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Long-Term Reoperation Rates After Single-Level Lumbar Discectomy: A Nationwide Cohort Study.

Suhas K Etigunta1, Andy M Liu1, Adeesya Gausper2

  • 1Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.

Spine
|March 14, 2025
PubMed
Summary
This summary is machine-generated.

Reoperation after single-level lumbar discectomy occurred in 14.4% of patients within five years. Revision discectomy had a higher reoperation rate of 18.2%, highlighting the need for careful surgical planning.

Keywords:
discectomysubsequent lumbar fusionsubsequent lumbar surgerysurvival analysis

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spinal Surgery

Background:

  • Reoperation rates after single-level lumbar discectomy vary widely (5-24%).
  • Accurate reoperation rates are crucial for patient and provider education.
  • Understanding reoperation trends informs surgical decision-making.

Purpose of the Study:

  • To evaluate reoperation rates following single-level lumbar discectomy.
  • To assess subsequent lumbar surgery and fusion rates within five years.
  • To identify risk factors for reoperation after lumbar discectomy.

Main Methods:

  • Retrospective cohort study utilizing the PearlDiver database.
  • Inclusion of patients aged 18+ with a minimum five-year follow-up.
  • Analysis of subsequent lumbar surgery, revision discectomy, and fusion rates using Kaplan-Meier and Cox regression.

Main Results:

  • A total of 308,979 patients were analyzed.
  • The five-year subsequent lumbar surgery rate was 14.4%; fusion rate was 6.1%.
  • Revision discectomy patients had an 18.2% five-year subsequent surgery rate and 12.4% fusion rate. Obesity and higher Elixhauser Comorbidity Index predicted reoperation.

Conclusions:

  • Single-level lumbar discectomy has a 14.4% five-year reoperation rate, increasing to 18.2% after revision surgery.
  • This study represents the largest cohort to date on reoperation rates.
  • Patients require counseling on reoperation risks, especially after revision discectomy, and careful consideration for fusion procedures is needed.