脊柱转移瘤手术并发症风险因素研究进展

doi:10.3877/cma.j.issn.1673-9450.2020.05.014

外科手术可改善脊柱转移瘤患者的功能预后，提高患者生活质量，甚至让患者获得长期生存机会。然而，脊柱转移瘤外科手术的并发症仍较高，这极大地打击了患者后续治疗信心，患者功能与生存预后也因此受到影响。脊柱转移瘤手术并发症的种类繁多，综合预防难度较大。目前认为，多学科联合治疗有利于预防并发症发生，每一种并发症都有其风险因素，了解与掌控脊柱转移瘤手术并发症发生的风险因素对并发症的预防与治疗具有重要意义。临床医师应根据每一位患者的具体情况进行术前评估与风险管控，以确定理想的预防措施和治疗策略。

关键词: 脊柱转移瘤, 并发症, 切口感染, 谵妄, 危险因素

Surgery can improve the functional prognosis of patients with spinal metastases, improve the quality of life of patients, and even allow patients to obtain long-term survival opportunities. However, the complications of spinal metastasis surgery are still high, which greatly affected the patients' confidence in the subsequent treatment, and the function and survival prognosis are also affected. There are many kinds of complications in the operation of spinal metastasis, so it is difficult to prevent them comprehensively. At present, it is believed that multidisciplinary treatment is beneficial to prevent complications. In addition, each complication has its own risk factors. It is also important to understand and control the risk factors of complications so as to prevent the complications of spinal metastasis due to surgery. Clinicians should make preoperative evaluation according to individual patient to determine the ideal preventive measures and treatment strategies.

Key words: Spinal metastasis, Complications, Incision infection, Delirium, Risk factors

