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Association between lumbar discectomy and subsequent cervical discectomy
QJM : Monthly Journal of the Association of Physicians
|February 10, 2015
Summary
Patients who undergo lumbar discectomy (LD) face a significantly higher risk of subsequent cervical discectomy (CD). This increased risk for CD after LD is substantial and affects all patient groups.
Area of Science:
- Spine surgery outcomes
- Epidemiology of spinal disorders
Background:
- Lumbar discectomy (LD) is a prevalent spinal surgical procedure.
- The impact of prior LD on subsequent cervical spine issues remains under-explored.
- Understanding the comparative incidence of cervical discectomy (CD) after LD is crucial.
Purpose of the Study:
- To investigate the association between lumbar discectomy (LD) and the subsequent risk of cervical discectomy (CD).
- To quantify the increased risk of CD in patients with a history of LD compared to those without.
Main Methods:
- A cohort comparative study was conducted using Taiwanese National Health Research Institute data (1996-2010).
- Included 14,480 patients without LD and 3,620 patients who underwent LD.
- Calculated incidence rates of CD and analyzed comorbidities like fracture and osteoporosis.
Main Results:
- The incidence rate of CD was markedly higher in the LD group (24.7 per 10,000 person-years) versus the non-LD group (2.73 per 10,000 person-years).
- Patients treated with LD showed approximately a 9-fold increased risk of subsequent CD (Hazard Ratio = 8.58).
Conclusions:
- Undergoing lumbar discectomy significantly elevates the risk of requiring a subsequent cervical discectomy.
- This heightened risk is consistent across various demographics and patient comorbidities, including fracture and osteoporosis.
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