Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis.
10.14245/kjs.2016.13.4.183
- Author:
Hee Jong HWANG
1
;
Hyung Ki PARK
;
Gwang Soo LEE
;
June Young HEO
;
Jae Chil CHANG
Author Information
1. Department of Neurosurgery, Soonchunhyang University College of Medicine, Seoul, Korea. schnsphk@gmail.com
- Publication Type:Original Article
- Keywords:
Microdecompression;
Lumbar spinal stenosis;
Laminotomy;
Outcome;
Reoperation
- MeSH:
Asian Continental Ancestry Group;
Body Mass Index;
Comorbidity;
Constriction, Pathologic;
Follow-Up Studies;
Humans;
Intervertebral Disc Degeneration;
Laminectomy;
Low Back Pain;
Orthopedics;
Reoperation*;
Retrospective Studies;
Risk Factors;
Spinal Stenosis*
- From:Korean Journal of Spine
2016;13(4):183-189
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The risk factors of reoperation after microdecompression (MD) for lumbar spinal stenosis (LSS) are unclear. In this study, we presented the outcomes of MD for degenerative LSS and investigated the risk factors associated with reoperation. METHODS: A retrospective review was conducted using the clinical records and radiographs of patients with LSS who underwent MD. For clinical evaluation, we used the Japanese Orthopedic Association (JOA) scoring system for low back pain, body mass index, and Charlson comorbidity index. For radiological evaluation, disc height, facet angle, and sagittal rotation angle were measured in operated segments. Also the Modic change and Pfirrmann grade for degeneration in the endplate and disc were scored. RESULTS: Forty-three patients aged 69±9 years at index surgery were followed for 48±25 months. The average preoperative JOA score was 6.9±1.6 points. The score improved to 9.1±2.1 points at the latest follow-up (p<0.001). Seven patients (16.3%) underwent reoperation. Clinical and radiological factors except operation level and Pfirrmann grade showed a p-value >0.1. Patients with Pfirrmann grade IV and lower lumbar segment had a 29.1% rate of reoperation (p=0.001), whereas patients without these factors had a 0% rate of reoperation. CONCLUSION: Moderate disk degeneration (Pfirrmann IV) in lower lumbar segments is a risk factor of disk herniation or foraminal stenosis requiring reoperation after MD in LSS.
