The Long-term Reoperation Rate Following Surgery for Lumbar Stenosis: A Nationwide Sample Cohort Study With a 10-year Follow-up
- Authors
- Jung, Jong-myung; Chung, Chun Kee; Kim, Chi Heon; Choi, Yunhee; Kim, Min-Jung; Yim, Dahae; Yang, Seung Heon; Lee, Chang Hyun; Hwang, Sung Hwan; Kim, Dong Hwan; Yoon, Joon Ho; Park, Sung Bae
- Issue Date
- Sep-2020
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Citation
- SPINE, v.45, no.18, pp.1277 - 1284
- Journal Title
- SPINE
- Volume
- 45
- Number
- 18
- Start Page
- 1277
- End Page
- 1284
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/80089
- DOI
- 10.1097/BRS.0000000000003515
- ISSN
- 0362-2436
- Abstract
- STUDY DESIGN: Retrospective cohort study of a nationwide sample database. OBJECTIVE: The objective of the present study was to compare the long-term incidence of reoperation for lumbar spinal stenosis (LSS) after anterior fusion, posterior fusion, and decompression. SUMMARY OF BACKGROUND DATA: Surgical treatment for LSS can be largely divided into 2 categories: decompression only and decompression with fusion. A previous nationwide study reported that fusion surgery was performed in 10% of patients with LSS, and the 10-year reoperation rate was approximately 17%. However, with the development of surgical techniques and changes in surgical trends, these results should be reassessed. METHODS: The National Health Insurance Service-National Sample Cohort of the Republic of Korea was utilized to establish a cohort of adult patients (N = 1400) who first underwent surgery for LSS during 2005 to 2007. Patients were followed for 8 to 10 years. Considering death before reoperation as a competing event, reoperation hazards were compared among surgical techniques using a Fine and Gray regression model after adjustment for sex, age, diabetes, osteoporosis, Charlson comorbidity index, severity of disability, type of medical coverage, and type of hospital. RESULTS: The overall cumulative incidence of reoperation was 6.2% at 2 years, 10.8% at 5 years, and 18.4% at 10 years. The cumulative incidence of reoperation was 20.6%, 12.6%, and 18.6% after anterior fusion, posterior fusion, and decompression, respectively, at 10 years postoperatively (P = 0.44). The first surgical technique did not affect the reoperation type (P = 0.27). Decompression was selected as the surgical technique for reoperation in 83.5% of patients after decompression, in 72.7% of patients after anterior fusion, and in 64.3% of patients after posterior fusion. CONCLUSION: The initial surgical technique did not affect reoperation during the 10-year follow-up period. Decompression was the most commonly used technique for reoperation.4.
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