Reoperations After Percutaneous Endoscopic Transforaminal Decompression for Treating Lumbar Spinal Stenosis: Incidence and Predictors

Abstract

Study Design Retrospective cohort study. Objectives The main purpose of the present study was to report the incidence and identify predictors of reoperation in patients with lumbar spinal stenosis (LSS) treated with percutaneous endoscopic transforaminal decompression (PETD). Methods This study retrospectively reviewed consecutive patients with LSS who underwent PETD at our center between January 2016 and July 2020. The incidence of reoperations was calculated. We then designed a surgical period-matched case-control study to identify predictors among demographic data, clinical baseline data, and imaging parameters. Results This study identified 496 eligible patients. 33 (6.7%) patients underwent reoperation with a mean follow-up of 3 years, consisting 22 (4.4%) at the index level and 11 (2.2%) at the adjacent levels. There were significant differences in age and age-adjusted Charlson comorbidity index (AACCI) between the two groups, with younger age (P = .004) and lower AACCI (P = .019) in reoperation group. Age was identified as the sole independent predictor (P = .006). The duration of symptoms ≥12 months (P = .034) and the presence of heart problems (P = .012) were recognized as specific predictors among patients younger than 65 years. Conclusions In a mean follow-up of 3 years, the incidence of reoperation in LSS treated with PETD was 6.7%. A younger age was the independent predictor for reoperation. Younger patients with the duration of symptoms ≥12 months or without heart problems were more likely to undergo a second operation. Prospective randomized controlled trials are required to confirm these findings.

Identification of preoperative radiological risk factors for reoperation following percutaneous endoscopic lumbar decompression to treat degenerative lumbar spinal stenosis

“…Yin (7) concluded that age and BMI could influence recurrence rate. Our previous study also confirmed that age was a risk factor for reoperation after PTED (19). However, we found that the associations between age, sex, and reoperation were ambiguous in the existing literature.…”

Efficacy of Repeat Percutaneous Endoscopic Lumbar Decompression for Reoperation of Lumbar Spinal Stenosis: A Retrospective Study

“…Recurrence after LSS is a common complication, and the choice of revision method is key to improving the success rate of revision surgery. Previous studies have focused on revision rates and risk factors leading to revision; 16 , 24–26 however, studies on the efficacy of revision PELD surgery have rarely been reported. Xu et al evaluated the efficacy of reoperation after percutaneous transforaminal endoscopic discectomy for LSS.…”

“…Our prior study found that the revision rate after PELD for LSS was 6.7%, for which the same-segment revision rate was 4.4%, and that age was a risk factor for revision. 16 However, few studies have reported the efficacy of reoperation in patients with recurrent LSS. Therefore, this study followed up patients with PELD recurrence due to LSS in our and other hospitals, and evaluated the efficacy of PELD revision surgery.…”