MRI predictors of revision surgery after primary lumbar discectomy

Jalil, Muhammad Fahmi Abdul; Dower, Ashraf; Tawfik, Samuel; Brooks, Michael; Davies, Mark; Ghahreman, Ali

doi:10.1016/j.jocn.2020.09.057

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…In an aim to minimize bias, we used propensity matching to control for variables present within one year anteceding inclusion and either positively or negatively associated with lumbar reoperation after discectomy. These included: age (negative [ 6 , 31 ]), body mass index (positive; [ 32 – 34 ]), nicotine dependence (positive; [ 35 ]), and spondylolisthesis (positive; [ 36 ]) (Supplemental Table 4 ). Considering prior studies found no association between sex and race/ethnicity and reoperation [ 31 , 32 , 34 , 36 – 39 ], we did not match for these variables but reported them for descriptive purposes.…”

Section: Methodsmentioning

confidence: 99%

“…These included: age (negative [ 6 , 31 ]), body mass index (positive; [ 32 – 34 ]), nicotine dependence (positive; [ 35 ]), and spondylolisthesis (positive; [ 36 ]) (Supplemental Table 4 ). Considering prior studies found no association between sex and race/ethnicity and reoperation [ 31 , 32 , 34 , 36 – 39 ], we did not match for these variables but reported them for descriptive purposes. We added several markers of potential interventions for LSR following lumbar discectomy for descriptive purposes including chiropractic spinal manipulation, physical therapy evaluation, epidural steroid injection, transforaminal steroid injection, and medications including gabapentinoids, NSAIDs, opioids, and skeletal muscle relaxants [ 8 , 10 ].…”

Section: Methodsmentioning

confidence: 99%

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Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study

Trager,

Gliedt,

Labak

et al. 2024

BMC Musculoskelet Disord

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Background Patients who undergo lumbar discectomy may experience ongoing lumbosacral radiculopathy (LSR) and seek spinal manipulative therapy (SMT) to manage these symptoms. We hypothesized that adults receiving SMT for LSR at least one year following lumbar discectomy would be less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT, over two years’ follow-up. Methods We searched a United States network of health records (TriNetX, Inc.) for adults aged ≥ 18 years with LSR and lumbar discectomy ≥ 1 year previous, without lumbar fusion or instrumentation, from 2003 to 2023. We divided patients into two cohorts: (1) chiropractic SMT, and (2) usual care without chiropractic SMT. We used propensity matching to adjust for confounding variables associated with lumbar spine reoperation (e.g., age, body mass index, nicotine dependence), calculated risk ratios (RR), with 95% confidence intervals (CIs), and explored cumulative incidence of reoperation and the number of SMT follow-up visits. Results Following propensity matching there were 378 patients per cohort (mean age 61 years). Lumbar spine reoperation was less frequent in the SMT cohort compared to the usual care cohort (SMT: 7%; usual care: 13%), yielding an RR (95% CIs) of 0.55 (0.35–0.85; P = 0.0062). In the SMT cohort, 72% of patients had ≥ 1 follow-up SMT visit (median = 6). Conclusions This study found that adults experiencing LSR at least one year after lumbar discectomy who received SMT were less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT. While these findings hold promise for clinical implications, they should be corroborated by a prospective study including measures of pain, disability, and safety to confirm their relevance. We cannot exclude the possibility that our results stem from a generalized effect of engaging with a non-surgical clinician, a factor that may extend to related contexts such as physical therapy or acupuncture. Registration Open Science Framework (https://osf.io/vgrwz).

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study

Trager,

Gliedt,

Labak

et al. 2024

BMC Musculoskelet Disord

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Predictors of reoperation in hispanic-americans with recurrent lumbosacral disc herniation following primary hemilaminectomy and discectomy surgery

Lastra-Power¹,

Nieves-Ríos

Baralt-Nazario

et al. 2023

World Neurosurgery: X

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Change in Patient-Reported Outcome Measures as Predictors of Revision Lumbar Decompression Procedures

et al. 2021

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Objective: To assess change in Patient-Reported Outcome Measures (PROM) as predictors for revision lumbar decompression (LD).Methods: Patients who underwent primary, single or multilevel LD were retrospectively reviewed. Patients were categorized according to whether or not they underwent revision LD within 2 years of the primary procedure. Visual analogue scale (VAS), Oswestry Disability Index (ODI), 12-item Short Form Health Survey and 12-item Veterans RAND physical component score (SF-12 PCS and VR-12 PCS), and Patient-Reported Outcome Measurement Information System physical function (PROMIS-PF) were recorded. Delta PROM scores were evaluated for differences between groups and as a risk factor for a revision LD.Results: The study included 135 patients, 91 undergoing a primary procedure only and 44 undergoing a primary and revision procedure. Matched patients did not demonstrate any significant differences in demographics or perioperative characteristics. Patients who underwent a revision had a mean time to revision of 7.4 ± 5.7 months. Primary cohort significantly improved for all PROMs (all p < 0.05), while the primary plus revision cohort significantly improved for VAS back, ODI, and PROMIS-PF (all p < 0.05). However, cohorts differed in VAS back and PROMIS-PF (p < 0.05). Delta PROMs were not a significant risk factor for revision except at 6 months for PROMIS-PF (p = 0.024).Conclusion: LD has been associated with reliable outcomes, but early identification of patients at risk for revision is critical. This study suggests that tools such as PROMIS-PF may serve a role in predicting who is at risk and the 6-month follow-up period may be valuable for counseling patients who are not experiencing improvement.

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MRI predictors of revision surgery after primary lumbar discectomy

Cited by 4 publications

References 23 publications

Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study

Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study

Predictors of reoperation in hispanic-americans with recurrent lumbosacral disc herniation following primary hemilaminectomy and discectomy surgery

Change in Patient-Reported Outcome Measures as Predictors of Revision Lumbar Decompression Procedures

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