Moon Soo Park1, Young-Su Ju2, Seong-Hwan Moon3, Tae-Hwan Kim4, Jae Keun Oh5, Paul S Sung6, Chi Heon Kim7, Chun Kee Chung7, Ho Guen Chang4. 1. Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, 22 Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, Republic of Korea. Electronic address: amhangpark@gmail.com. 2. Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Medical College of Hallym University, 22 Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, Republic of Korea. 3. Department of Orthopaedic Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. 4. Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, 22 Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, Republic of Korea. 5. Department of Neurosurgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, 22 Gwanpyeong-ro 170 beon-gi, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, Republic of Korea. 6. Department of Physical Therapy/Motion Analysis Center, Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University, Health Professions Building, 1220, Mt. Pleasant, MI 48859, USA. 7. Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Neurosurgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Neuroscience Research Institute, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Clinical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Brain and Cognitive Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
Abstract
OBJECTIVE: The reoperation rate after lumbar degenerative disease surgery is low. It is difficult to find statistical differences in reoperation rates according to the different diagnoses of lumbar degenerative diseases. National population-based database overcomes the statistical problem by its large cohorts with longitudinal follow-up in a nation. The purpose was to compare the reoperation rates after single-level lumbar spinal posterior decompression and fusion surgeries depending on different preoperative diagnoses of lumbar degenerative disease. PATIENTS AND METHODS: We used the Korean Health Insurance Review & Assessment Service national database. The study population was the patients with a diagnosis of a degenerative lumbar disease who underwent single-level decompression and fusion from January 1, 2011, to June 30, 2016. We classified the patients into one of three groups based on diagnosis codes of lumbar disc herniation, spondylolisthesis, or spinal stenosis. A reoperation was defined as repeated decompression and fusion. We considered age, sex, the presence of diabetes, osteoporosis, associated comorbidities, and hospital types as potential confounding factors. RESULTS: The reoperation rate was higher in patients with spinal stenosis than in those with lumbar disc herniation. However, there was no difference in the reoperation rate between the patients with lumbar disc herniation and those with spondylolisthesis. Male gender and hospital type were risk factors for reoperation. CONCLUSION: The incidence of reoperation was dependent on the diagnostic subgroups of lumbar degenerative diseases. This information can help surgeons accurately communicate with their patients and enhance the preoperative informed consent process.
OBJECTIVE: The reoperation rate after lumbar degenerative disease surgery is low. It is difficult to find statistical differences in reoperation rates according to the different diagnoses of lumbar degenerative diseases. National population-based database overcomes the statistical problem by its large cohorts with longitudinal follow-up in a nation. The purpose was to compare the reoperation rates after single-level lumbar spinal posterior decompression and fusion surgeries depending on different preoperative diagnoses of lumbar degenerative disease. PATIENTS AND METHODS: We used the Korean Health Insurance Review & Assessment Service national database. The study population was the patients with a diagnosis of a degenerative lumbar disease who underwent single-level decompression and fusion from January 1, 2011, to June 30, 2016. We classified the patients into one of three groups based on diagnosis codes of lumbar disc herniation, spondylolisthesis, or spinal stenosis. A reoperation was defined as repeated decompression and fusion. We considered age, sex, the presence of diabetes, osteoporosis, associated comorbidities, and hospital types as potential confounding factors. RESULTS: The reoperation rate was higher in patients with spinal stenosis than in those with lumbar disc herniation. However, there was no difference in the reoperation rate between the patients with lumbar disc herniation and those with spondylolisthesis. Male gender and hospital type were risk factors for reoperation. CONCLUSION: The incidence of reoperation was dependent on the diagnostic subgroups of lumbar degenerative diseases. This information can help surgeons accurately communicate with their patients and enhance the preoperative informed consent process.