5-Year Reoperation Rates After Different Types of Lumbar Spine Surgery

Malter, Alex D.; McNeney, Brad; Loeser, John D.; Deyo, Richard A.

doi:10.1097/00007632-199804010-00015

Cited by 223 publications

(102 citation statements)

References 19 publications

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“…Our overall mortality rates are comparable to those found by Street et al [19] and in agreement with a systematic review of the literature reporting mortality rates for cervical spine and lumbar spine surgery \1 %. In disagreement with Malter et al [20] we demonstrated that fusion especially PLIF was associated with lower rates of iterative surgery than decompression alone. Reoperation rates after decompressive surgical procedures are reported to range from 6 to 23 % and are well above our findings which corroborate fairly well with the range of repeat surgery after lumbar decompression for herniated disc (4.3 to 10.5 %) reported by Martin et al [21,22].…”

Section: Resultscontrasting

confidence: 93%

“…Claimants who underwent a less invasive procedure with a shorter recovery period such as standard discectomy were more likely to return to work than patients undergoing fusions. Spinal fusion is a more complicated procedure because it involves bone grafting with or without internal fixation devices resulting in a larger dissection and a longer operating time [20,24,25]. Return to work status after standard discectomy was in line with the Spine Patient Outcomes Research Trial (SPORT) and substantially above the 64 % return to work found by Veresciagina et al [26,27].…”

Section: Resultsmentioning

confidence: 76%

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A decade’s experience in lumbar spine surgery in Belgium: sickness fund beneficiaries, 2000–2009

2012

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Purpose The purpose is to study rates, trends, geographic variations and outcome of lumbar spine surgery in the Belgian population during the last decade. Methods This is a retrospective cohort study using administrative data of the largest Belgian sickness fund from January 1, 2000 through December 31, 2009. Cases included lumbar laminectomy, combined discectomy and fusion, posterior interarticular fusion, anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF) and standard discectomy. The main outcome measures were age-and sex-adjusted rates of lumbar spine surgery, 1-year mortality, 1-year iterative surgery, no return to work (RTW) rate 1 year after surgery and length of hospital stay. Multivariate logistic regression analysis was used to determine the association between age, sex, geographic region, type of surgery, year of intervention and duration of pre-operative sick leave on outcome. Results Spine surgery rates rose 44 % from 2001 through 2009 and data for 2009 showed twofold variations in spine surgery rates among 10 Belgian provinces. Reported 1-year mortality varied from 0.6 to 2.5 % among surgical procedures performed in 2008. The overall 5-year reoperation rate was 12 %. RTW rates 1 year after standard discectomy, ALIF, PLIF and combined discectomy and fusion for the follow-up sample of 2008 were 14.4, 22.7, 26.1 and 30.6 %, respectively. The median length of hospital stay significantly decreased throughout the decade. Type of surgery and geographic region were significantly related to patient outcomes. Conclusions Regional variations highlight professional uncertainty and controversy. The study results point to the need for peer comparisons and surgeon feedback.

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Section: Resultscontrasting

confidence: 93%

Section: Resultsmentioning

confidence: 76%

A decade’s experience in lumbar spine surgery in Belgium: sickness fund beneficiaries, 2000–2009

2012

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“…Regarding the re-operation rate, Ö stermann reported 14% after lumbar intervertebral disc operations in a population of 35,309 patients in a period of 11 years [29]. In large cohort-and population-based studies with follow-up periods ranging from 4 to 10 years revision rates between 5 and 19% were observed [5,18,21]. For studies with a shorter follow-up period of 3-year revision rates between 4 and 11% are documented [12,24,33,38].…”

Section: Discussionmentioning

confidence: 99%

Comparison of a minimally invasive procedure versus standard microscopic discotomy: a prospective randomised controlled clinical trial

