背景:胸部创伤,胸腰椎(TL),腰椎很常见,会导致残疾和神经功能缺损。使用一组患有胸部疾病的患者,TL,东非一家三级医院的腰椎外伤,当前的研究旨在:(1)描述人口统计学和手术治疗模式,(2)评估神经系统的结果,和(3)报告与手术相关的预测因素,神经系统的改善,和死亡率。
方法:2016年9月至2020年12月在一个著名的东非转诊中心进行了一项患者记录的回顾性队列研究。这项研究收集了人口统计数据,损伤,和操作特征。使用AO(ArbeitsgemeinschaftfürOsteosynthesesepragen)TL骨折分类系统和神经功能评估了手术指征。Logistic回归分析确定了手术治疗的预测因素,神经系统的改善,和死亡率。
结果:研究表明,257名TL脊柱创伤患者中有64.9%接受了手术,入院后的中位天数为17.0。死亡率为1.2%。道路交通事故造成的伤害占43.6%。最常见的骨折类型为AOA型骨折(78.6%)。在97.6%的手术病例中进行了椎板切除术和后外侧融合。无神经功能缺损的患者(OR:0.27,95%CI:0.13-0.54,P<0.001)和从损伤到入院延迟较长的患者手术可能性较小(OR:0.95,95%CI:0.92-0.99,P=0.007)。神经功能改善率为11.1%。单因素分析显示手术与神经系统改善之间存在显著关联(OR:3.83,95%CI:1.27-16.61,P<0.001)。然而,这一发现在多变量回归中丢失了.
结论:本研究强调了在低资源环境中处理TL脊柱创伤的各种主题,包括较低的手术率,从入院到手术的延误,手术安全,死亡率低,以及手术改善神经系统的潜力。
结论:尽管东非存在手术延误和资源有限等挑战,手术干预有可能改善胸部的神经系统预后,TL,腰椎外伤患者.
方法:
BACKGROUND: Trauma to the thoracic, thoracolumbar (TL), and lumbar spine is common and can cause disability and neurological deficits. Using a cohort of patients suffering from thoracic, TL, and lumbar spine trauma in a tertiary hospital in East Africa, the current
study sought to: (1) describe demographics and operative treatment patterns, (2) assess neurologic outcomes, and (3) report predictors associated with undergoing surgery, neurologic improvement, and mortality.
METHODS: A retrospective cohort
study of patient records from September 2016 to December 2020 was conducted at a prominent East Africa referral center. The
study collected data on demographics, injury, and operative characteristics. Surgical indications were assessed using the AO (Arbeitsgemeinschaft für Osteosynthesefragen) TL fracture classification system and neurological function. Logistic regression analysis identified predictors for operative treatment, neurologic improvement, and mortality.
RESULTS: The
study showed that 64.9% of the 257 TL spine trauma patients underwent surgery with a median postadmission day of 17.0. The mortality rate was 1.2%. Road traffic accidents caused 43.6% of the injuries. The most common fracture pattern was AO Type A fractures (78.6%). Laminectomy and posterolateral fusion were performed in 97.6% of the surgical cases. Patients without neurological deficits (OR: 0.27, 95% CI: 0.13-0.54, P < 0.001) and those with longer delays from injury to admission were less likely to have surgery (OR: 0.95, 95% CI: 0.92-0.99, P = 0.007). The neurologic improvement rate was 11.1%. Univariate analysis showed a significant association between surgery and neurologic improvement (OR: 3.83, 95% CI: 1.27-16.61, P < 0.001). However, this finding was lost in multivariate regression.
CONCLUSIONS: This
study highlights various themes surrounding the management of TL spine trauma in a low-resource environment, including lower surgery rates, delays from admission to surgery, safe surgery with low mortality, and the potential for surgery to lead to neurologic improvement.
CONCLUSIONS: Despite challenges such as surgical delays and limited resources in East Africa, there is potential for surgical intervention to improve neurologic outcomes in thoracic, TL, and lumbar spine trauma patients.
METHODS: