Zhao Lang1,2, Jing-Sheng Li1,3, Felix Yang1, Yan Yu1,4, Kamran Khan1, Louis G Jenis1, Thomas D Cha1,5, James D Kang6, Guoan Li7. 1. Orthopaedic Bioengineering Research Center, Department of Orthopaedic Surgery, Newton-Wellesley Hospital and Harvard Medical School, 159 Wells Avenue, Newton, MA, 02459, USA. 2. Department of Spine Surgery, Beijing Jishuitan Hospital, Fourth Clinical Medical College of Peking University, Beijing, 100035, China. 3. College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, MA, 02215, USA. 4. Department of Spine Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, 2000065, China. 5. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. 6. Department of Orthopaedic Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02115, USA. 7. Orthopaedic Bioengineering Research Center, Department of Orthopaedic Surgery, Newton-Wellesley Hospital and Harvard Medical School, 159 Wells Avenue, Newton, MA, 02459, USA. gli1@partners.org.
Abstract
PURPOSE: The objective of this paper was to compare the reoperation rates, timing and causes between decompression alone and decompression plus fusion surgeries for degenerative lumbar diseases through a systematic review of the published data. METHODS: A search of the literature was conducted on PubMed/MEDLINE, EMBASE and the Cochrane Collaboration Library. Reports that included reoperations after decompression alone and/or decompression plus fusion surgeries were selected using designed eligibility criteria. Comparative analysis of reoperation rates, timing and causes between the two surgeries was conducted. RESULTS: Thirty-two retrospective and three prospective studies were selected from 6401 papers of the literature search. The analysis of data reported in these studies revealed that both surgeries resulted in similar reoperation rates after the primary surgery. However, majority of reoperations following the fusion surgeries were due to adjacent-segment diseases, and following the decompression alone surgeries were due to the same-segment diseases. Reoperation rates were not found to decrease in patients operated more recently than those operated in early times. CONCLUSIONS: Reoperation rates were similar following decompression alone or plus fusion surgeries for degenerative lumbar diseases. However, different underlying major causes exist between the two surgeries. There is no evidence showing that the reoperation rate has a trend to decline with newer surgical techniques used. The exact mechanisms of reoperation after both surgeries are still unclear. Further researches are necessary to investigate the mechanisms of reoperation for improvement of surgical techniques that aim to delay or prevent reoperation after lumbar surgery. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: The objective of this paper was to compare the reoperation rates, timing and causes between decompression alone and decompression plus fusion surgeries for degenerative lumbar diseases through a systematic review of the published data. METHODS: A search of the literature was conducted on PubMed/MEDLINE, EMBASE and the Cochrane Collaboration Library. Reports that included reoperations after decompression alone and/or decompression plus fusion surgeries were selected using designed eligibility criteria. Comparative analysis of reoperation rates, timing and causes between the two surgeries was conducted. RESULTS: Thirty-two retrospective and three prospective studies were selected from 6401 papers of the literature search. The analysis of data reported in these studies revealed that both surgeries resulted in similar reoperation rates after the primary surgery. However, majority of reoperations following the fusion surgeries were due to adjacent-segment diseases, and following the decompression alone surgeries were due to the same-segment diseases. Reoperation rates were not found to decrease in patients operated more recently than those operated in early times. CONCLUSIONS: Reoperation rates were similar following decompression alone or plus fusion surgeries for degenerative lumbar diseases. However, different underlying major causes exist between the two surgeries. There is no evidence showing that the reoperation rate has a trend to decline with newer surgical techniques used. The exact mechanisms of reoperation after both surgeries are still unclear. Further researches are necessary to investigate the mechanisms of reoperation for improvement of surgical techniques that aim to delay or prevent reoperation after lumbar surgery. These slides can be retrieved under Electronic Supplementary Material.
Authors: Tomoyuki Akamaru; Norio Kawahara; S Tim Yoon; Akihito Minamide; Keun Su Kim; Katsuro Tomita; William C Hutton Journal: Spine (Phila Pa 1976) Date: 2003-07-15 Impact factor: 3.468
Authors: Chaochao Zhou; Guoan Li; Cong Wang; Haiming Wang; Yan Yu; Tsung-Yuan Tsai; Thomas Cha Journal: Med Eng Phys Date: 2020-11-25 Impact factor: 2.242