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

被引：27

作者：

Kobayashi, Kazuyoshi ^{[1
]}

Ando, Kei ^{[1
]}

Kato, Fumihiko ^{[2
]}

Kanemura, Tokumi ^{[3
]}

Sato, Koji ^{[4
]}

Hachiya, Yudo ^{[5
]}

Matsubara, Yuji ^{[6
]}

Kamiya, Mitsuhiro ^{[7
]}

Sakai, Yoshihito ^{[8
]}

Yagi, Hideki ^{[9
]}

Shinjo, Ryuichi ^{[10
]}

Nishida, Yoshihiro ^{[1
]}

Ishiguro, Naoki ^{[1
]}

Imagama, Shiro ^{[1
]}

机构：

[1] Nagoya Univ, Grad Sch Med, Dept Orthopaed Surg, Showa Ku, 65 Tsurumai Cho, Nagoya, Aichi 4668560, Japan

[2] Chubu Rosai Hosp, Dept Orthopaed Surg, Minato Ku, 1-10-6 Komei, Nagoya, Aichi 4558530, Japan

[3] Konan Kousei Hosp, Dept Orthopaed Surg, 137 Omatsubara,Takaya Cho, Konan, Aichi 4838704, Japan

[4] Japanese Red Cross Nagoya Daini Hosp, Dept Orthopaed Surg, Showa Ku, 2-9 Myoken Cho, Nagoya, Aichi 4668650, Japan

[5] Hachiya Orthopaed Hosp, Dept Orthopaed Surg, Chikusa Ku, 2-4 Suemoridori, Nagoya, Aichi 4640821, Japan

[6] Kariya Toyota Gen Hosp, Dept Orthopaed Surg, 15 Sumiyoshi Cho5, Kariya, Aichi 4488505, Japan

[7] Aichi Med Univ, Dept Orthopaed Surg, 1-1 Iwasaku, Nagakute, Aichi 4801195, Japan

[8] Natl Ctr Geriatr & Gerontol, Dept Orthopaed Surg, 7-430 Morioka Cho, Obu, Aichi 4748511, Japan

[9] Japanese Red Cross Nagoya Daiichi Hosp, Dept Orthopaed Surg, Nakamura Ku, 3-35 Michishita Cho, Nagoya, Aichi 4538511, Japan

[10] Anjo Kosei Hosp, Dept Orthopaed Surg, 28 Higashi Kohan,Anjo Cho, Anjo, Aichi 4468602, Japan

来源：

EUROPEAN SPINE JOURNAL | 2018年 / 27卷 / 08期

关键词：

Reoperation; Multicenter; Posterior lumbar interbody fusion (PLIF); Transforaminal lumbar interbody fusion (TLIF); Complications; Surgical site infection; Epidural hematoma; Adjacent segment degeneration; Invasiveness; Screw misplacement; Dural tear; ADJACENT-SEGMENT DEGENERATION; PEDICLE SCREW INSTRUMENTATION; OF-THE-LITERATURE; AGED; 80; YEARS; SPINAL-FUSION; RISK-FACTORS; FOLLOW-UP; JAPAN ASSOCIATION; BONE-GRAFT; SURGERY;

D O I：

10.1007/s00586-018-5508-1

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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. 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. 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. 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. These slides can be retrieved under Electronic Supplementary Material. [GRAPHICS] .

引用

页码：1972 / 1980

页数：9

共 45 条

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