Reoperation rate after surgery for lumbar spinal stenosis without spondylolisthesis: a nationwide cohort study

Kim, Chi Heon; Chung, Chun Kee; Park, Choon Seon; Choi, Bok Kyoung; Hahn, Seokyung; Kim, Min Jung; Lee, Kun Sei; Park, Byung Joo

doi:10.1016/j.spinee.2013.06.069

Cited by 106 publications

(97 citation statements)

References 28 publications

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“…A wide range (10%-38%) of reoperation rates for the surgical treatment of DS have been reported in the previous publications [9][10][11][12]. In the present study, the reoperation rate was significantly higher in the decompression-only group compared with the decompression and fusion group in both the short and the long terms.…”

Section: Discussionsupporting

confidence: 61%

“…Two large population-based series addressed the reoperation rate after decompression and fusion for the treatment of DS. Deyo et al [10] reported a 10.6% incidence of reoperation in patients who underwent decompression and fusion for the treatment for DS, and Kim et al [12] reported a 14.2% incidence of reoperation in their mean 3.5 years follow-up study. The present study confirmed the results of these previous reports.…”

Section: Discussionmentioning

confidence: 99%

“…However, some patients require reoperation because of complications, such as pseudoarthrosis, persistent pain, and infection, or because of progressive degenerative changes, such as adjacent segment disease. Previous studies have reported an approximately 10% to 38% rate of reoperation in the surgical treatment of DS [9][10][11][12]. Among the major complications requiring reoperation are adjacent segmental disease (ASD) and same segment disease (SSD, including disc herniation, recurrent stenosis, and others).…”

Section: Introductionmentioning

confidence: 99%

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Reoperation rate and risk factors of elective spinal surgery for degenerative spondylolisthesis: minimum 5-year follow-up

et al. 2015

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reoperation rate and risk factors of elective spinal surgery for degenerative spondylolisthesis: minimum 5-year follow-up

et al. 2015

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“…Because randomized controlled trials are also difficult with a heterogeneous patient group, studies of large, population-based, prospectively observed cohorts are required to identify significant predictors of radiographic and clinical outcomes in the neurogenic claudication population. 29 …”

Section: Discussionmentioning

confidence: 99%

Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts

Guha

Heary

Shamji

2015

FOC

102

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OBJECT Decompression without fusion for degenerative lumbar stenosis is an effective treatment for both the pain and disability of neurogenic claudication. Iatrogenic instability following decompression may require further intervention to stabilize the spine. The authors review the incidence of postsurgical instability following lumbar decompression, and assess the impact of surgical technique as well as study design on the incidence of instability. METHODS A comprehensive literature search was performed to identify surgical cohorts of patients with degenerative lumbar stenosis, with and without preexisting spondylolisthesis, who were treated with laminectomy or minimally invasive decompression without fusion. Data on patient characteristics, surgical indications and techniques, clinical and radiographic outcomes, and reoperation rates were collected and analyzed. RESULTS A systematic review of 24 studies involving 2496 patients was performed, assessing both open laminectomy and minimally invasive bilateral canal enlargement. Postoperative pain and functional outcomes were similar across the various studies, and postoperative radiographie instability was seen in 5.5% of patients. Instability was seen more frequently in patients with preexisting spondylolisthesis (12.6%) and in those treated with open laminectomy (12%). Reoperation for instability was required in 1.8% of all patients, and was higher for patients with preoperative spondylolisthesis (9.3%) and for those treated with open laminectomy (4.1%). CONCLUSIONS Instability following lumbar decompression is a common occurrence. This is particularly true if decompression alone is selected as a surgical approach in patients with established spondylolisthesis. This complication may occur less commonly with the use of minimally invasive techniques; however, larger prospective cohort studies are necessary to more thoroughly explore these findings.

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“…4 Subsequent operative intervention to treat ASLD usually includes decompression and fusion of adjacent spinal levels. During surgery for ASLD, it is not unusual to expose all of the preexisting hardware, which leads to significant pain and may potentially increase the risk of infection and need for perioperative blood transfusion.…”

mentioning

confidence: 99%

Novel placement of cortical bone trajectory screws in previously instrumented pedicles for adjacent-segment lumbar disease using CT image-guided navigation

Rodriguez¹,

Neal²,

Liu³

et al. 2014

FOC

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A djAcent-segment lumbar disease (ASLD) refers to the development of pathology in the mobile segment proximal or distal to a previous lumbar fusion. Adjacent pathology includes disc degeneration, disc herniation, listhesis, instability, stenosis, hypertrophic facet arthritis, scoliosis, and vertebral compression fracture. 7,13 The prevalence of ASLD is widely variable in the literature as some studies refer to radiographic rather than symptomatic disease.3 A recent meta-analysis review reports the prevalence of symptomatic ASLD to be 8.5%.24 A large portion of these patients will require reoperation to address symptomatic ASLD. 4 Subsequent operative intervention to treat ASLD usually includes decompression and fusion of adjacent spinal levels. During surgery for ASLD, it is not unusual to expose all of the preexisting hardware, which leads to significant pain and may potentially increase the risk of infection and need for perioperative blood transfusion. The cortical bone trajectory (CBT) technique can be used to avoid extensive tissue dissection by limiting the surgical corridor to the levels adjacent to the existing hardware. Cortical bone trajectory was developed to increase screw-bone purchase during posterior pedicle fixation. 10,16Because the starting point for CBT screws is at the lateral aspect of the pars interarticularis, there is less need Novel placement of cortical bone trajectory screws in previously instrumented pedicles for adjacent-segment lumbar disease using CT image-guided navigation Object. Symptomatic adjacent-segment lumbar disease (ASLD) after lumbar fusion often requires subsequent surgical intervention. The authors report utilizing cortical bone trajectory (CBT) pedicle screw fixation with intraoperative CT (O-arm) image-guided navigation to stabilize spinal levels in patients with symptomatic ASLD. This unique technique results in the placement of 2 screws in the same pedicle (1 traditional pedicle trajectory and 1 CBT) and obviates the need to remove preexisting instrumentation.Methods. The records of 5 consecutive patients who underwent lumbar spinal fusion with CBT and posterior interbody grafting for ASLD were retrospectively reviewed. All patients underwent screw trajectory planning with the O-arm in conjunction with the StealthStation navigation system. Basic demographics, operative details, and radiographic and clinical outcomes were obtained.Results. The average patient age was 69.4 years (range 58-82 years). Four of the 5 surgeries were performed with the Minimal Access Spinal Technologies (MAST) Midline Lumbar Fusion (MIDLF) system. The average operative duration was 218 minutes (range 175-315 minutes). In the entire cohort, 5.5-mm cortical screws were placed in previously instrumented pedicles. The average hospital stay was 2.8 days (range 2-3 days) and there were no surgical complications. All patients had more than 6 months of radiographic and clinical follow-up (range 10-15 months). At last follow-up, all patients reported improved symptoms from their preoperative state....

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Reoperation rate after surgery for lumbar spinal stenosis without spondylolisthesis: a nationwide cohort study

Cited by 106 publications

References 28 publications

Reoperation rate and risk factors of elective spinal surgery for degenerative spondylolisthesis: minimum 5-year follow-up

Reoperation rate and risk factors of elective spinal surgery for degenerative spondylolisthesis: minimum 5-year follow-up

Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts

Novel placement of cortical bone trajectory screws in previously instrumented pedicles for adjacent-segment lumbar disease using CT image-guided navigation

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