Causes and Timing of Reoperation after Thoraco-Lumbar Spine Surgery

Jae Chul Lee; Seong-Seok Yang; Hyeong-Mo Ku; Byung-Joon Shin

doi:10.4055/jkoa.2013.48.4.251

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Lee, Yang, Ku, and Shin: Causes and Timing of Reoperation after Thoraco-Lumbar Spine Surgery

Original Article

Journal of the Korean Orthopaedic Association 2013; 48(4): 251-257.

Published online: 28 August 2013

DOI: https://doi.org/10.4055/jkoa.2013.48.4.251

Causes and Timing of Reoperation after Thoraco-Lumbar Spine Surgery

Jae Chul Lee, M.D., Seong-Seok Yang, M.D., Hyeong-Mo Ku, M.D., Byung-Joon Shin, M.D.

Department of Orthopaedic Surgery, Soon Chun Hyang University Seoul Hospital, Soon Chun Hyang University College of Medicine, Seoul, Korea.

Correspondence to: Byung-Joon Shin, M.D. Department of Orthopaedic Surgery, Soon Chun Hyang University Seoul Hospital, Soonchunhyang University College of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul 140-743, Korea. TEL: +82-2-709-9250, FAX: +82-2-794-9414, schsbj@schmc.ac.kr

Received 24 January 2013 Revised 29 April 2013 Accepted 6 May 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We analyzed the patients who needed reoperation after undergoing a thoracolumbar spine operation and investigated the causes, pattern of timing, medical history and clinical outcome after reoperation.

Materials and Methods

Out of 2,198 patients who underwent spine surgery for thoracolumbar spine disease from 1988 to 2011, we targeted 193 patients who underwent reoperation. We studied the causes, operative method of initial surgery, time-variant causes and outcome of reoperation.

Results

The number of patients who underwent thoracolumbar spine reoperation was 193 out of 2,198 and the reoperation rate was 8.7%. We researched time-variant causes of reoperation. In six weeks after the initial operation, exploration for hematoma and neurologic deficit was 18 (26.8%), recurred heniated intervertebral disc (HIVD) was 18 (26.8%), and surgical site infection was 17 (25.4%). From six weeks to six months, recurred HIVD was 10 (47.6%), surgical site infection was 7 (33.3%), and after six months, adjacent segmental disease (ASD) was 38 (35.7%), recurred HIVD was 26 (23.2%), and implant related problem was 17 (16.0%).

Conclusion

Causes of thoracolumbar spine reoperation included complications (2.8%); infection, hematoma, neurologic deficit, incomplete decompression, and natural courses (5.9%); ASD, recurred HIVD, implant related problem, instability after decompression, tumor recur, progression of deformity.

Keywords: thoracolumbar, spine, reoperation, causes, timing

Figures and Tables

Table 1

Method of Initial Thoraco-Lumbar Spine Surgery and Postoperative Follow up Period

Table 2

Initial Operation Method and Duration from the First Operation to Reoperation on ASD

ASD, adjacent segment diseases; PLIF, posterior lumbar interbody fusion; PLF, posterolateral fusion; ALIF, anterior lumbar interbody fusion.

Table 3

Infection Classified according to Timing of Superficial and Deep Infection

Table 4

Causes and Timing of Reoperation Thoraco-Lumbar Spine Surgery

Values are presented as number. HIVD, heniated intervertebral disc; ASD, adjacent segment diseases; SSI, surgical site infection.

Table 5

Comparison of Causes between Single and Multiple Reoperation

HIVD, heniated intervertebral disc; ASD, adjacent segment diseases; SSI, surgical site infection.

Table 6

Follow-up of Clinical Outcome after Reoperation

LBP, low back pain; RP, radiating pain; ODI, Oswestry disability index.

Table 7

Comparison of Reoperation Rates among Other Literature Studies

PSSS, post-spinal spine surgery; HIVD, heniated intervertebral disc.

Notes

The abstract of this article was announced at 2012 The Korean Orthopedic Association Annual Fall Congress.

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