Orthopaedic Surgery Department, Medical Sciences Campus, UPR, PO Box 365067, San Juan, PR, 00936-5067, USA.
Surgery Department, School of Medicine, Ponce Health Sciences University, Ponce, PR, 00716, USA.
Eur J Orthop Surg Traumatol. 2022 Dec;32(8):1491-1499. doi: 10.1007/s00590-021-03127-5. Epub 2021 Sep 22.
The aim of this study was to evaluate the associated factors of patients with LSS who undergo reoperation after a PLSF in a Hispanic-American population.
A retrospective single-center review was performed from all non-age-related Hispanic-Americans with LSS who underwent one or two-level PLSF from 2008 to 2018. Baseline characteristics were analyzed between the reoperation and no-reoperation group using a bivariate and multivariate analyses.
Out of 425 patients who underwent PLSF, 38 patients underwent reoperation. At a two-year follow-up, the reoperation rate was 6.1% (26/425), mostly due to pseudoarthrosis (39.5%), recurrent stenosis (26.3%), new condition (15.8%), infection (10.5%), hematoma (5.3%), and dural tear (2.6%). Patients who underwent reoperation were more likely to have a preoperative history of epidural steroid injection (ESI) (OR 5.18, P = 0.009), four or more comorbidities (OR 2.69, P = 0.028), and operated only with a posterolateral fusion without intervertebral fusion (OR 2.15, P = 0.032). Finally, the multivariable analysis showed that ESI was the only independent associated factor in patients who underwent reoperation after a PLSF in our group.
Among this population who underwent surgery, a reoperation rate at two years of follow-up was less than ten percent. Our study did not find any associated factor inherent to Hispanic-Americans, as ethnic group, who were reoperated after LSS.
本研究旨在评估在西班牙裔美国人人群中,行后路腰椎间融合术(PLSF)后再次手术的腰椎管狭窄症(LSS)患者的相关因素。
回顾性分析了 2008 年至 2018 年间行单或双节段 PLSF 的非年龄相关性 LSS 西班牙裔美国人患者的所有数据。采用单变量和多变量分析比较再次手术组和未再次手术组的基线特征。
在 425 例行 PLSF 的患者中,38 例患者接受了再次手术。在两年的随访中,再次手术率为 6.1%(26/425),主要原因是假关节(39.5%)、再狭窄(26.3%)、新病症(15.8%)、感染(10.5%)、血肿(5.3%)和硬脊膜撕裂(2.6%)。再次手术的患者更有可能有硬膜外类固醇注射(ESI)的术前史(OR 5.18,P=0.009)、四种或更多合并症(OR 2.69,P=0.028),并且只进行单纯后路融合而没有椎间融合(OR 2.15,P=0.032)。最终,多变量分析显示,ESI 是我们组中 PLSF 后再次手术患者的唯一独立相关因素。
在接受手术的人群中,两年随访时的再次手术率不到 10%。我们的研究没有发现任何与西班牙裔美国人固有相关的因素,即种族,作为 LSS 患者再次手术的原因。