Characterization and Risk Factor Analysis for Reoperation After Microendoscopic Diskectomy.
Orthopedics
; 38(6): e490-6, 2015 Jun.
Article
em En
| MEDLINE
| ID: mdl-26091222
ABSTRACT
A population-based database of 1263 consecutive patients who underwent microendoscopic diskectomy for single-level lumbar disk herniation between 2005 and 2010 was retrospectively analyzed to identify causes and characteristics of reoperation and associated risk factors. A total of 952 patients were eligible. Of these, 58 had revision spinal surgery. Causes and clinical parameters were retrospectively assessed, and possible risk factors were evaluated by multivariate logistic regression analysis. In total, 76 disk herniations were excised with revision diskectomy, with or without interbody fusion. The overall mean interval between primary surgery and revision surgery was 39.05 months (range, 2-95 months). Cumulative overall reoperation rates gradually increased from 1.56% at 1 year to 8.17% after nearly 10 years. Reoperated patients were older and had a higher level of lumbar degeneration, with severe Modic changes (type 1, 17.2%; type 2, 34.5%), vs patients without reoperation (type 1, 1.5%; type 2, 30.6%). In addition, patients with reoperation had a higher rate of obvious adjacent disk degeneration (81.1%). Logistic regression analysis showed that adjacent segment degeneration and Pfirrmann grading for disk degeneration were significant risk factors for reoperation after primary microendoscopic diskectomy (odds ratios, 2.448 and 1.510, respectively). The current study reported a relatively low incidence of reoperation after primary microendoscopic diskectomy. Adjacent segment degeneration and Pfirrmann grading for disk degeneration were identified as risk factors for reoperation after microendoscopic diskectomy to treat lumbar disk herniation. Treatment options for patients with these factors at the first visit should be carefully evaluated.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Reoperação
/
Discotomia
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Deslocamento do Disco Intervertebral
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Vértebras Lombares
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
/
Male
País/Região como assunto:
Asia
Idioma:
En
Revista:
Orthopedics
Ano de publicação:
2015
Tipo de documento:
Article