原发性椎间盘切除术后椎间盘突出症的公开发生率约为6%,但患者在接受椎间盘翻修术后的最终再手术结果尚不清楚.此外,初次/翻修椎间盘切除术后,术后椎间盘翻修术(SRD)与术后腰椎融合术(SLF)结果的差异仍未得到充分研究.
分别确定初次/翻修椎间盘切除术后8年SRD/SLF发生率和直至SRD/SLF的时间。
回顾性队列研究。
接受初次或修正椎间盘切除术的患者,2010年至2019年PearlDiver患者记录数据库中的记录。
后续手术类型和后续手术时间。
从2010年到PearlDiver患者记录数据库中的19个保险数据集,使用ICD9/10和CPT程序代码,根据“索引”程序(初次或修正椎间盘切除术)的性质,将患者分为初次或修正椎间盘切除术队列。收集术前人口统计学数据。在PearlDiverMariner数据库中前瞻性地收集了诸如后续手术类型(融合或椎间盘切除术)和后续手术时间等结果指标。使用BellWeather统计软件进行统计分析。对每个队列进行SLF/SRD时间的Kaplan-Meier生存分析,和对数秩检验用于比较队列之间的SLF/SRD率。
共确认20,147例患者(17,849例原发性椎间盘切除术,2,298修正椎间盘切除术)。8年SRD发生率(修订队列中6.1%,初级队列中的4.8%,p<.01)和SLF(修订队列中的10.4%,初级队列中的6.2%,p<.01)在翻修后比原发性椎间盘切除术后更高。与原发性椎间盘切除术相比,翻修后的SLF时间较短(709与886天,p<.01)。在初次和修正椎间盘切除术后,8年SLF率(修订队列中为10.4%,初级队列中的6.2%,p<.01)大于SRD(修订队列中的6.1%,初级队列中的4.8%,p<.01)。
与原发性椎间盘切除术相比,椎间盘翻修术的SLF发生率较高(10.4%vs.6.2%),和更快的SLF时间(2.4与1.9年),随访8年。
Published rates for disc reherniation following primary discectomy are around 6%, but the ultimate reoperation outcomes in patients after receiving revision discectomy are not well understood. Additionally, any disparity in the outcomes of subsequent revision discectomy (SRD) versus subsequent lumbar fusion (SLF) following primary/revision discectomy remains poorly studied.
To determine the 8-year SRD/SLF rates and time until SRD/SLF after primary/revision discectomy respectively.
Retrospective cohort
study.
Patients undergoing primary or revision discectomy, with records in the
PearlDiver Patient Records Database from the years 2010 to 2019.
Subsequent surgery type and time to subsequent surgery.
Patients were grouped into primary or revision discectomy cohorts based off of the nature of \"index\" procedure (primary or revision discectomy) using ICD9/10 and CPT procedure codes from 2010 to 19 insurance data sets in the
PearlDiver Patient Records Database. Preoperative demographic data was collected. Outcome measures such as subsequent surgery type (fusion or discectomy) and time to subsequent surgery were collected prospectively in
PearlDiver Mariner database. Statistical analysis was performed using BellWeather statistical software. A Kaplan-Meier survival analysis of time to SLF/SRD was performed on each cohort, and log-rank test was used to compare the rates of SLF/SRD between cohorts.
A total of 20,147 patients were identified (17,849 primary discectomy, 2,298 revision discectomy). The 8-year rates of SRD (6.1% in revision cohort, 4.8% in primary cohort, p<.01) and SLF (10.4% in revision cohort, 6.2% in primary cohort, p<.01) were higher after revision versus primary discectomy. Time to SLF was shorter after revision versus primary discectomy (709 vs. 886 days, p<.01). After both primary and revision discectomy, the 8-year rate of SLF (10.4% in revision cohort, 6.2% in primary cohort, p<.01) is greater than SRD (6.1% in revision cohort, 4.8% in primary cohort, p<.01).
Compared to primary discectomy, revision discectomy has higher rates of SLF (10.4% vs. 6.2%), and faster time to SLF (2.4 vs. 1.9 years) at 8-year follow up.