Franke

Greiner-Perth²,

Boehm

et al. 2009

Eur Spine J

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A Prospective randomised controlled study was done to determine statistical difference between the standard microsurgical discotomy (MC) and a minimally invasive microscopic procedure for disc prolapse surgery by comparing operation duration and clinical outcome. Additionally, the transferability of the results was determined by a bicentric design. The microscopic assisted percutaneous nucleotomy (MAPN) has been advocated as a minimally invasive tubular technique. Proponents have claimed that minimally invasive procedures reduce postoperative pain and accelerate the recovery. In addition, there exist only a limited number of well-designed comparison studies comparing standard microdiscotomy to a tubular minimally invasive technique that support this claim. Furthermore, there are no well-designed studies looking at the transferability of those results and possible learning curve phenomena. We studied 100 patients, who were planned for disc prolapse surgery at two centres [50 patients at the developing centre (index) and 50 patients at the less experienced (transfer) centre]. The randomisation was done separately for each centre, employing a blockrandomisation procedure with respect to age and preoperative Oswestry score. Operation duration was chosen as a primary outcome parameter as there was a distinguished shortening observed in a preliminary study at the index centre enabling a sound case number estimation. The following data were compared between the two groups and the centres with a 12-month follow-up: surgical times (operation duration and approach duration), the clinical results, leg and back pain by visual analogue scale, the Oswestry disability index, length of hospital stay, return to work time, and complications. The operation duration was statistically identical for MC (57.8 ± 20.2 min) at the index centre and for MAPN (50.3 ± 18.3 min) and MC (54.7 ± 18.1 min) at the transfer centre. The operation duration was only significantly shorter for the MAPN technique at the index centre with 33.3 min (SD 12.1 min). There was a huge clinical improvement for all patients regardless of centre or method revealed by a repeated measures ANOVA for all follow-up visits Separate post hoc ANOVAs for each centre revealed that there was a significant time-method (MAPN vs. MC) interaction at the index centre (F = 3.75, P = 0.006), whereas this crucial interaction was not present at the transfer centre (F = 0.5, P = 0.7). These results suggest a slightly faster clinical recovery for the MAPN patients only at the index centre. This was due to a greater reduction in VAS score for back pain at discharge, 8-week and 6-month follow up (P \ 0.002). The Oswestry-disability scores reached a significant improvement compared to the initial values extending over the complete follow-up at both centres for J. Franke and R. Greiner-Perth contributed equally to this work. both methods without revealing any differences for the two methods in either centre. There was no difference regarding complications. The results demonstrate...

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“…Across groups reoccurrence of symptoms (2.9%) was the most frequent complication at follow-up. The reoperation rate described in literature at 4 to 5 years after lumbar spinal surgery ranges between 12-18% of cases, although newer technologies have not led to a decrease [8,10,13,14]. Poorer bone quality in the aged leads to higher rates of malunion, which, however, does not appear to affect clinical results [16].…”

Section: Discussionmentioning

confidence: 99%

“…However, we observed no higher rate of implant related complications in group 3 compared to group 1 and 2 ( Table 3). The probability for a reoperation appears to decrease with increasing age [8,13,21]. Outcomes described in the literature vary based on length of FU, patient selection, indications, and surgical procedures and present good to excellent results in 53-93% of cases [24].…”

Section: Discussionmentioning

confidence: 99%

Predictors of surgical, general and follow-up complications in lumbar spinal stenosis relative to patient age as emerged from the Spine Tango Registry

et al. 2011

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Introduction Published opinions regarding the outcomes and complications in older patients have a broad spectrum and there is a disagreement whether surgery in older patients entails a higher risk. Therefore this study examines the risk of surgery for lumbar spinal stenosis relative to age in the pooled data set of the Spine Tango registry. Materials and methods Between May 2005 and February 2010 the database query resulted in 1,764 patients. The patients were subdivided into three socio-economically relevant age groups: \65 years, 65-74 years, C75 years. Frequencies for occurred surgical, general and follow-up complications were assessed. Multivariate and univariate logistic regressions were performed to reveal predictors for respective complication types. Results and discussion Our study found that age, ASA status and blood loss were significant co-varieties for the occurrence of general complications. The risk of general complications is increased in older versus younger patients. Fusion or rigid stabilization does not lead to more complications. Surgical complications as well as complication rates at follow-up showed no significant age-related variation. Physician-based outcome was good or excellent in over 80% of patients in all age groups.

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5-Year Reoperation Rates After Different Types of Lumbar Spine Surgery

Cited by 223 publications

References 19 publications

A decade’s experience in lumbar spine surgery in Belgium: sickness fund beneficiaries, 2000–2009

A decade’s experience in lumbar spine surgery in Belgium: sickness fund beneficiaries, 2000–2009

Comparison of a minimally invasive procedure versus standard microscopic discotomy: a prospective randomised controlled clinical trial

Predictors of surgical, general and follow-up complications in lumbar spinal stenosis relative to patient age as emerged from the Spine Tango Registry

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