Reoperation within 2 years after lumbar interbody fusion: a multicenter study
| Autor: | Koji Sato, Ryuichi Shinjo, Naoki Ishiguro, Fumihiko Kato, Kei Ando, Yuji Matsubara, Hideki Yagi, Yoshihiro Nishida, Mitsuhiro Kamiya, Yudo Hachiya, Tokumi Kanemura, Shiro Imagama, Kazuyoshi Kobayashi, Yoshihito Sakai |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Bone Screws Operative Time 03 medical and health sciences 0302 clinical medicine Epidural hematoma Lumbar interbody fusion Risk Factors medicine Humans Minimally Invasive Surgical Procedures Orthopedics and Sports Medicine Prospective Studies Risk factor Aged Retrospective Studies 030222 orthopedics Lumbar Vertebrae business.industry Dural tear Perioperative Middle Aged medicine.disease Hematoma Epidural Spinal Surgery Pseudarthrosis Spinal Fusion Multicenter study Female Neurosurgery business Surgical site infection 030217 neurology & neurosurgery |
| Zdroj: | European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 27(8) |
| ISSN: | 1432-0932 |
| Popis: | 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. 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. 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. 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. These slides can be retrieved under Electronic Supplementary Material. |
| Databáze: | OpenAIRE |
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