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Reoperation within 2 years after lumbar interbody fusion: a multicenter study

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Abstract

Purpose

Posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) can have complications that require reoperation. The goal of the study was to identify risk factors for reoperation within 2 years after PLIF/TLIF.

Methods

A retrospective analysis of a prospective multicenter database was performed for patients who underwent PLIF/TLIF. A total of 1363 patients (689 males and 674 females) were identified, with an average age of 65.9 years old. Comorbidities, perioperative ASA grade, and operative factors were compared between patients with and without reoperation. Risk factors for reoperation were identified in multivariate logistic analysis.

Results

There were 38 reoperations within 2 years after PLIF/TLIF (2.8%). The original surgical procedures were open PLIF (n = 26), open TLIF (n = 10), and minimally invasive surgery (n = 2). Reoperation was due to adjacent segment degeneration (ASD) (n = 10), surgical site infection (SSI) (n = 9), screw misplacement (n = 6), postoperative epidural hematoma (n = 6), pseudoarthrosis (n = 4), and cage protrusion (n = 3). Number of levels fused and dural tear were significantly associated with reoperation. In analysis of complications requiring reoperation, SSI was related to diabetes mellitus and dural tear, and postoperative epidural hematoma was related to fusion of two or more levels, EBL, and operation time. In multivariate logistic regression, fusion of two or more levels (HR 2.19) was significantly associated with reoperation.

Conclusion

Surgical invasiveness, as reflected by number of fused levels, operation time, EBL and dural tear, was associated with reoperation. Fusion of two or more levels is a strong risk factor for reoperation within 2 years after initial PLIF/TLIF.

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Funding

Funding was from institutional sources only.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan

    Kazuyoshi Kobayashi, Kei Ando, Yoshihiro Nishida, Naoki Ishiguro & Shiro Imagama

  2. Department of Orthopaedic Surgery, Chubu Rosai Hospital, 1-10-6, Komei, Minato-ku, Nagoya, 455-8530, Japan

    Fumihiko Kato

  3. Department of Orthopaedic Surgery, Konan Kousei Hospital, 137, Omatsubara, Takaya-cho, Konan, Aichi, 483-8704, Japan

    Tokumi Kanemura

  4. Department of Orthopaedic Surgery, Japanese Red Cross Nagoya Daini Hospital, 2-9, Myoken-cho, Showa-ku, Nagoya, 466-8650, Japan

    Koji Sato

  5. Department of Orthopaedic Surgery, Hachiya Orthopaedic Hospital, 2-4, Suemoridori, Chikusa-ku, Nagoya, 464-0821, Japan

    Yudo Hachiya

  6. Department of Orthopaedic Surgery, Kariya Toyota General Hospital, 15, Sumiyoshi-cho5, Kariyashi, Aichi, 448-8505, Japan

    Yuji Matsubara

  7. Department of Orthopaedic Surgery, Aichi Medical University, 1-1, Iwasaku, Nagakute, Aichi, 480-1195, Japan

    Mitsuhiro Kamiya

  8. Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan

    Yoshihito Sakai

  9. Department of Orthopaedic Surgery, Japanese Red Cross Nagoya Daiichi Hospital, 3-35, Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan

    Hideki Yagi

  10. Department of Orthopaedic Surgery, Anjo Kosei Hospital, 28, Higashi-Kohan, Anjo-cho, Anjo, Aichi, 446-8602, Japan

    Ryuichi Shinjo

Authors
  1. Kazuyoshi Kobayashi
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  2. Kei Ando
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  4. Tokumi Kanemura
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  5. Koji Sato
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  7. Yuji Matsubara
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  8. Mitsuhiro Kamiya
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  9. Yoshihito Sakai
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  10. Hideki Yagi
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  11. Ryuichi Shinjo
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  12. Yoshihiro Nishida
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  13. Naoki Ishiguro
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  14. Shiro Imagama
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Corresponding author

Correspondence to Shiro Imagama.

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Kobayashi, K., Ando, K., Kato, F. et al. Reoperation within 2 years after lumbar interbody fusion: a multicenter study. Eur Spine J 27, 1972–1980 (2018). https://doi.org/10.1007/s00586-018-5508-1

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  • DOI: https://doi.org/10.1007/s00586-018-5508-1

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