[1]	Igoumenou VG, Mavrogenis AF, Angelini A, et al. Complications of spine surgery for metastasis[J]. Eur J Orthop Surg Traumatol, 2020, 30(1): 37-56.
[2]	Greif DN, Ghasem A, Butler A, et al. Multidisciplinary Management of Spinal Metastasis and Vertebral Instability: A Systematic Review[J]. World Neurosurg, 2019, 128: e944-e955.
[3]	Yoshihara H, Yoneoka D. Trends in the surgical treatment for spinal metastasis and the in-hospital patient outcomes in the United States from 2000 to 2009[J]. Spine Journal, 2014, 14(9): 1844-1849.
[4]	Luksanapruksa P, Buchowski JM, Zebala LP, et al. Perioperative Complications of Spinal Metastases Surgery[J]. Clin Spine Surg, 2017, 30(1): 4-13.
[5]	Bouthors C, Prost S, Court C, et al. Outcomes of surgical treatments of spinal metastases: a prospective study[J]. Support Care Cancer, 2019, 27(10): 1-20.
[6]	Quraishi NA, Ahmed MS, Arealis G, et al. Does surgical site infection influence neurological outcome and survival in patients undergoing surgery for metastatic spinal cord compression[J]? Eur Spine J, 2019, 28(4): 792-797.
[7]	Olsen MA, Mayfield J, Lauryssen C, et al. Risk factors for surgical site infection in spinal surgery. Journal of Neurosurgery[J], 2013, 98(2): 149-155.
[8]	Peng W, Liang Y, Lu T, et al. Multivariate analysis of incision infection after posterior lumbar surgery in diabetic patients: A single-center retrospective analysis[J]. Medicine (Baltimore), 2019, 98(23): e15935-e15941.
[9]	Nota SP, Braun Y, Ring D, et al. Incidence of surgical site infection after spine surgery: what is the impact of the definition of infection[J]? Clin Orthop Relat Res, 2015, 473(5): 1612-1619.
[10]	Waltz PK, Zuckerbraun BS. Surgical Site Infections and Associated Operative Characteristics[J]. Surg Infect (Larchmt), 2017, 18(4): 447-450.
[11]	Liu JM, Deng HL, Chen XY, et al. Risk Factors for Surgical Site Infection After Posterior Lumbar Spinal Surgery[J]. Spine (Phila Pa 1976), 2018, 43(10): 732-737.
[12]	Ranson WA, White SJW, Cheung ZB, et al. The Effects of Chronic Preoperative Steroid Therapy on Perioperative Complications Following Elective Posterior Lumbar Fusion[J]. Global Spine J, 2018, 8(8): 834-841.
[13]	Iwata E, Shigematsu H, Yamamoto Y, et al. Lymphocyte Count at 4 Days Postoperatively: A Reliable Screening Marker for Surgical Site Infection After Posterior Lumbar Decompression Surgery[J]. Spine (Phila Pa 1976), 2018, 43(18): E1096-E1101.
[14]	Kumar S, Popta DV, Rodrigues-Pinto R, et al. Risk factors for wound infection in surgery for spinal metastasis[J]. European Spine Journal, 2013, 24(3): 528-532.
[15]	Sugita S, Hozumi T, Yamakawa K, et al. White Blood Cell Count and C-Reactive Protein Variations Following Posterior Surgery with Intraoperative Radiotherapy for Spinal Metastasis[J]. Clinical Spine Surgery, 2015, 30(8): E1022-E1025.
[16]	Mesfin A, Sciubba DM, Dea N, et al. Changing the Adverse Event Profile in Metastatic Spine Surgery: An Evidence-Based Approach to Target Wound Complications and Instrumentation Failure[J]. Spine (Phila Pa 1976), 2016, 41 (20): S262-S270.
[17]	Sugita S, Hozumi T, Yamakawa K, et al. Risk factors for surgical site infection after posterior fixation surgery and intraoperative radiotherapy for spinal metastases[J]. Eur Spine J, 2016, 25(4): 1034-1038.
[18]	Williams BJ, Sansur CA, Smith JS, et al. Incidence of unintended durotomy in spine surgery based on 108，478 cases[J]. Neurosurgery, 2011, 68(1): 117-123.
[19]	Thomas A, Hollstein T, Zwingenberger S, et al. Intraoperative and late complications after spinal tumour resection and dorsoventral reconstruction[J]. Orthopade, 2020, 49(2): 157-168.
[20]	Pedreira R, Abubonsrah N, Ahmed AK, et al. Hardware failure in patients with metastatic cancer to the spine[J]. Journal of Clinical Neuroscienc, 2017, 45: 166-171.
[21]	NA Q, A R, A S, et al. Reoperation rates in the surgical treatment of spinal metastases[J]. Spine Journal, 2015, 15(3): S37-S43.
[22]	Palumbo MA, Shah KN, Eberson CP, et al. Outrigger rod technique for supplemental support of posterior spinal arthrodesis[J]. Spine J, 2015, 15(6): 1409-1414.
[23]	Amankulor NM, Xu R, Iorgulescu JB, et al. The incidence and patterns of hardware failure after separation surgery in patients with spinal metastatic tumors[J]. Spine J, 2014, 14(9): 1850-1859.
[24]	Park SJ, Lee KH, Lee CS, et al. Instrumented surgical treatment for metastatic spinal tumors: is fusion necessary[J]? J Neurosurg Spine 2019, 22: 1-9.
[25]	Kumar N, Patel R, Wadhwa AC, et al. Basic concepts in metal work failure after metastatic spine tumour surgery[J]. Eur Spine J, 2018, 27(4): 806-814.
[26]	Yoshida G, Ando M, Imagama S, et al. Alert Timing and Corresponding Intervention With Intraoperative Spinal Cord Monitoring for High-Risk Spinal Surgery[J]. Spine (Phila Pa 1976), 2019, 44(8): E470-E479.
[27]	Murakami H, Kawahara N, Demura S, et al. Perioperative complications and prognosis for elderly patients with spinal metastases treated by surgical strategy[J]. Orthopedics, 2010, 33(3): 165-168.
[28]	Yang Y, Zhao X, Dong T, et al. Risk factors for postoperative delirium following hip fracture repair in elderly patients: a systematic review and meta-analysis[J]. Aging Clin Exp Res, 2017, 29(2): 115-126.
[29]	Cui XP, Jing ZZ, Song JF, et al. A retrospective study on risk factors associated with postoperative delirium in elderly patients with spinal operation[J]. Zhongguo Gu Shang, 2019, 32(6): 549-554.
[30]	Groot OQ, Ogink PT, Paulino Pereira NR, et al. High Risk of Symptomatic Venous Thromboembolism After Surgery for Spine Metastatic Bone Lesions: A Retrospective Study[J]. Clin Orthop Relat Res, 2019, 477(7): 1674-1686.
[31]	Zacharia BE, Kahn S, Bander ED, et al. Incidence and risk factors for preoperative deep venous thrombosis in 314 consecutive patients undergoing surgery for spinal metastasis[J]. J Neurosurg Spine, 2017, 27(2): 189-197.
[32]	Saracen A, Kotwica Z. Complications of percutaneous vertebroplasty: An analysis of 1100 procedures performed in 616 patients[J]. Medicine (Baltimore), 2016, 95(24): e3850-e3854.
[33]	Yevich S, Tselikas L, Gravel G, et al. Percutaneous Cement Injection for the Palliative Treatment of Osseous Metastases: A Technical Review[J]. Semin Intervent Radiol, 2018, 35(4): 268-280.
[34]	Corcos G, Dbjay J, Mastier C, et al. Cement leakage in percutaneous vertebroplasty for spinal metastases: a retrospective evaluation of incidence and risk factors[J]. Spine (Phila Pa 1976), 2014, 39(5): E332-338.
[35]	Zhu SY, Zhong ZM, Wu Q, et al. Risk factors for bone cement leakage in percutaneous vertebroplasty: a retrospective study of four hundred and eighty five patients[J]. Int Orthop, 2016, 40(6): 1205-1210.
[36]	Alekhin MN, Ter-Akopian AV, Abramov AS, et al. Intracardiac and Pulmonary Cement Embolism after Percutaneous Vertebroplasty[J]. Kardiologiia, 2019, 59(4): 92-96.

