STUDY DESIGN: A retrospective subgroup analysis was performed on surgically treated patients from the lumbar spinal stenosis (SpS) arm of the Spine Patient Outcomes Research Trial (SPORT), randomized, and observational cohorts. OBJECTIVE: To identify risk factors for reoperation in patients treated surgically for SpS and compare outcomes between patients who underwent reoperation with those who did not. SUMMARY OF BACKGROUND DATA: SpS is one of the most common indications for surgery in the elderly; however, few long-term studies have identified risk factors for reoperation. METHODS: A post-hoc subgroup analysis was performed on patients from the SpS arm of the SPORT, randomized and observational cohorts. Baseline characteristics were analyzed between reoperation and no-reoperation groups using univariate and multivariate analysis on data 8 years postoperation. RESULTS: Of the 417 study patients, 88% underwent decompression only, 5% noninstrumented fusion, and 6% instrumented fusion. At the 8-year follow-up, the reoperation rate was 18%; 52% of reoperations were for recurrent stenosis or progressive spondylolisthesis, 25% for complication or other reason, and 16% for new condition. Of patients who underwent a reoperation, 42% did so within 2 years, 70% within 4 years, and 84% within 6 years. Patients who underwent reoperation were less likely to have presented with any neurological deficit (43% reop vs. 57% no reop, P = 0.04). Patients improved less at follow-up in the reoperation group (P < 0.001). CONCLUSION: In patients undergoing surgical treatment for SpS, the reoperation rate at 8-year follow-up was 18%. Patients with a reoperation were less likely to have a baseline neurological deficit. Patients who did not undergo reoperation had better patient reported outcomes at 8-year follow-up compared with those who had repeat surgery. LEVEL OF EVIDENCE: 2.
STUDY DESIGN: A retrospective subgroup analysis was performed on surgically treated patients from the lumbar spinal stenosis (SpS) arm of the Spine Patient Outcomes Research Trial (SPORT), randomized, and observational cohorts. OBJECTIVE: To identify risk factors for reoperation in patients treated surgically for SpS and compare outcomes between patients who underwent reoperation with those who did not. SUMMARY OF BACKGROUND DATA: SpS is one of the most common indications for surgery in the elderly; however, few long-term studies have identified risk factors for reoperation. METHODS: A post-hoc subgroup analysis was performed on patients from the SpS arm of the SPORT, randomized and observational cohorts. Baseline characteristics were analyzed between reoperation and no-reoperation groups using univariate and multivariate analysis on data 8 years postoperation. RESULTS: Of the 417 study patients, 88% underwent decompression only, 5% noninstrumented fusion, and 6% instrumented fusion. At the 8-year follow-up, the reoperation rate was 18%; 52% of reoperations were for recurrent stenosis or progressive spondylolisthesis, 25% for complication or other reason, and 16% for new condition. Of patients who underwent a reoperation, 42% did so within 2 years, 70% within 4 years, and 84% within 6 years. Patients who underwent reoperation were less likely to have presented with any neurological deficit (43% reop vs. 57% no reop, P = 0.04). Patients improved less at follow-up in the reoperation group (P < 0.001). CONCLUSION: In patients undergoing surgical treatment for SpS, the reoperation rate at 8-year follow-up was 18%. Patients with a reoperation were less likely to have a baseline neurological deficit. Patients who did not undergo reoperation had better patient reported outcomes at 8-year follow-up compared with those who had repeat surgery. LEVEL OF EVIDENCE: 2.
Authors: Richard A Deyo; Darryl T Gray; William Kreuter; Sohail Mirza; Brook I Martin Journal: Spine (Phila Pa 1976) Date: 2005-06-15 Impact factor: 3.468
Authors: Brook I Martin; Sohail K Mirza; Bryan A Comstock; Darryl T Gray; William Kreuter; Richard A Deyo Journal: Spine (Phila Pa 1976) Date: 2007-02-01 Impact factor: 3.468
Authors: J S Fischgrund; M Mackay; H N Herkowitz; R Brower; D M Montgomery; L T Kurz Journal: Spine (Phila Pa 1976) Date: 1997-12-15 Impact factor: 3.468
Authors: Kris Radcliff; Patrick Curry; Alan Hilibrand; Christopher Kepler; Jon Lurie; Wenyan Zhao; Todd J Albert; James Weinstein Journal: Spine (Phila Pa 1976) Date: 2013-04-01 Impact factor: 3.468
Authors: S J Atlas; R A Deyo; R B Keller; A M Chapin; D L Patrick; J M Long; D E Singer Journal: Spine (Phila Pa 1976) Date: 1996-08-01 Impact factor: 3.468
Authors: Y Raja Rampersaud; Peggy Tso; Kevin R Walker; Stephen J Lewis; J Roderick Davey; Nizar N Mahomed; Peter C Coyte Journal: Spine J Date: 2013-11-12 Impact factor: 4.166
Authors: Christian Barz; Markus Melloh; Lukas P Staub; Sarah J Lord; Harry R Merk; Thomas Barz Journal: Eur Spine J Date: 2017-02-04 Impact factor: 3.134
Authors: Zhao Lang; Jing-Sheng Li; Felix Yang; Yan Yu; Kamran Khan; Louis G Jenis; Thomas D Cha; James D Kang; Guoan Li Journal: Eur Spine J Date: 2018-06-28 Impact factor: 3.134
Authors: Sharada Weir; Tzu-Chun Kuo; Mihail Samnaliev; Travis S Tierney; Andrea Manca; Rod S Taylor; Julie Bruce; Sam Eldabe; David Cumming Journal: Eur Spine J Date: 2019-01-30 Impact factor: 3.134
Authors: Keith W Lyons; Christian M Klare; Samuel T Kunkel; Jason R Lemire; Mike Bao; Kevin J McGuire; Adam M Pearson; William A Abdu Journal: Int J Spine Surg Date: 2019-08-31
Authors: Amandine Bays; Andrea Stieger; Ulrike Held; Lisa J Hofer; Eva Rasmussen-Barr; Florian Brunner; Johann Steurer; Maria M Wertli Journal: N Am Spine Soc J Date: 2021-06-02
Authors: V Quack; M Boecker; C A Mueller; V Mainz; M Geiger; A W Heinemann; M Betsch; Y El Mansy Journal: BMC Musculoskelet Disord Date: 2019-11-23 Impact factor: 2.362