Analysis of Reasons for Failure of Surgery for Degenerative Disease of Lumbar Spine

Baranowska, Alicja; Baranowska, Joanna; Baranowski, Paweł

doi:10.5604/15093492.1205004

Cited by 10 publications

(8 citation statements)

References 22 publications

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“…From existing literature we know that early failures requiring revision are most commonly due to recurrent disc herniation and inadequate primary discectomy, usually treated with reoperation. 16,17 The lack of association of multilevel discectomy with reoperation surgery suggests that the increased readmissions may partially be due to increased postoperative pain or muscle spasm from the more extensive surgical dissection.…”

Section: Discussionmentioning

confidence: 99%

Early Failures After Lumbar Discectomy Surgery: An Analysis of 62 690 Patients

Samuel

Morse

Lovecchio

et al. 2020

Global Spine Journal

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Study Design: Retrospective cohort study. Objective: To determine the rate of early failures (readmission or reoperation for new or recurrent pain/neurological symptoms) within 30 days after lumbar discectomy and identify associated risk factors. Methods: A retrospective cohort study was conducted of patients undergoing lumbar discectomy in the National Surgical Quality Improvement Program database between 2013 and 2017. Rates of readmission for new or recurrent symptoms or reoperation for revision discectomy or fusion within 30 days postoperatively were measured and correlated with risk factors. Results: In total 62 690 patients were identified; overall rate of readmission within 30 days was 3.3%, including 1.2% for pain or neurological symptoms. Populations at increased risk of readmission were those with 3 or more levels of treatment (2.0%, odds ratio [OR] 2.8%, P < .01), age >70 years (1.8%, OR 1.6, P < .01), class 3 obesity (1.5%, OR 1.4, P = .04), and female gender (1.4%, OR 1.2, P = .02). The overall rate of reoperation within 30 days was 2.2%, including 1.2% for revision decompression or lumbar fusion surgery. Populations at increased risk of reoperation were revision discectomies (1.4%, OR 1.7, P < .01) and females (1.1%, OR 1.4, P < 0.01). Extraforaminal discectomies were associated with lower rates of readmission (0.7%, OR 0.6, P = 0.02) and reoperation (0.4%, OR 0.4, P = .01). Conclusions: Early failures after lumbar discectomy surgery are rare. However, certain subpopulations are associated with increased rates of early failure: obesity, multilevel surgery, females, and revision discectomies.

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Section: Discussionmentioning

confidence: 99%

Early Failures After Lumbar Discectomy Surgery: An Analysis of 62 690 Patients

Samuel

Morse

Lovecchio

et al. 2020

Global Spine Journal

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“…subjective decision making, and subsequently, rather high percentage of poor postoperative outcomes [5,6]. Moreover, the above-mentioned circumstances involve heavy cost loading on healthcare system in the form of readmissions, reoperations, as well as perioperative complications, with long-term or permanent total disability of operated patients [7].…”

Section: Modern Spine Surgerymentioning

confidence: 99%

“…In addition, the lack of unique medical and diagnostic algorithms in vertebrology, high variability of surgical decisions, a wide range of morphological substrates specifying neurological disorders determine surgeon’s subjective decision making, and subsequently, rather high percentage of poor postoperative outcomes [ 5 , 6 ]. Moreover, the above-mentioned circumstances involve heavy cost loading on healthcare system in the form of readmissions, reoperations, as well as perioperative complications, with long-term or permanent total disability of operated patients [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Clinical Decision Support System Efficiency in Spinal Neurosurgery for Personalized Minimally Invasive Technologies Used on Lumbar Spine

