Revision Spinal Surgery at a University Hospital: Incidence, Causes, and Microbiological Agents in Infected Patients

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Preferred reporting items for systematic reviews and meta-analyses flow chart of population selection.

Table 1

Demographics for patients undergoing primary spinal surgery between 1 January 2015 and 20 May 2018, grouped by the type of surgery.

Characteristic	All Operations (n = 2110)	All Operations With Implants (n = 973)	Decompression/Laminectomy (n = 620)	Open Discectomy (n = 380)	Posterior Spinal Fusion and Fixation (n = 374)	Deformity Surgery (n = 147)	Anterior Spinal Fusion (n = 129)
Women	1035 (49.1)	487 (50.1)	304 (49.0)	181 (47.6)	189 (50.5)	114 (77.6)	55 (42.6)
Age (at primary operation)	55.3 (19.9), 58 (6; 93)	54.2 (21.2), 58 (6; 92)	67.2 (13.5), 70.0 (22; 93)	43.8 (13.7), 41 (16; 89)	62.1 (14.5), 64 (14; 92)	23.7 (17.3), 16 (6; 75)	55,4 (14.8), 54(15; 86)
ASA classification score (at primary operation)
I	715 (33.9)	287 (29.5)	107 (17.3)	235 (61.8)	65 (17.4)	82 (55.8)	48 (37.2)
II	861 (40.8)	395 (40.6)	302 (48.7)	128 (33.7)	175 (46.8)	47 (32.0)	57 (44.2)
III	510 (24.2)	274 (28.2)	205 (33.1)	17 (4.5)	129 (34.5)	18 (12.2)	23 (17.8)
IV	23 (1.1)	16 (1.6)	6 (1.0)	-	5 (1.3)	-	1 (0.8)
V	1 (0.05)	1 (0.1)	-	-	-	-	-
Operating time (min)	119.0 (77.1), 100 (6; 779)	167.0 (78.1), 153 (6; 779)	81.5 (36.0), 75 (19; 312)	62.4 (29.4), 55 (15; 212)	180.0 (73.9), 166(51; 521)	216.9 (94.6), 195 (26; 531)	145.3 (46.1), 137 (65; 331)
Patients requiring reoperation	232 (11.0)	132 (13.6)	60 (9.7)	25 (6.6)	54 (14.4)	28 (19.0)	10 (7.8)
Total number of reoperations	389	263	66	34	118	44	13
Patients requiring >1 reoperation	55 (2.6)	45 (4.6)	4 (0.6)	4 (1.1)	18 (4.8)	11 (7.5)	3 (2.3)

Abbreviations: ASA, American Society of Anesthesiologists.
Note: For categorical variables, n (%) is presented. For continuous variables, the mean (SD), median (min; max) is presented.

Table 2

Reoperation frequency depending on follow-up time for patients undergoing spinal surgery between 1 January 2015 and 20 May 2018.

Follow-Up Time	30 d (n = 2084)	1 y (n = 1633)	2 y (n = 978)	Entire Study Population (n = 2110)
Total number of patients requiring reoperation	116 (5.6)	164 (10.0)	133 (13.6)	232 (11.0)
30-d reoperation frequency	116 (5.6)	96 (5.9)	58 (5.9)	118 (5.6)

Table 3

Causes of reoperations in all groups, with primary causes.

Patient Group	Implant-Related	Infection	Restenosis/ Residual Stenosis	Postoperative Hematoma	Disc Herniation Recurrence	Patient not Experiencing Improvement	Spinal Fluid Leakage	Other
All operations (n = 232)	44 (19.0)	65 (28.0)	31 (13.4)	34 (14.7)	22 (9.5)	14 (6.0)	11 (4.7)	11 (4.7)
All operations with implants (n = 132)	43 (32.6)	58 (43.9)	5 (3.8)	10 (7.6)	1 (0.8)	6 (4.5)	7 (5.3)	2 (1.5)
Posterior spinal fusion and fixation (n = 54)	15 (27.8)	23 (42.6)	1 (1.9)	7 (13.0)	-	3 (5.6)	4 (7.4)	1 (1.9)
Decompression (n = 60)	-	2 (3.3)	21 (35.0)	22 (36.7)	2 (3.3)	7 (11.7)	1 (1.7)	5 (8.3)
Deformity surgery (n = 28)	6 (21.4)	20 (71.4)	-	-	-	1 (3.6)	1 (3.6)	-
Open discectomy (n = 25)	-	2 (8.0)	4 (16.0)	1 (4.0)	16 (64.0)	1 (4.0)	-	1 (4.0)
Anterior spinal fusion (n = 10)	6 (60.0)	1 (10.0)	1 (10.0)	-	-	2 (20.0)	-	-