دورية أكاديمية
Perioperative complications and cost of posterior decompression with fusion in thoracic spine for ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum -a comparative study using a national inpatient database.
العنوان: | Perioperative complications and cost of posterior decompression with fusion in thoracic spine for ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum -a comparative study using a national inpatient database. |
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المؤلفون: | Morishita S; Department of Orthopedic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan., Yoshii T; Department of Orthopedic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. yoshii.orth@tmd.ac.jp., Inose H; Department of Orthopedic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan., Hirai T; Department of Orthopedic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan., Yamada K; Department of Orthopedic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan., Matsukura Y; Department of Orthopedic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan., Egawa S; Department of Orthopedic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan., Hashimoto J; Department of Orthopedic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan., Takahashi T; Department of Orthopedic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan., Ogawa T; Department of Orthopedic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan., Fushimi K; Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. |
المصدر: | BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2024 Jul 03; Vol. 25 (1), pp. 513. Date of Electronic Publication: 2024 Jul 03. |
نوع المنشور: | Journal Article; Comparative Study |
اللغة: | English |
بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 100968565 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2474 (Electronic) Linking ISSN: 14712474 NLM ISO Abbreviation: BMC Musculoskelet Disord Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: London : BioMed Central, [2000- |
مواضيع طبية MeSH: | Thoracic Vertebrae*/surgery , Ligamentum Flavum*/surgery , Spinal Fusion*/economics , Spinal Fusion*/adverse effects , Spinal Fusion*/methods , Decompression, Surgical*/economics , Decompression, Surgical*/adverse effects , Decompression, Surgical*/methods , Ossification of Posterior Longitudinal Ligament*/surgery , Ossification of Posterior Longitudinal Ligament*/economics , Postoperative Complications*/epidemiology , Postoperative Complications*/etiology , Postoperative Complications*/economics , Databases, Factual*, Humans ; Male ; Female ; Middle Aged ; Aged ; Japan/epidemiology ; Ossification, Heterotopic/surgery ; Ossification, Heterotopic/economics ; Ossification, Heterotopic/epidemiology ; Length of Stay/economics ; Reoperation/economics ; Reoperation/statistics & numerical data ; Retrospective Studies ; Inpatients ; Treatment Outcome |
مستخلص: | Background: Although posterior decompression with fusion (PDF) are effective for treating thoracic myelopathy, surgical treatment has a high risk of various complications. There is currently no information available on the perioperative complications in thoracic ossification of the longitudinal ligament (T-OPLL) and thoracic ossification of the ligamentum flavum (T-OLF). We evaluate the perioperative complication rate and cost between T-OPLL and T-OLF for patients underwent PDF. Methods: Patients undergoing PDF for T-OPLL and T-OLF from 2012 to 2018 were detected in Japanese nationwide inpatient database. One-to-one propensity score matching between T-OPLL and T-OLF was performed based on patient characteristics and preoperative comorbidities. We examined systemic and local complication rate, reoperation rate, length of hospital stays, costs, discharge destination, and mortality after matching. Results: In a total of 2,660 patients, 828 pairs of T-OPLL and T-OLF patients were included after matching. The incidence of systemic complications did not differ significantly between the T-OPLL and OLF groups. However, local complications were more frequently occurred in T-OPLL than in T-OLF groups (11.4% vs. 7.7% P = 0.012). Transfusion rates was also significantly higher in the T-OPLL group (14.1% vs. 9.4%, P = 0.003). T-OPLL group had longer hospital stay (42.2 days vs. 36.2 days, P = 0.004) and higher medical costs (USD 32,805 vs. USD 25,134, P < 0.001). In both T-OPLL and T-OLF, the occurrence of perioperative complications led to longer hospital stay and higher medical costs. While fewer patients in T-OPLL were discharged home (51.6% vs. 65.1%, P < 0.001), patients were transferred to other hospitals more frequently (47.5% vs. 33.5%, P = 0.001). Conclusion: This research identified the perioperative complications of T-OPLL and T-OLF in PDF using a large national database, which revealed that the incidence of local complications was higher in the T-OPLL patients. Perioperative complications resulted in longer hospital stays and higher medical costs. (© 2024. The Author(s).) |
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فهرسة مساهمة: | Keywords: Costs; Diagnosis procedure combination database; Perioperative complications; Posterior decompression with fusion; Thoracic ossification of the ligamentum flavum; Thoracic ossification of the posterior longitudinal ligament |
تواريخ الأحداث: | Date Created: 20240703 Date Completed: 20240704 Latest Revision: 20240706 |
رمز التحديث: | 20240706 |
مُعرف محوري في PubMed: | PMC11221184 |
DOI: | 10.1186/s12891-024-07617-5 |
PMID: | 38961370 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1471-2474 |
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DOI: | 10.1186/s12891-024-07617-5 |