5-year reoperation rates after different types of lumbar spine surgery

Alex D. Malter, Brad McNeney, John D. Loeser, Richard (Rick) Deyo

Research output: Contribution to journalArticle

172 Citations (Scopus)

Abstract

Study Design. Population-based cohort study of Washington State patients who underwent lumbar spine surgery for degenerative conditions in 1988. Objectives. To compare complications and reoperation rates during the 5-year period after surgery between patients who have undergone lumbar spine fusion surgery and those who have undergone laminectomy or discectomy alone. Summary of Background Data. Spinal fusion is associated with wider surgical exposure, more extensive dissection, and longer operative times than lumbar surgery without fusion, and previous studies have shown higher complication rates and hospital charges associated with these more complex procedures. In elderly patients spinal fusion operations were associated with higher mortality rates than laminectomy or discectomy, alone, and reoperation rates were not lower. In the current study, reoperations, mortality, and complications following lumbar spine surgery were examined for the general population. Methods. A statewide hospital discharge database was used to identify all Washington patients who underwent spine surgery in 1988 and to determine the rate of reoperation during the subsequent 5 years. Administrative records also were used to identify complications, mortality, and hospital charges associated with the operations. Unadjusted complication and reoperation rates for the groups were compared using chisquare statistics. Adjusted rates were compared using logistic regression and proportional hazards (Cox) regression after controlling for age, gender, prior spine surgery, diagnosis, comorbidity type of surgery, and coverage by Workers' Compensation. Results. Of 6376 patients who underwent lumbar surgery for degenerative conditions in Washington in 1988, 1041 (16%) had operations involving spine fusion. Diagnoses of degenerative disc disease or possible instability were more frequent among patients undergoing fusion surgery, whereas herniated discs were more frequent among those undergoing discectomy or laminectomy alone. Complications were recorded in 18% of fusion patients and 7% of nonfusion patients (P

Original languageEnglish (US)
Pages (from-to)814-820
Number of pages7
JournalSpine
Volume23
Issue number7
DOIs
StatePublished - Apr 1 1998
Externally publishedYes

Fingerprint

Reoperation
Spine
Diskectomy
Laminectomy
Hospital Charges
Spinal Fusion
Mortality
Workers' Compensation
Intervertebral Disc Displacement
Operative Time
Population
Dissection
Comorbidity
Cohort Studies
Logistic Models
Databases

Keywords

  • Cohort studies
  • Health resources
  • Lumbar vertebrae
  • Multivariate analysis
  • Outcome assessment health care
  • Postoperative complications
  • Reoperations
  • Spinal fusion

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

5-year reoperation rates after different types of lumbar spine surgery. / Malter, Alex D.; McNeney, Brad; Loeser, John D.; Deyo, Richard (Rick).

In: Spine, Vol. 23, No. 7, 01.04.1998, p. 814-820.

Research output: Contribution to journalArticle

Malter, Alex D. ; McNeney, Brad ; Loeser, John D. ; Deyo, Richard (Rick). / 5-year reoperation rates after different types of lumbar spine surgery. In: Spine. 1998 ; Vol. 23, No. 7. pp. 814-820.
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