A new study published in Spine examines risk factors for reoperation in degenerative spondylolisthesis patients.
The study covered 406 patients who underwent surgery to correct degenerative spondylolisthesis; 72 percent underwent instrumented fusions, 21 percent underwent non-instrumented fusions and 7 percent received decompressions alone. The study authors found:
1. Eight years after surgery, 22 percent of patients underwent reoperations and 28 percent of those reoperations occurred within the first year of the primary procedure. By four years after surgery, 70 percent of the reoperations had occurred.
2. The reasons for reoperation were:
● Recurrent or progressive spondylolisthesis: 45 percent
● Complications like hematoma, dehiscence or infection: 36 percent
● New condition: 14 percent
3. The patients undergoing reoperations were typically younger at the time of the primary procedure, at 62 years old on average compared to 65 years old overall.
4. The factors associated with reoperation rates were:
● Antidepressant use
● No neurogenic claudication upon enrollment
5. Diabetic patients and smokers weren't at a greater risk for reoperation. Obesity and workers compensation status also were not risk factors for reoperation among the patients studied.
6. Eight years after treatment, the patients who did not undergo surgery reported better SF-36 bodily pain, Oswestry Disability Index and American Academy of Orthopaedic Surgeons/Modems version scores. The stenosis frequency index was also better in the nonoperative patient group.