively. There was no difference in infection rates between groups within 90 days. Patients with Parkinson’s Disease undergoing multilevel posterior spinal fusion for spinal deformity correction have an increased risk of medical complications and need for surgical revision compared to age and comorbidity matched controls. Non-operative management should be exhausted prior to surgical treatment and further research is needed to optimize outcomes in this high-risk patient population.
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来源期刊
Journal of Clinical Neuroscience
Journal of Clinical Neuroscience 医学-临床神经学
CiteScore
4.50
自引率
0.00%
发文量
402
审稿时长
40 days
期刊介绍: This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.
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