Wound infection poses as most common reason for lumbar spine surgery reoperation — 4 takeaways

傷口感染是脊柱外科再手術(shù)最常見的原因,；關(guān)于脊柱外科再手術(shù)的研究進(jìn)展，四個(gè)要點(diǎn)知識(shí)帶回家,！

Researchers analyzed the reasons and risks associated with unplanned reoperation for lumbar spine surgery, according to a study published in spine.The study reviewed 3,936 patients who had primary lumbar spinal surgery at three centers between January 2010 and April 2015. Of those 3,936 patients, 82 underwent unplanned reoperations.

研究人員基于一篇近期發(fā)表在《Spine》雜志的文章,，分析了腰椎手術(shù)后計(jì)劃外再手術(shù)的原因和危險(xiǎn)因素,。這篇文章回顧了從2010年1月至2015年4月期間，3936名在三個(gè)醫(yī)療中心接受了首次腰椎手術(shù)的患者,；3936名患者中,，82人接受了計(jì)劃外再手術(shù)。

The demographics,diagnosis, surgical procedure and complications of patients were reviewed and statistical analysis was performed to investigate the incidences and risk factors of unplanned revision.

在本篇文章中,，作者回顧并分析了患者的人口統(tǒng)計(jì)學(xué),、診斷、手術(shù)方式以及伴隨疾病,，以研究非計(jì)劃翻修的概率和危險(xiǎn)因素,。

1. A total of 3936 patients who underwent lumbar spinal surgery from three institutions were reviewed, and 82 (2.08%) required unplanned reoperation during the primary admission because of wound infection (0.94%), screw misplacement (0.53%), cerebrospinal fluid leakage (0.27%),wound hematoma (0.18%) and neurologic deficit (0.15%). 

總共回顧了3936名在三個(gè)醫(yī)療中心接受了腰椎手術(shù)的患者，82人（2.08%）由于傷口感染(0.94%),，內(nèi)固定物位置不佳(0.53%),，腦脊液漏(0.27%)，傷口血腫(0.18%)和神經(jīng)功能損傷(0.15%)接受了計(jì)劃外再次手術(shù),。

2.For the diagnosis, patients with lumbar spinal spondylolisthesis had a much higher rate of reoperation (4.3%) than those of lumbar stenosis (2.3%), vertebral tumor (2.2%), vertebral fracture (1.2%) and disc herniation (1.1%) with a significant difference (P<>

對于不同的病因而言,，腰椎滑脫癥患者的再手術(shù)率較高（4.3%），相對腰椎管狹窄癥（2.3%）,、椎體腫瘤（2.2%）,、椎體骨折（1.2%）和腰椎間盤突出癥（1.1%）患者的再手術(shù)率,，有明顯的統(tǒng)計(jì)學(xué)差異(P<>

3.The revision rate was significantly higher in patients underwent posterior lumbar interbody fusion (PLIF) than those received transforaminal lumbar interbody

fusion (TLIF).

接受了后路腰椎椎間融合術(shù)(PLIF)患者的手術(shù)翻修率明顯高于那些接受了經(jīng)椎間孔腰椎椎間融合術(shù)(TLIF)的患者，但是兩種手術(shù)之間的差距并不存在統(tǒng)計(jì)學(xué)意義,。(P = 0.007)

4. Overall, researchers found the unplanned reoperation rate for lumbar spinal surgery to be 2.08 percent.

總而言之,，研究者發(fā)現(xiàn)腰椎術(shù)后再手術(shù)的總概率為2.08%。

There are several limitations in this study. Firstly, it is a retrospective study and some preoperative and postoperative clinical information were not available. These may affect the analysis of risk factor for unplanned reoperation. Secondly, this study is a multicenter research. The surgical skill and nursing quality in the three institutions were different, which may exert influence on the reoperation rates after primary lumbar surgery. Thirdly, the risk factors analysis in this study was not comprehensive. Some of the factors were not analysis due to the limited data, such as surgical duration, blood loss and surgical level involved. Surgeons should pay attention to these factors when performing the surgery.

本篇文章還是存在一些局限性的,。首先,，本文是一篇回顧性研究，無法評估一部分患者術(shù)前和術(shù)后的臨床信息,；因此可能會(huì)影響再手術(shù)風(fēng)險(xiǎn)因素的分析,。其次，本文是一個(gè)多中心的研究,；三個(gè)醫(yī)療中心的手術(shù)技術(shù)和護(hù)理治療存在差距,，這些差距可能會(huì)引起再手術(shù)率的差異。第三,，本文對于臨床結(jié)果的分析并不全面,，因?yàn)橐徊糠謹(jǐn)?shù)據(jù)并不完整；比如手術(shù)時(shí)間,、術(shù)中失血量和手術(shù)涉及的節(jié)段,；術(shù)者在進(jìn)行手術(shù)的過程中應(yīng)該考慮以上因素。

In conclusion, we presented the rates, reasons and risk factors for unplanned reoperation of lumbar spinal surgery during the primary admission based on a multicenter and a large patient population study. The rate of unplanned reoperation for lumbar spinal surgery was 2.08%.The reasons for reoperation included wound infection, screw misplacement, cerebrospinal fluid leakage, wound hematoma and neurologic deficit. Patients with a diagnosis of lumbar spinal spondylolisthesis and who underwent PLIF were significantly associated with a higher incidence of unplanned reoperation.

總而言之,，基于多中心,、大樣本量的數(shù)據(jù)，我們統(tǒng)計(jì)了腰椎疾患患者首次入院,，非計(jì)劃再次手術(shù)的概率,、原因和危險(xiǎn)因素。腰椎術(shù)后再手術(shù)的總概率為2.08%,。再手術(shù)的原因包括傷口感染,、內(nèi)固定物位置不佳、腦脊液漏,、傷口血腫,、和神經(jīng)功能損傷。腰椎滑脫癥的患者進(jìn)行PLIF手術(shù)時(shí)接受再手術(shù)的概率明顯增加,。

本信息原文出處：

Liu, J.M., et al., Unplanned Reoperation of Lumbar Spinal Surgery During the Primary Admission: A Multicenter Study Based on a Large Patient Population. Spine (Phila Pa 1976), 2016. 41(16): p. 1279-83.