Byvaltsev¹,

Kalinin²

2021

Sovrem Tehnol Med

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The aim of the study was to assess clinical decision support system (CDSS) in spinal surgery for personalized minimally invasive technologies on lumbar spine. Materials and Methods The prospective study involved 59 patients operated on using CDSS based on a personalized surgical algorithm considering patient-specific parameters of lumbar segments. Among them, 11 patients underwent total disk replacement (TDR), 25 and 23 patients had minimally invasive (MI-TLIF) and open (O-TLIF) dorsal rigid stabilization, respectively, according to an original technology. The comparative analysis was carried out using retrospective findings of 196 patients operated on involving TDR (n=42), MI-TLIF (n=79), and O-TLIF (n=75). The efficiency of CDSS medical algorithms was assessed by pain syndrome in the lumbar spine and lower limbs, as well as by patients’ functional status on discharge according to ODI, 3 and 6 months after the operation. Results The comparison by gender characteristics and anthropometric data revealed no significant intergroup differences among the groups under study (p>0.05). Intergroup analysis of functional status by ODI, pain intensity in lower limbs and lumbar spine showed better clinical outcomes in patients operated using CDSS compared to a retrospective group (p<0.05): 6 months after TDR and O-TLIF, and 3 months after MI-TLIF. Conclusion The study findings demonstrated high efficiency of CDSS developed for personalized surgical treatment of patients with degenerative lumbar spine diseases taking into consideration individual biometric parameters of lumbar segments.

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“…The effectiveness and safety of surgical treatment for DSD are affected by the eligibility of the patient for surgery, their general health status (i.e. medical risk factors), the experience and knowledge of their surgeon, the type of medical equipment in their treatment centre, their postoperative care, and the quality of rehabilitation [7]. Additional factors include psychological, social, economic and occupational determinants of the patient.…”

Section: Introductionmentioning

confidence: 99%

“…There have been very few studies on reoperation after spinal surgery in Poland [7,[14][15][16], so the literature is still scarce. However, some Polish medical institutions provide data to EUROSPINE's International Spine Registry (Spine Tango), founded in 2002 [5].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for reoperation after surgical treatment for degenerative spinal disease in Poland: a nationwide retrospective study of 38,953 hospitalisations

Słowiński

Žůrek

Wypych-Ślusarska

et al. 2023

Neurol Neurochir Pol.

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Introduction. Degenerative spinal disease (DSD) is one of the most common musculoskeletal conditions and a leading cause of sickness absence. It also contributes significantly to the global burden of disease. The aim of this study was to assess the frequency of reoperation after surgical treatment of DSDs in Poland, and to identify risk factors for reoperation. Material and methods.A retrospective analysis of hospitalisations for DSD in 2018 that were reported to Poland's National Health Fund (NHF) was performed. Reoperations reported within 365 days of hospital discharge were identified. Demographic factors and multimorbidities were included in the analysis. A logistic regression model was then performed to assess risk factors for reoperations.Results. In 2018, 38,953 surgical hospitalszations for DSD were reported. A total of 3,942 hospitalised patients (10.12%) required reoperation within 365 days. Patients requiring reoperation were predominantly female (female-to-male ratio 1.34:1) and elderly (mean age of reoperated patients 56.66 years, mean age of other patients 53.24). The percentage reoperated upon correlated with multiple diseases (from 8.81% in the group of patients without comorbidities to 15.31% in the group of patients with three or more comorbidities). The risk of reoperation was most increased by comorbid depression, neurological diseases, obesity, and older age. The risk of reoperation was reduced by instrumented spinal surgery, surgery in a neurosurgical unit, and hospitalisations other than same-day surgery.Conclusions. Reoperations within a year after DSD surgical treatment are common. Identifying risk factors for reoperation, including those related to the presence of comorbidities and the phenomenon of multimorbidity, can be an important tool in reducing reoperation rates.

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Analysis of Reasons for Failure of Surgery for Degenerative Disease of Lumbar Spine

Abstract: Use of implants and spinal fusion is always associated with a risk of complications and is frequently independent of the surgeon. 2. In order to reduce the rate of revision surgeries, it is important to perform complete decompression and select an adequate surgical technique.

Cited by 10 publications

References 22 publications

Early Failures After Lumbar Discectomy Surgery: An Analysis of 62 690 Patients

Early Failures After Lumbar Discectomy Surgery: An Analysis of 62 690 Patients

Assessment of Clinical Decision Support System Efficiency in Spinal Neurosurgery for Personalized Minimally Invasive Technologies Used on Lumbar Spine

Risk factors for reoperation after surgical treatment for degenerative spinal disease in Poland: a nationwide retrospective study of 38,953 hospitalisations

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