Reoperations After Surgery for Lumbar Spinal Stenosis

Javalkar, Vijayakumar; Cardenas, Raul; Tawfik, Tamir; Khan, Imad Saeed; Bollam, Papireddy; Banerjee, Anirban; Nanda, Anil

doi:10.1016/j.wneu.2010.10.043

Cited by 25 publications

(12 citation statements)

References 15 publications

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“…They found out 14.9% ( n = 50) reoperations after unknown period of followup. 28 We believe that over a period of time, reoperation might increase which is similar to the reported literature. In their evaluation, they also reported a higher rate of postoperative complications in patients who underwent decompression with instrumentation (19%) than those with decompression alone (5.5%).…”

Section: Discussionsupporting

confidence: 87%

Reoperations Following Lumbar Spinal Canal Stenosis

Goel

Modi

2018

IJOO

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In the current clinical scenario, restenosis following the primary surgical procedure for lumbar canal stenosis is being frequently noticed. A number of studies have evaluated the reoperation rates following different surgical procedures for lumbar canal stenosis. However, a dilemma still exists about the surgical procedures, associated comorbidities and reoperation rates. In this study, we have reviewed the existing literature for lumbar canal stenosis surgery and their reoperation rates. A PubMed search for all papers stating “reoperation after spinal stenosis,” “revision surgery after spinal stenosis,” and “reoperations and lumbar canal stenosis” were explored. A total of 440 publications were found, of which 23 publications were shortlisted. The existing literature on reoperation rates after surgery for lumbar canal stenosis was reviewed and analyzed. From the literature search, 29680 patients who underwent surgeries for spinal stenosis have been included in the review. 11.65% ± 4.25% of them underwent reoperations following the primary procedure with a followup period of 6.80 ± 3.90 years. Fenestration surgeries showed an average reoperation rate of 7.58% ± 5.29% in 8.28 ± 6.26 years followup as compared to laminectomy alone (12.70% ± 7.49%, 6.50 ± 2.12 years followup). Laminectomy with or without fusion showed a reoperation rate of 11.22% ± 4.25% in 6.00 ± 2.60 years followup period. The comparative results of these studies were however not significant. The causes of reoperation were multifactorial ranging from the type of procedure performed, associated comorbidities or smoking. Statistical data do not indicate the superiority of any particular type of surgery, which reduces the rate of reoperation. The causes for reoperation are inadequate decompression or instability. The literature does not give statistics for these complications in the papers. Smoking is an independent risk factor for revision surgery. Diabetes reduces the time interval between the initial surgery and the revision surgery. This review highlights the causes of reoperations in various lumbar stenosis surgeries, associated comorbidities and expected outcome.

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Section: Discussionsupporting

confidence: 87%

Reoperations Following Lumbar Spinal Canal Stenosis

Goel

Modi

2018

IJOO

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“…22,25 Postoperative instability after lumbar decompression remains one of the primary motivators of arthrodesis performed during the index procedure, or in reoperations after decompression. 23 The incidence of postdecompression instability varies widely in the literature, ranging from 0% to 63%, 1,14 due partly to the lack of standardized radiographic criteria. 53 In our review alone, 10 of 24 studies reported incidences of postoperative instability without specifying its definition; the remaining studies varied widely in their stated criteria.…”

Section: Discussionmentioning

confidence: 99%

“…23,36 Minimally invasive surgery (MIS) techniques for the spine purport, among other advantages, to preserve the posterior osseoligamentous structures, and may minimize destabilization while achieving adequate decompression of the neural elements.…”

mentioning

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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“…This procedure, however, involves extensive muscular disruption and damage to posterior spinal structures [11••, 15]. As a result, spinal instability with development of spondylolisthesis and refractory back pain is significant postoperative concerns [16,17]. Minimally invasive approaches to lumbar decompression were developed with the goal of preventing postoperative instability by preserving spinal musculature and requiring minimal posterior element disruption [13].…”

Section: Degenerative Spinal Stenosis: Mis Lumbar Decompressionmentioning

confidence: 99%

Minimally invasive techniques for lumbar decompressions and fusions

Narain

Hijji

Markowitz

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of review The purpose of this study is to summarize the recent literature investigating the use of minimally invasive (MIS) techniques in the treatment of lumbar degenerative stenosis, spondylolisthesis, and scoliosis. Correction of sagittal alignment, however, is more variable based on current reports. Summary MIS techniques are both safe and effective in the treatment of lumbar degenerative pathologies. While some studies have reported on long-term outcomes and costs associated with MIS procedures, more investigation into these topics is still necessary. Additionally, further work is required to analyze the training requirements and learning curves of MIS procedures to better promote adoption amongst surgeons.

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Reoperations After Surgery for Lumbar Spinal Stenosis

Cited by 25 publications

References 15 publications

Reoperations Following Lumbar Spinal Canal Stenosis

Reoperations Following Lumbar Spinal Canal Stenosis

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

Minimally invasive techniques for lumbar decompressions and fusions

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