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Reoperation Rates After Single-level Lumbar Discectomy.
Patrick Heindel1, Alexander Tuchman2, Patrick C Hsieh2
1Departments of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Spine
|August 23, 2016
Summary
Reoperation after single-level lumbar discectomy occurs in 12.2% of patients within 4 years. A significant portion of these patients undergo lumbar fusion, highlighting the need for improved treatment strategies.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Health Services Research
Background:
- Single-level lumbar discectomy is a common procedure for radiculopathy due to disc herniation.
- While effective for rapid symptom relief, population-level data on reoperation rates is limited.
Purpose of the Study:
- To investigate the trends and rates of reoperation following single-level lumbar discectomy.
- To analyze the subsequent procedures, including lumbar fusion, after initial discectomy.
Main Methods:
- Retrospective analysis of a national insurance billing database.
- Utilized PearlDiver software to identify patients undergoing hemilaminotomy and disc removal (January 2007-September 2014).
- Followed patients for up to 4 years to track recurrent lumbar surgeries.
Main Results:
- The 4-year reoperation rate after single-level lumbar discectomy was 12.2%.
- Lumbar spinal fusion was performed in 5.9% of patients within 4 years.
- Re-exploration discectomy within 2 years led to lumbar fusion in 38.4% of cases within 4 years post-reoperation.
- Average additional cost of reoperation was ~$11,161 per patient annually.
Conclusions:
- A significant reoperation rate exists after single-level lumbar discectomy, with a notable progression to lumbar fusion.
- Findings provide crucial data for shared decision-making between surgeons and patients regarding reoperation risks.
- Further research is needed to establish optimal treatment algorithms for reherniation or instability post-discectomy.
