Analysis Of The Related Factors About Hindering The Rapid Rehabilitation Of Patients After Lumbar Spinal Fusion

Objective:To analyze the main reasons and the related risk factors hindering the rapid rehabilitation of patients after lumbar spinal fusion,and provide the scientific basis for the application of enhanced recovery after surgery in lumbar spinal fusion.Methods:We included 88 patients after lumbar spinal fusion surgery from November 2016 to November 2018 in the Second Hospital of Jilin University Orthopedic Treatment Center.The clinical data included gender,age,Body Mass Index(BMI),JOA score,ASA score,VAS score,operation time,preoperative fasting time,preoperative albumin values,length of stay(LOS),postoperative complications,and we used multiariable Logistic regression analysis analyze the risk factors of each complications.In addition,single factor repeated measurement analysis of variance was used to analyze the changes of postoperative pain.Results:The complications after lumbar spinal fusion include Nerve Root Pain(21.6%),Fat Liquefaction of Incision(9.1%),Dysuresia(8%),Postoperative Delirium(6.8%),inflammatory Reaction(6.8%),Thrombosis of Lower Limbs(5.7%),Nausea and Vomiting(6%).The length of stay of the patients with postoperative complications(11.5±5.8)d is significantly different to that without postoperative complications(6.6±1.2)d(t=-5.531,P=0.00).There is a statistically significant difference in VAS score after surgery(F=123.542,P<0.001),but the VAS score rebounded on the third day after surgery,significantly higher than that on the second and fourth day after surgery(P<0.001).Anxiety(OR=1.128,B=0.167,P=0.000)and age(OR=0.925,B=-0.078,P=0.028)are the risk factors for never root pain.Operative time(OR=1.023,B=0.055,P=0.029)is the risk factor for postoperative fat liquefaction.Preoperative albumin level(OR=0.627,B=-0.468,P=0.035)is the risk factor for postoperative inflammatory reaction.Advanced age(OR=1.141,B=0.132,P=0.033)is the risk factor for postoperative dysuresia and non-advanced age(OR=0.812,B=-0.208,P=0.033)is the risk factor for nausea and vomiting.Conclusion:1?Postoperative complications are the main obstacle to postoperative rehabilitation;2?Preoperative malnutrition,anxiety during hospitalization and long operation time are the main risk factors for postoperative complications;3?Postoperative nerve root pain is the most common complication after lumbar spinal fusion and is most likely to occur on the third day after surgery.