Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Medical College of Hallym University, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, Republic of Korea.
Department of Occupational and Environmental Medicine, National Medical Center, 245, Eulji-ro, Jung-gu, Seoul, 04564, Republic of Korea.
BMC Musculoskelet Disord. 2021 Jul 10;22(1):617. doi: 10.1186/s12891-021-04491-3.
Reoperation is one of the key factors affecting postoperative clinical outcomes. The reoperation rates of cervical surgeries might be different from those of lumbar surgeries due to the anatomical and biomechanical differences. However, there has been no study to compare the reoperation rate between them. The purpose is to compare reoperation rates after fusion surgeries for degenerative spinal diseases depending on the anatomic region of cervical and lumbar spines.
We used the Korean Health Insurance Review & Assessment Service national database. Subjects were included if they had any of the primary procedures of fusion combined with the procedure of decompression procedures under the diagnosis of degenerative diseases (n = 42,060). We assigned the patients into two groups based on anatomical regions: cervical and lumbar fusion group (n = 11,784 vs 30,276). The primary endpoint of reoperation was the repeat of any aforementioned fusion procedures. Age, gender, presence of diabetes, associated comorbidities, and hospital types were considered potential confounding factors.
The reoperation rate was higher in the patients who underwent lumbar fusion surgery than in the patients who underwent cervical fusion surgery during the entire follow up period (p = 0.0275). A similar pattern was found during the late period (p = 0.0468). However, in the early period, there was no difference in reoperation rates between the two groups. Associated comorbidities and hospital type were noted to be risk factors for reoperation.
The incidence of reoperation was higher in the patients who underwent lumbar fusion surgery than those who underwent cervical fusion surgery for degenerative spinal diseases.
再次手术是影响术后临床结果的关键因素之一。由于颈椎和腰椎在解剖学和生物力学上的差异，颈椎手术和腰椎手术的再次手术率可能不同。然而，目前还没有研究比较它们之间的再次手术率。本研究旨在比较因退行性脊柱疾病而行融合手术的患者中，颈椎和腰椎融合手术的再次手术率。
我们使用了韩国健康保险审查和评估服务国家数据库。如果患者的主要手术程序为融合术，并伴有退行性疾病的减压手术（n=42060），则将其纳入研究。我们根据解剖区域将患者分为两组：颈椎融合组（n=11784）和腰椎融合组（n=30276）。再次手术的主要终点是重复进行任何上述融合手术。年龄、性别、是否患有糖尿病、合并症和医院类型被认为是潜在的混杂因素。
在整个随访期间，接受腰椎融合手术的患者的再次手术率高于接受颈椎融合手术的患者（p=0.0275）。在晚期也发现了类似的模式（p=0.0468）。然而，在早期，两组之间的再次手术率没有差异。合并症和医院类型被认为是再次手术的危险因素。
与颈椎融合术相比，退行性脊柱疾病患者行腰椎融合术的再次手术发生率更高。
