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Study investigates risks for re operation after spondylolisthesis surgery
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SAN FRANCISCO — A subgroup analysis of the SPORT study showed a 14% re-operation rate at 4 years for patients who undergo surgery for degenerative spondylolisthesis and found no link between the risk of revision and traditional factors, such as surgical variables, body mass index and baseline clinical scores.
 Edward P. Curry |
“There was no association between obesity, age, smoking, medical comorbidities and re-operation,” Edward P. Curry, MD, said at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting, here. “Pseudoclaudication and asymmetric depressed reflexes, if present, were protective against re-operation, but … we are not sure of the clinical implications of that. There was less improvement over the course of 4 years in the patients who required re-operation, but the magnitude of that difference was less at the 4-year follow-up point.”
The investigators studied nearly 400 patients who underwent surgery for degenerative spondylolisthesis and had 4 years follow-up. Of these, 60 patients (14.6%) underwent re-operation.
A comparison of patients who underwent re-operation to those patients who did not, showed no correlation between the need for revision and clinical factors on exams, straight leg raise, motor weakness, stenosis levels and severity. The investigators also found no difference between the groups regarding operative time and length of hospital stay. In addition, they discovered no statistically significant differences between the groups whether they underwent decompression alone, fusion with or without instrumentation, multilevel fusion or multilevel decompressions.
“We looked at the change in outcome from scores between the re-operation group and the non re-operation group, and the area under the curve was significantly different, with worse outcomes for the patients who required re-operation — although this difference decreased over time,” Curry said. “At 4 years, the re-operation group was approaching the non re-operation group.”
However, the investigators found that patients who had preoperative symptoms of pseudoclaudication and asymmetric depressed reflexes had a lower risk of re-operation.
Reference:
- Curry EP, Radcliff KE, Hilibrand, et al. Re-operation following degenerative spondylolisthesis surgery: A subgroup analysis of the SPORT. Paper #77. Presented at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting. Feb. 7-11. San Francisco.
- Disclosure: Curry has no relevant financial disclosures.
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