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Osteoporosis in Cervical Spine Surgery

机译：颈椎手术中的骨质疏松症

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Study Design.Retrospective administrative database analysis.Objective.To investigate the effect of osteoporosis (OS) on complications and outcomes in patients undergoing cervical spine surgery.Summary of Background Data.OS is the most prevalent degenerative human bone disease, and spine surgeons will inevitably perform procedures on patients with OS. These patients might present a difficult patient cohort because many fixation techniques depend on bone quality and adequate bone healingboth of which are compromised in OS.Methods.The nationwide inpatient sample was queried using the Ninth Revision, Clinical Modification procedural codes for cervical spine procedures and diagnosis codes for degenerative conditions of cervical spine from 2002 to 2011. Patients were separated into two cohorts, those patients with OS and those without OS. Demographics, hospital characteristics, and adjusted complication likelihood were analyzed. Multivariate regression analysis was performed to determine odds of revision surgery in patients with OS.Results.Of all patients undergoing degenerative cervical spine surgery, 2% were identified as having OS (32,557 of a sample of 1,602,129 patients). Osteoporotic patients were more likely to undergo posterior cervical spine fusion when compared with those patients without OS (11.3% vs. 5.4%, P<0.0001). Moreover, circumferential fusion was performed 3 times more frequently in the osteoporotic cohort. Adjusted complications showed increased odds for postoperative hemorrhage (odds ratio=1.70, 95% confidence interval=1.46-1.98, P<0.0001). Patients with OS stayed in the hospital longer (3.5 vs. 2.5 days, P<0.0001) and had 30% costlier hospitalizations. Multivariate for revision surgery indicated that osteoporotic patients had significantly increased odds of revision surgery (odds ratio=1.54, P0.0001) when referenced to non-osteoporotic patients undergoing cervical spine surgery.Conclusion.Osteoporotic patients were more likely to undergo revision surgery, have longer hospitalizations, and have higher hospitalization costs, than their non-osteoporotic counterparts.Level of Evidence: 3
机译：研究设计，回顾性行政数据库分析，目的，研究骨质疏松（OS）对接受颈椎手术的患者的并发症和结局的影响背景资料摘要OS是最普遍的变性人骨疾病，脊柱外科医师将不可避免对OS患者执行程序。这些患者可能会出现困难的患者队列，因为许多固定技术取决于骨质和适当的骨愈合，这两者都在OS中受到影响。方法：使用第九版修订版，临床修改程序代码对颈椎手术和诊断方法查询全国住院患者样本。规范针对2002年至2011年颈椎的退行性疾病。患者分为两组，即OS患者和OS患者。分析人口统计学，医院特征和调整后的并发症可能性。结果进行了多变量回归分析，以确定OS患者进行翻修手术的几率。结果：在所有接受变性颈椎手术的患者中，有2％被确定患有OS（在1,602,129名患者中占32,557名）。与没有OS的患者相比，骨质疏松患者更有可能接受颈椎后路融合术（11.3％对5.4％，P <0.0001）。此外，在骨质疏松队列中，周向融合的频率提高了3倍。调整后的并发症显示术后出血的几率增加（赔率= 1.70，95％置信区间= 1.46-1.98，P <0.0001）。 OS患者在医院的住院时间更长（3.5天vs. 2.5天，P <0.0001），住院费用高出30％。翻修手术的多变量表明，以接受颈椎手术的非骨质疏松患者为参考，骨质疏松患者翻修手术的几率显着增加（优势比= 1.54，P0.0001）。与非骨质疏松症相比，住院时间更长，住院费用也更高。证据等级：3

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