Article record

80岁以上颈椎创伤患者枕颈固定手术的围手术期并发症

Perioperative Complications of the Occipitocervical Fixation Surgery for Cervical Trauma in Patients Aged Over 80 Years.

临床研究耳科IF 1.9Q3

文献信息

PMID	42893159
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Norihiro Isogai 查看其他 22 位作者 Haruki Funao；Mitsuru Yagi；Noriaki Yokogawa；Hiroaki Nakashima；Toru Funayama；Shota Ikegami；Kota Watanabe；Atsushi Yunde；Nobuyuki Suzuki；Hidenori Suzuki；Gen Inoue；Hideaki Nakajima；Tomohiko Hasegawa；Yoshinori Terashima；Ko Hashimoto；Hiroshi Uei；Kenichiro Kakutani；Katsuhito Kiyasu；Hiroyuki Tominaga；Masayuki Ishihara；Takashi Kaito；Satoshi Kato
作者单位	Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita, Japan. 查看其他 23 条单位信息 Department of Orthopaedic Surgery and Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital, Tokyo, Japan.；Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, Narita, Japan.；Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.；Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.；Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.；Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.；Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.；Department of Orthopaedic Surgery, Graduate school of Medicine, Chiba University, Chiba, Japan.；Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.；Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.；Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.；Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, Eiheiji-cho, Japan.；Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.；Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.；Department of Orthopaedic Surgery, Matsuda Orthopedic Memorial Hospital, Sapporo, Japan.；Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.；Department of Orthopaedic Surgery, Nihon University Hospital, Tokyo, Japan.；Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo, Japan.；Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.；Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Nankoku, Japan.；Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.；Department of Orthopaedic Surgery, Kansai Medical University Hospital, Hirakata, Japan.；Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
期刊	Spine surgery and related research
SCI 分区	Q3
IF	1.9
研究类型	临床研究 · 临床
所属专科	耳科

中文摘要

引言： 尽管已有报道指出颈椎创伤行枕颈固定手术后可出现严重围手术期并发症，但尚无研究专门评估80岁以上患者的这些并发症。本研究旨在评估80岁以上颈椎创伤患者行枕颈固定手术后的围手术期并发症。
方法： 在2010年至2020年间治疗的1,512例颈椎损伤患者中，日本77家机构纳入了41例接受枕颈固定手术的65岁及以上患者。患者被分为年轻老年组（65-79岁，n=21）和高龄老年组（≥80岁，n=20）。比较两组的人口学和手术数据、诊断、合并症及围手术期并发症。
结果： 年轻老年组包括8例寰椎骨折和16例枢椎骨折，而高龄老年组包括7例寰椎骨折和15例枢椎骨折。围手术期并发症在年轻老年组发生于11例（52%），在高龄老年组发生于4例（20%）。报告的并发症包括谵妄、吞咽困难、肺炎、内固定失败、神经性疼痛加重、呼吸障碍、尿路感染、憩室出血、脑梗死、深静脉血栓形成和死亡。
结论： 尽管存在若干选择偏倚，包括创伤严重程度和手术指征，但仅高龄超过80岁并不一定导致创伤性颈椎损伤行枕颈固定手术后围手术期并发症风险显著增加。
证据等级： III级。

英文摘要

INTRODUCTION: Although severe perioperative complications have been reported after occipitocervical fixation surgery for cervical trauma, no studies have specifically evaluated these complications in patients aged over 80 years. This study aimed to assess perioperative complications following occipitocervical fixation surgery for cervical trauma in patients older than 80 years.
METHODS: Among the 1,512 patients with cervical injury treated between 2010 and 2020, 41 patients aged ≥65 years who underwent occipitocervical fixation surgery were enrolled at 77 institutions in Japan. Patients were classified into a young-old group (65-79 years, n=21) and an old-old group (≥80 years, n=20). Demographic and surgical data, diagnosis, comorbidities, and perioperative complications were compared between the two groups.
RESULTS: The young-old group included eight atlas fractures and 16 axis fractures, while the old-old group included seven atlas fractures and 15 axis fractures. Perioperative complications occurred in 11 (52%) cases in the young-old group and in four cases (20%) in the old-old group. Reported complications included delirium, dysphagia, pneumonia, implant failure, worsening neurological pain, respiratory disorder, urinary tract infection, diverticular bleeding, cerebral infarction, deep vein thrombosis, and death.
CONCLUSIONS: Although there were several selection biases, including trauma severity and surgical indication, advanced age of over 80 years alone does not necessarily lead to a markedly increased risk of perioperative complications following occipitocervical fixation surgery for traumatic cervical spine injuries.
LEVEL OF EVIDENCE: Level III.