Predictors of reoperation in hispanic-americans with recurrent lumbosacral disc herniation following primary hemilaminectomy and discectomy surgery

Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study

“…As in all observational studies, we are unable to infer causality from our findings. Between-cohort differences in unmeasured confounding variables may have influenced results, such as socioeconomic variables (e.g., unemployment [ 57 ]), patient-reported outcome measures of pain, disability or quality of life [ 31 ], length of preoperative symptoms before the primary discectomy [ 58 ], type of disc herniation (e.g., extrusion, sequestration; [ 38 ]), presence of adjacent segment degeneration [ 24 ], and lumbar spine range of motion [ 38 ], which were largely unavailable in the TriNetX dataset. It is also possible that variation in geographic region, surgeon specialty, or surgeon experience would influence the likelihood of reoperation [ 4 ].…”

“…As a real-world study, patients in both cohorts used several types of pharmacologic and/or non-pharmacologic interventions prior to the index date of meeting our selection criteria, yet we were unable to examine their response to these forms of care. While it remains possible that the type of response to previous interventions influenced patients’ likelihood of reoperation, available evidence regarding this is limited [ 31 , 57 ]. It is possible that cohorts had differential follow-up completeness, however, our required follow-up encounter, lengthy follow-up duration, and capacity for TriNetX to link patients’ encounters across included healthcare organizations minimized this potential variation.…”