1 research outputs found
Reoperation Rates Following Instrumented Lumbar Spine Fusion
Study Design. A prospective cohort study.
Objective. This study evaluated the cumulative reoperation rate
and indications for reoperation following instrumented lumbar
spine fusion (LSF).
Summary of Background Data. LSF reduces disability and
improves health-related quality of life for patients with several
spinal disorders. The rate of instrumented LSF has drastically
increased over the last few decades. The increased incidence of
LSF, however, has led to increased reoperation rates.
Methods. The data are based on the prospective LSF database
of Tampere University Hospital that includes all elective
indications for LSF surgery. A total of 433 consecutive patients
(64% women, mean age 62 years) who underwent LSF in
Tampere University Hospital between 2008 and 2011 were
evaluated and indications for reoperations were rechecked from
patient records and radiographs. The most common diagnosis
for the primary surgery was degenerative spondylolisthesis and
the mean follow-up time was 3.9 years. The cumulative
incidence of reoperations and the ‘‘time to event’’ survival rate
was calculated by Kaplan-Meier analysis.
Results. By the end of 2013, 81 patients had undergone at least
one reoperation. The cumulative reoperation rate at 2 years was
12.5% (95% confidence interval: 95% CI: 9.7–16.0) and at 4
years was 19.3% (95% CI: 15.6–23.8). The most common
pathology leading to reoperation was adjacent segment pathology
with a cumulative reoperation rate of 8.7% (95% CI:
6.1–12.5) at 4 years. The corresponding rates for early and late
instrumentation failure were 4.4% (95% CI: 2.7–7.0) and 2.9%
(95% CI: 1.9–7.1), respectively, and for acute complications,
2.5% (95% CI: 1.4–4.5).
Conclusion. Although previous studies reported that early
results of spinal fusion are promising, one in five patients
required reoperation within 4 years after surgery. Patients and
surgeons should be aware of the reoperation rates when
planning fusion surgery.
Key words: adjacent segment, complications, instrumented
lumbar spine fusion, pathology, reoperation.
Level of Evidence: 4
Spine 2018;43:295–301peerReviewe