[1]	刘欢颜, 华扬, 贾凌云, 赵新宇, 刘蓓蓓. 颈内动脉闭塞病变管腔结构和血流动力学特征分析[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 809-815.
[2]	马艳波, 华扬, 刘桂梅, 孟秀峰, 崔立平. 中青年人颈动脉粥样硬化病变的相关危险因素分析[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 822-826.
[3]	易晨, 张亚东, 董茜, 唐海阔, 刘志国. 应用骨盖技术拔除下颌低位骨性埋伏阻生第三磨牙的疗效观察[J]. 中华口腔医学研究杂志(电子版), 2023, 17(06): 424-429.
[4]	黄应雄, 叶子, 蒋鹏, 詹红, 姚陈, 崔冀. 急性肠系膜静脉血栓形成致透壁性肠坏死的临床危险因素分析[J]. 中华普通外科学文献(电子版), 2023, 17(06): 413-421.
[5]	唐旭, 韩冰, 刘威, 陈茹星. 结直肠癌根治术后隐匿性肝转移危险因素分析及预测模型构建[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 16-20.
[6]	李建美, 邓静娟, 杨倩. 两种术式联合治疗肝癌合并肝硬化门静脉高压的安全性及随访评价[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 41-44.
[7]	吴方园, 孙霞, 林昌锋, 张震生. HBV相关肝硬化合并急性上消化道出血的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 45-47.
[8]	逄世江, 黄艳艳, 朱冠烈. 改良π形吻合在腹腔镜全胃切除消化道重建中的安全性和有效性研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 66-69.
[9]	杨体飞, 杨传虎, 陆振如. 改良无充气经腋窝入路全腔镜下甲状腺手术对喉返神经功能的影响研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 74-77.
[10]	陈旭渊, 罗仕云, 李文忠, 李毅. 腺源性肛瘘经手术治疗后创面愈合困难的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 82-85.
[11]	倪文凯, 齐翀, 许小丹, 周燮程, 殷庆章, 蔡元坤. 结直肠癌患者术后发生延迟性肠麻痹的影响因素分析[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 484-489.
[12]	王小娜, 谭微, 李悦, 姜文艳. 预测性护理对结直肠癌根治术患者围手术期生活质量、情绪及并发症的影响[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 525-529.
[13]	陆猛桂, 黄斌, 李秋林, 何媛梅. 蜂蛰伤患者发生多器官功能障碍综合征的危险因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1010-1015.
[14]	李达, 张大涯, 陈润祥, 张晓冬, 黄士美, 陈晨, 曾凡, 陈世锔, 白飞虎. 海南省东方市幽门螺杆菌感染现状的调查与相关危险因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(08): 858-864.
[15]	李琪, 黄钟莹, 袁平, 关振鹏. 基于某三级医院的ICU多重耐药菌医院感染影响因素的分析[J]. 中华临床医师杂志(电子版), 2023, 17(07): 777-782.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Research progress on risk factors of operative complications of spinal metastases

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Research progress on risk factors of operative complications of spinal metastases