A new study published in Clinical Orthopaedics and Related Research examines revision rates for lumbar discectomy.
Previous studies estimate revision rates for lumbar discectomy from 5.1 percent to 7.9 percent, but this study sought to examine revision rate on a national scale over several years. The study authors examined the Medicare 5% National Sample Administrative Database and a large Humana database including patients who underwent lumbar discectomy. A total of 7,520 patients were included in the study that included at least five year follow-ups.
The study authors found:
1. Of the 2,613 patients in the Humana database, 5.6 percent reported revisions; of the 4,907 patients in the National Sample Administrative Database, 6.2 percent reported revisions within seven years of surgery.
2. Survival rates were greater than 93 percent seven years after surgery among all cohorts studied. However, based on age, survivorship could be lower:
● Patients younger than 65 years old had a 93 percent survivorship, compared to 95 percent for patients 65 years or older
● After adding nondiscectomy lumbar surgeries, patients younger than 65 years old reported 83 percent survivorship, compared to 87 percent survivorship among patients 65 years and older
3. Revision discectomy rates were similar across all geographic regions over the study period.
4. Survivorship between Medicare patients and Humana patients were similar throughout the study. "We hope these data allow physicians to offer accurate advice to patients regarding the risk of revision surgery for patients of all ages during five to seven years after their index procedure to enhance shared decision making in spinal surgery."
5. Public policy makers and ACOs can use these results to allocate resources to patients with symptomatic lumbar disc herniation.