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08.02.2018 | Original Article

Reoperation within 2 years after lumbar interbody fusion: a multicenter study

verfasst von: Kazuyoshi Kobayashi, Kei Ando, Fumihiko Kato, Tokumi Kanemura, Koji Sato, Yudo Hachiya, Yuji Matsubara, Mitsuhiro Kamiya, Yoshihito Sakai, Hideki Yagi, Ryuichi Shinjo, Yoshihiro Nishida, Naoki Ishiguro, Shiro Imagama

Erschienen in: European Spine Journal | Ausgabe 8/2018

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Abstract

Purpose

Posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) can have complications that require reoperation. The goal of the study was to identify risk factors for reoperation within 2 years after PLIF/TLIF.

Methods

A retrospective analysis of a prospective multicenter database was performed for patients who underwent PLIF/TLIF. A total of 1363 patients (689 males and 674 females) were identified, with an average age of 65.9 years old. Comorbidities, perioperative ASA grade, and operative factors were compared between patients with and without reoperation. Risk factors for reoperation were identified in multivariate logistic analysis.

Results

There were 38 reoperations within 2 years after PLIF/TLIF (2.8%). The original surgical procedures were open PLIF (n = 26), open TLIF (n = 10), and minimally invasive surgery (n = 2). Reoperation was due to adjacent segment degeneration (ASD) (n = 10), surgical site infection (SSI) (n = 9), screw misplacement (n = 6), postoperative epidural hematoma (n = 6), pseudoarthrosis (n = 4), and cage protrusion (n = 3). Number of levels fused and dural tear were significantly associated with reoperation. In analysis of complications requiring reoperation, SSI was related to diabetes mellitus and dural tear, and postoperative epidural hematoma was related to fusion of two or more levels, EBL, and operation time. In multivariate logistic regression, fusion of two or more levels (HR 2.19) was significantly associated with reoperation.

Conclusion

Surgical invasiveness, as reflected by number of fused levels, operation time, EBL and dural tear, was associated with reoperation. Fusion of two or more levels is a strong risk factor for reoperation within 2 years after initial PLIF/TLIF.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

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Titel: Reoperation within 2 years after lumbar interbody fusion: a multicenter study
verfasst von: Kazuyoshi Kobayashi
Kei Ando
Fumihiko Kato
Tokumi Kanemura
Koji Sato
Yudo Hachiya
Yuji Matsubara
Mitsuhiro Kamiya
Yoshihito Sakai
Hideki Yagi
Ryuichi Shinjo
Yoshihiro Nishida
Naoki Ishiguro
Shiro Imagama
Publikationsdatum: 08.02.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 8/2018
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-018-5508-1

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Springer Medizin

Reoperation within 2 years after lumbar interbody fusion: a multicenter study

Abstract

Purpose

Methods

Results

Conclusion

Graphical abstract

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Update Orthopädie und Unfallchirurgie

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Graphical abstract

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