Is fusion the most suitable treatment option for recurrent lumbar disc herniation? A systematic review

Arif, Shahswar; Brady, Zarina; Enchev, Yavor; Peev, Nikolay

doi:10.1080/01616412.2020.1787661

Cited by 12 publications

(11 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lumbar instrumented fusion is a common procedure for the treatment of a variety of degenerative spinal disorders including lumbar spondylolisthesis and is supported by multiple guidelines. [ 2 , 7 , 9 , 18 , 24 , 25 , 30 ] Numerous factors are involved in the decision to perform a lumbar fusion, including patient characteristics, imaging features, and diagnosis. Over the past decade, the use of lumbar fusion has increased by 32.1%, with the greatest increase being for spondylolisthesis.…”

Section: Introductionmentioning

confidence: 99%

Age, body mass index, and osteoporosis are more predictive than imaging for adjacent-segment reoperation after lumbar fusion

Ankrah

Eli

Magge

et al. 2021

Surgical Neurology International

View full text Add to dashboard Cite

Background: Adjacent-segment disease (ASD) is a well-described long-term complication after lumbar fusion. There is a lack of consensus about the risk factors for development of ASD, but identifying them could improve surgical outcomes. Our goal was to analyze the effect of patient characteristics and radiographic parameters on the development of symptomatic ASD requiring revision surgery after posterior lumbar fusion. Methods: In this retrospective cohort study, we identified patients who underwent lumbar fusion surgery and revision surgery from May 2012 to November 2018 using an institutional lumbar fusion registry. Patients having both pre- and post-operative upright radiographs were included in the study. Revision surgeries for which the index operation was performed at an outside hospital were excluded from analysis. Univariate analysis was conducted on candidate variables, and variables with P< 0.2 were selected for multivariate logistic regression. Results: Of the 106 patients identified, 21 required reoperation (29 months average follow-up). Age >65 years (OR 4.14, 95% CI 1.46–11.76, P= 0.008), body mass index (BMI) >34 (OR 1.13, 95% CI 1.04–1.23, P = 0.004), and osteoporosis (OR 14, 95% CI 1.38–142.42, P = 0.03) were independent predictors of reoperation in the multivariate analysis. Increased facet diastasis at fusion levels (OR 0.60, 95% CI 0.42–0.85, P = 0.004) was associated with reduced reoperation rates. Change in segmental LL at the index operation level, rostral and caudal facet diastasis, vacuum discs, and T2 hyperintensity in the facets were not predictors of reoperation. Conclusion: Age >65, BMI >34, and osteoporosis were independent predictors of adjacent-segment reoperation after lumbar spinal fusion.

show abstract

Section: Introductionmentioning

confidence: 99%

Age, body mass index, and osteoporosis are more predictive than imaging for adjacent-segment reoperation after lumbar fusion

Ankrah

Eli

Magge

et al. 2021

Surgical Neurology International

View full text Add to dashboard Cite

show abstract

“…Spinal fusion has also been included in multiple studies and has existing low-value care indicators (2,7,8). Spinal fusion and arguably the other spinal procedures we included are defined as low-value or inappropriate for patients with low back pain (9)(10)(11)(12). Since low back pain can relate to multiple potential diagnoses/labels, creating a complete definition can be challenging (13,14).…”

Section: Diseases [Icd] Codes)mentioning

confidence: 99%

Health service research definition builder: An R Shiny application for exploring diagnosis codes associated with services reported in routinely collected health data

Chalmers

Gopinath

Elshaug

2022

Preprint

View full text Add to dashboard Cite

Many administrative health data-based studies define patient cohorts using procedure and diagnosis codes. The impact these criteria have on a study's final cohort is not always transparent to co-investigators or other audiences if access to the research data is restricted. We developed a SAS and R Shiny interactive research support tool which generates and displays the diagnosis code summaries associated with a selected medical service or procedure. This allows non-analyst users to interrogate claims data and groupings of reported diagnosis codes. The SAS program uses a tree classifier to find associated diagnosis codes with the service claims compared against a matched, random sample of claims without the service. Claims are grouped based on the overlap of these associated diagnosis codes. The Health Services Research (HSR) Definition Builder Shiny application uses this input to create interactive table and graphics, which updates estimated claim counts of the selected service as users select inclusion and exclusion criteria. This tool can help researchers develop preliminary and shareable definitions for cohorts for administrative health data research. It allows an additional validation step of examining frequency of all diagnosis codes associated with a service, reducing the risk of incorrect included or omitted codes from the final definition. In our results, we explore use of the application on three example services in 2016 US Medicare claims for patients aged over 65: knee arthroscopy, spinal fusion procedures and urinalysis. Readers can access the application at https://kelsey209.shinyapps.io/hsrdefbuilder/ and the code at https://github.com/kelsey209/hsrdefbuilder.

show abstract

“…1 For these patients, discectomy and vertebral fusion with internal fixation via a posterior approach is the most classic surgical treatment protocol. [2][3][4] However, Aleem et al 5 reported that the incidence of deep postoperative infection following spine surgery, which is one of the most common complications resulting in hospital readmission and results in an extension of hospital length of stay by approximately 9.7 days, ranges from 1% to 4%. Nasser et al 6 emphasized that over 156,000 spine infections could potentially be averted with appropriate screening.…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Value of Blood Next-Generation Sequencing in Early Surgical Site Infection After Spine Surgery

Zhang

Ding

2023

IJGM

View full text Add to dashboard Cite

To determine the diagnostic value of blood next-generation sequencing (NGS) in early surgical site infection after spine surgery. Because the blood is sterile in healthy individuals, it is expected that blood NGS is both sensitive and specific for the detection of infection. Methods: A total of 28 patients with definitive spinal surgical site infections and controls (n=30) were retrospectively included. The postoperative results of NGS and culture on different samples, such as blood and drainage fluid, were obtained and compared to evaluate the diagnostic value of blood NGS. The diagnostic value parameters (sensitivity, specificity, etc.) were calculated. Results: Among the four bacteriological exam methods, blood NGS was both sensitive and specific for the determination of infection after spine surgery. The sensitivities of blood and drainage fluid NGS were similar (0.82 vs 0.89, P=0.617). However, the specificities of the two assessments differed, which were 0.97 for blood NGS and 0.40 for drainage fluid NGS (P<0.001). The sensitivities of bacterial culture were lower than those of NGS (blood: 0.82 vs 0.25, P<0.001; drainage fluid: 0.89 vs 0.61, P<0.001), regardless of the sample type. However, the specificities of bacterial culture were equal to or higher than those of NGS (blood: 0.97 vs 0.97, P=1.000; drainage fluid: 0.40 vs 0.80, P=0.002). Conclusion:This article emphasizes the superiority of blood NGS in infection detection and bacterial determination in patients undergoing spine surgery. Compared with traditional drainage fluid bacterial culture and NGS, blood NGS was more sensitive and specific, and its extensive application could be expected.

show abstract

Is fusion the most suitable treatment option for recurrent lumbar disc herniation? A systematic review

Cited by 12 publications

References 48 publications

Age, body mass index, and osteoporosis are more predictive than imaging for adjacent-segment reoperation after lumbar fusion

Age, body mass index, and osteoporosis are more predictive than imaging for adjacent-segment reoperation after lumbar fusion

Health service research definition builder: An R Shiny application for exploring diagnosis codes associated with services reported in routinely collected health data

The Diagnostic Value of Blood Next-Generation Sequencing in Early Surgical Site Infection After Spine Surgery

Contact Info

Product

Resources

About