Reoperation and Revision Rates of 3 Surgical Treatment Methods for Lumbar Stenosis Associated With Degenerative Scoliosis and Spondylolisthesis

Brodke, Darrel S.; Annis, Prokopis; Lawrence, Brandon D.; Woodbury, Ashley; Daubs, Michael D.

doi:10.1097/brs.0000000000000068

Cited by 51 publications

(39 citation statements)

References 26 publications

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“…Over a mean 5.4-year period, 27% of the patients were subjected to additional lumbar spine surgery. This is similar to Brodke et al [23] who reported a repeated surgery rate of 26% after a mean follow-up of 5.2 years in 96 patients treated for lumbar spinal stenosis and degenerative deformity. More extensive surgery may carry a higher risk of reoperation.…”

Section: Discussionsupporting

confidence: 90%

Outcome of surgery for degenerative lumbar scoliosis: an observational study using the Swedish Spine register

Tian

Gerdhem

2017

Eur Spine J

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Purpose The outcome of surgery for degenerative lumbar scoliosis was studied in the Swedish Spine register. Methods 209 patients (mean age 66 years) were identified; 45 had undergone decompression and/or fusion of one segment (minor group) and 164 had undergone fusion of two or more segments, with or without decompression (major group). Results VAS back pain, VAS leg pain, ODI and EQ-5D index improved after surgery in both groups (p \ 0.05), with medium to large effect sizes of surgery. Global assessment for back pain and satisfaction was significantly better in the major group than in the minor group (p \ 0.05) at the 2-year follow-up. Additional spine surgery was observed in 57 out of the 209 patients during a mean period of 5.4 years. Conclusion Surgery for degenerative lumbar scoliosis improves quality of life with medium to large effect sizes, but carries a high risk of additional surgery.

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Section: Discussionsupporting

confidence: 90%

Outcome of surgery for degenerative lumbar scoliosis: an observational study using the Swedish Spine register

Tian

Gerdhem

2017

Eur Spine J

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“…5,10,12 Unfortunately, there are few studies 25,27,38 that have investigated predictive risk factors for revision surgery following an index procedure for patients with ASD, with none focusing primarily on an elderly population, likely because of low cohort sizes at individual institutions.…”

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confidence: 98%

Risk factors for revision surgery following primary adult spinal deformity surgery in patients 65 years and older

Puvanesarajah

Shen

Cancienne

et al. 2016

SPI

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OBJECTIVE Surgical correction of adult spinal deformity (ASD) is a complex undertaking with high revision rates. The elderly population is poorly studied with regard to revision surgery, yet senior citizens constitute a rapidly expanding surgical demographic. Previous studies aimed at elucidating appropriate risk factors for revision surgery have been limited by small cohort sizes. The purpose of this study was to assess factors that modify the risk of revision surgery in elderly patients with ASD. METHODS The PearlDiver database (2005–2012) was used to determine revision rates in elderly ASD patients treated with a primary thoracolumbar posterolateral fusion of 8 or more levels. Analyzed risk factors included demographics, comorbid conditions, and surgical factors. Significant univariate predictors were further analyzed with multivariate analysis. The causes of revision at each year of follow-up were determined. RESULTS A total of 2293 patients who had been treated with posterolateral fusion of 8 or more levels were identified. At the 1-year follow-up, 241 (10.5%) patients had been treated with revision surgery, while 424 (18.5%) had revision surgery within 5 years. On univariate analysis, obesity was found to be a significant predictor of revision surgery at 1 year, while bone morphogenetic protein (BMP) use was found to significantly decrease revision surgery at 4 and 5 years of followup. Diabetes mellitus, osteoporosis, and smoking history were all significant univariate predictors of increased revision risk at multiple years of follow-up. Multivariate analysis at 5 years of follow-up revealed that osteoporosis (OR 1.98, 95% CI 1.60–2.46, p < 0.0001) and BMP use (OR 0.70, 95% CI 0.56–0.88, p = 0.002) were significantly associated with an increased and decreased revision risk, respectively. Smoking history trended toward significance (OR 1.37, 95% CI 1.10–1.70, p = 0.005). Instrument failure was consistently the most commonly cited reason for revision. Five years following surgery, it was estimated that the cohort had 68.8% survivorship. CONCLUSIONS For elderly patients with ASD, osteoporosis increases the risk of revision surgery, while BMP use decreases the risk. Other comorbidities were not found to be significant predictors of long-term revision rates. It is expected that within 5 years following the index procedure, over 30% of patients will require revision surgery.

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“…The ideal and long-lasting surgical treatment of lumbar spinal stenosis with associated mild spinal deformity is still debated in the literature and reported results vary [5,6]. Anjarwalla et al found that spinal canal decompression improves the functioning of the patients, and reduces back pain and lower limb pain.…”

Section: Discussionmentioning

confidence: 99%

“…The authors stated that there was a significantly higher rate of same-level recurrence in the ISP group (33.3%) than the laminectomy (8.3%) and laminectomy combined with fusion (0%) groups [5]. …”

Section: Discussionmentioning

confidence: 99%

Evaluation of Functional Outcomes in Individuals 10 Years after Posterior Lumbar Interbody Fusion with Corundum Implants and Decompression: A Comparison of 2 Surgical Techniques

Cabak

2014

Med Sci Monit

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BackgroundThe purpose of this study was to evaluate lumbar spine-related functional disability in individuals 10 years after lumbar decompression and lumbar decompression with posterior lumbar interbody fusion (PLIF) with corundum implants surgery for degenerative stenosis and to compare the long-term outcome of these 2 surgical techniques.Material/MethodsFrom 1998 to 2002, 100 patients with single-level lumbar stenosis were surgically treated. The patients were randomly divided into 2 groups that did not differ in terms of clinical or neurological symptoms. Group A consisted of 50 patients who were treated with PLIF and the use of porous ceramic corundum implants; the mean age was 57.74 and BMI was 27.34. Group B consisted of 50 patients treated with decompression by fenestration; mean age was 51.28 and the mean BMI was 28.84.ResultsThere was no statistical significance regarding age, BMI, and sex. Both treatments revealed significant improvements. In group A, ODI decreased from 41.01% to 14.3% at 1 year and 16.3 at 10 years. In group B, ODI decreased from 63.8% to 18.36% at 1 year and 22.36% at 10 years. The difference between groups was statistically significant. There were no differences between the groups regarding the Rolland-Morris disability questionnaire and VAS at 1 and 10 years after surgery.ConclusionsLong-term results evaluated according to the ODI, the Rolland-Morris disability questionnaire, and the VAS showed that the both methods significantly reduce patient disability, and this was maintained during next 10 years. The less invasive fenestration procedure was only slightly less favorable than surgical treatment of stenosis by both PLIF with corundum implants and decompression.

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Reoperation and Revision Rates of 3 Surgical Treatment Methods for Lumbar Stenosis Associated With Degenerative Scoliosis and Spondylolisthesis

Abstract: 3.

Cited by 51 publications

References 26 publications

Outcome of surgery for degenerative lumbar scoliosis: an observational study using the Swedish Spine register

Outcome of surgery for degenerative lumbar scoliosis: an observational study using the Swedish Spine register

Risk factors for revision surgery following primary adult spinal deformity surgery in patients 65 years and older

Evaluation of Functional Outcomes in Individuals 10 Years after Posterior Lumbar Interbody Fusion with Corundum Implants and Decompression: A Comparison of 2 Surgical Techniques

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