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. 2020 Aug 24;20(1):301.
doi: 10.1186/s12877-020-01717-2.

Complications rate of and risk factors for the unplanned reoperation of degenerative lumbar spondylolisthesis in elderly patients: a retrospective single-Centre cohort study of 33 patients

Weiyang Zhong  1 , Xinjie Liang  2 , Xiaoji Luo  3 , Tianji Huang  1 , Zhengxue Quan  1
Affiliations

Complications rate of and risk factors for the unplanned reoperation of degenerative lumbar spondylolisthesis in elderly patients: a retrospective single-Centre cohort study of 33 patients

Weiyang Zhong et al. BMC Geriatr. .

Abstract

Background: The study was to investigate the complications rate of and risk factors for unplanned reoperation among elderly patients who underwent posterior lumbar fusion (PLF) for degenerative lumbar spondylolisthesis (DLS).

Methods: A total of 1100 DLS patients who were older than 60 years were reviewed from January 2006 to December 2016. 33 patients underwent unplanned reoperations and were analysed and divided into two groups (group A: posterolateral fusion, 650 patients; group B: intervertebral fusion, 450 patients). Sex, body mass index (BMI), radiographic data and clinical outcome data were analysed to evaluate the complications rate of and the risk factors for unplanned reoperations.

Results: A total of 33 patients underwent unplanned reoperations (3%). The patients were followed up for an average of 4.20 ± 2.25 years (group A) and 4.32 ± 2.54 years (group B) without a significant difference. Significant differences were found in mean age, levels of involvement, hospital stay, surgery time, and blood loss between the groups. The causes of unplanned operation were wound infection, screw misplacement, neurological deficit, nonunion, and screw fracture, which were significant except for wound infection between the groups. Higher BMI (obesity), diabetes mellitus (DM), more bleeding and sex (female) were risk factors for complications. Cases of screw misplacement, neurological deficit, nonunion and screw fracture in group A were more significant than those in group B.

Conclusion: Patients with higher BMI, DM, older age, posterolateral fusion, and female sex predicted a higher incidence of unplanned reoperations. Spine surgeons may need to pay more attention to their preoperative training and to improving surgical techniques that could reduce the reoperation rate.

Keywords: Degenerative lumbar spondylolisthesis; Elderly patients; Risk factor; Unplanned operation.

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Conflict of interest statement

No conflict of interest declared by the authors.

Figures

Fig. 1
Fig. 1
L4 DLS in a patient treated with L4 laminectomy and posterolateral fusion. Because of leg pain, she underwent revision surgery (ab). Postoperative X-ray showed screw displacement. c Postoperative X-ray showed that the screw was corrected and the pain improved. d L4-L5 disc height narrowing and posterolateral fusion were observed at the 48-month follow-up
Fig. 2
Fig. 2
L5 DLS in a patient treated with L5 laminectomy and intervertebral interbody fusion. (a, b) Postoperative X-ray was normal. c The X-ray showed screw displacement and bone union at the 52-month follow-up
Fig. 3
Fig. 3
L4 and L5 DLS in a patient treated with L4/5 laminectomy and intervertebral interbody fusion (L4–5, L5-S1). a The postoperative X-ray was normal. b The X-ray showed bone union and screw displacement, and the patient refused revision surgery at the 12-month follow-up. c The X-ray showed that screw displacement and bone union worsened at the 2-year follow-up. The patient suffered from leg pain, and the patient underwent reoperation
Fig. 4
Fig. 4
L4 DLS in a patient treated with L5 laminectomy and posterolateral fusion. (a, b) Postoperative X-ray was normal. c The X-ray showed screw displacement and fracture at the 36-month follow-up
See this image and copyright information in PMC

References

    1. Matz PG, Meagher RJ, Lamer T, et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis. Spine J. 2016;16(3):439–448. doi: 10.1016/j.spinee.2015.11.055. - DOI - PubMed
    1. Jacobsen S, Sonne-Holm S, Rovsing H, et al. Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study. Spine (Phila Pa1976) 2007;32(1):120–125. doi: 10.1097/01.brs.0000250979.12398.96. - DOI - PubMed
    1. Sclafani JA, Constantin A, Ho PS, et al. Descriptive analysis of spinal neuroaxial injections, surgical interventions, and physical therapy utilization for degenerative lumbar spondylolisthesis within medicare beneficiaries from 2000 to 2011. Spine (Phila Pa 1976) 2017;42(4):240–246. doi: 10.1097/BRS.0000000000001724. - DOI - PMC - PubMed
    1. Gerling MC, Leven D, Passias PG, et al. Risks factors for reoperation in patients treated surgically for degenerative spondylolisthesis: a subanalysis of the 8 year data from the SPORT trial. Spine (Phila Pa 1976) 2017;42(20):1559–1569. doi: 10.1097/BRS.0000000000002196. - DOI - PMC - PubMed
    1. Forsth P, Olafsson G, Carlsson T, et al. A randomized, controlled trial of fusion surgery for lumbar spinal stenosis. N Engl J Med. 2016;374(15):1413–1423. doi: 10.1056/NEJMoa1513721. - DOI - PubMed

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