Takayoshi Shimizu1, Shunsuke Fujibayashi2, Mitsuru Takemoto2, Bungo Otsuki2,3, Hiroaki Kimura2, Masato Ota4, Akira Kusuba5, Youngwoo Kim6, Tsunemitsu Soeda7, Kei Watanabe8, Takeshi Sakamoto8, Akira Uchikoshi9, Naoya Tsubouchi10, Shuichi Matsuda2. 1. Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto, 606-8507, Japan. takayosh@kuhp.kyoto-u.ac.jp. 2. Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto, 606-8507, Japan. 3. Department of Orthopaedic Surgery, Kobe Central General Hospital, Kobe, Japan. 4. Department of Orthopaedic Surgery, Kitano Hospital, Osaka, Japan. 5. Department of Orthopaedic Surgery, Kurashiki Central Hospital, Okayama, Japan. 6. Department of Orthopaedic Surgery, Kyoto City Hospital, Kyoto, Japan. 7. Department of Orthopaedic Surgery, Gakkentoshi Hospital, Kyoto, Japan. 8. Department of Orthopaedic Surgery, Osaka Red Cross Hospital, Osaka, Japan. 9. Department of Orthopaedic Surgery, Wakayama Red Cross Hospital, Wakayama, Japan. 10. Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
Abstract
PURPOSE: To investigate the incidence and causes of reoperations within 30 days of spine surgery. METHODS: Patients who underwent spine surgery between 2002 and 2012, at one of 9 institutions, were enrolled. The causes of all reoperations, within 30 days of the index surgery, were reviewed. The incidence of reoperations within 30 days were calculated and compared according to the preoperative diagnosis, use of instrumentation, surgical level, and approach. Moreover, the distribution of the causes for reoperations within the 30-day period was also assessed. RESULTS: The overall incidence of reoperations, within 30 days of spine surgery, was 1.6% (175/10,680). Patients who underwent instrumentation procedures demonstrated a higher incidence of reoperations than patients who underwent procedures without instrumentation (P < 0.001). Moreover, patients diagnosed with preoperative trauma had a higher incidence of reoperation than those with other diagnoses (P < 0.001). Surgical site infection (SSI), postoperative epidural hematoma, pedicle screw malposition, and inadequate decompression were the four main causes of reoperation. Motor paralysis, due to epidural hematoma, was the predominant cause of reoperations during the hyper-acute phase (0-1 days, postoperatively), whereas SSI was the dominant cause during the sub-acute phase (11-30 days, postoperatively). CONCLUSIONS: This large, multi-center study indicated the causes and incidence of reoperations, within 30 days of the initial spinal surgery. Based on these data, spinal surgeons can provide patients with information that allows them to better understand the surgical risk and expected post-surgical management.
PURPOSE: To investigate the incidence and causes of reoperations within 30 days of spine surgery. METHODS:Patients who underwent spine surgery between 2002 and 2012, at one of 9 institutions, were enrolled. The causes of all reoperations, within 30 days of the index surgery, were reviewed. The incidence of reoperations within 30 days were calculated and compared according to the preoperative diagnosis, use of instrumentation, surgical level, and approach. Moreover, the distribution of the causes for reoperations within the 30-day period was also assessed. RESULTS: The overall incidence of reoperations, within 30 days of spine surgery, was 1.6% (175/10,680). Patients who underwent instrumentation procedures demonstrated a higher incidence of reoperations than patients who underwent procedures without instrumentation (P < 0.001). Moreover, patients diagnosed with preoperative trauma had a higher incidence of reoperation than those with other diagnoses (P < 0.001). Surgical site infection (SSI), postoperative epidural hematoma, pedicle screw malposition, and inadequate decompression were the four main causes of reoperation. Motor paralysis, due to epidural hematoma, was the predominant cause of reoperations during the hyper-acute phase (0-1 days, postoperatively), whereas SSI was the dominant cause during the sub-acute phase (11-30 days, postoperatively). CONCLUSIONS: This large, multi-center study indicated the causes and incidence of reoperations, within 30 days of the initial spinal surgery. Based on these data, spinal surgeons can provide patients with information that allows them to better understand the surgical risk and expected post-surgical management.
Entities:
Keywords:
30 days; Incidence; Reoperation; Spine surgery
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