Surgical site infection most common reason for early reoperation following lumbar fusion surgery

Written By : Dr Supreeth D R |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 22 Aug 2022 3:00 PM | Updated On 22 Aug 2022 3:00 PM

Shuai Kang Wang et al conducted a retrospective cohort study to determine the rates and indications of reoperations following primary lumbar fusion, as well as the independent risk factors for early and late reoperation. The study was conducted at Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing , China.

The authors found that - the most common reasons for early reoperation and late operation were surgical site infection and adjacent segment diseases, respectively. Osteoporosis and diabetes were independent risk factors for early reoperation, and multilevel fusion was independent risk factor for late reoperation.

The researchers retrospectively reviewed patients who underwent lumbar fusion surgery. All patients were followed up for more than 2 years. Characteristics, laboratory tests, primary diagnosis and surgery related variables were compared among the early reoperation (3 months) and the non-reoperation groups. Multivariable logistic regression analysis was used to identify independent risk factors for early and late reoperations.

Inclusion criteria for this study were: (1) age older than 18 years, (2) patients underwent elective primary TLIF surgery due to the failure of conservative treatment and (3) surgical segments less than six. Then, patients diagnosed with spinal fracture, any spinal infection or any malignancy was excluded; patients with follow-up times less than 2 years were also excluded.

The observations of the study were:

• Of 821 patients included in study, 34 patients underwent early reoperation, and 36 patients underwent late reoperation.

• The cumulative reoperation rate was about

4.1% (95% CI 3.8–4.5%) at 3 months,

6.2% (95% CI 5.9–6.5%) at 1 year and

8.2% (95% CI 8.0–8.5%) at 3 years.

• Multivariable analysis indicated that osteoporosis (odds ratio [OR] 3.6, 95% CI 1.2–10.5, p=0.02) and diabetes (OR 2.1, 95% CI 1.1–4.5, p=0.04) were independently associated with early reoperation and multilevel fusion (OR 2.4, 95% CI 1.1–5.4, p=0.03) was independently associated with late reoperation.

• Age, weight, BMI, operative time and estimated blood loss (EBL) were not significantly associated with reoperation.

The authors commented "Although the patient's lower back pain was significantly improved after the reoperation, the VAS score was lower in the non-reoperation group than in the reoperation group at the final follow up point. The future studies should consider the effects of follow up periods on results."

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751