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Additional operatio...
Additional operations after surgery for lumbar disc prolapse : indications, type of surgery, and long-term follow-up of primary operations performed from 2007 to 2008
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- Sigmundsson, Freyr Gauti, 1972- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Orthopaedics, University Hospital of Örebro, Örebro, Sweden
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- Joelson, Anders, 1970- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopaedics, University Hospital of Örebro, Örebro, Sweden
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- Strömqvist, Fredrik (författare)
- Lund University,Lunds universitet,Ortopedi - klinisk och molekylär osteoporosforskning,Forskargrupper vid Lunds universitet,Orthopedics - Clinical and Molecular Osteoporosis Research,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- British Editorial Society of Bone and Joint Surgery (JBJS), 2022
- 2022
- Engelska.
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Ingår i: The Bone & Joint Journal. - : British Editorial Society of Bone and Joint Surgery (JBJS). - 2049-4394 .- 2049-4408. ; 104-B:5, s. 627-632
- Relaterad länk:
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http://dx.doi.org/10...
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visa fler...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- AIMS: Lumbar disc prolapse is a frequent indication for surgery. The few available long-term follow-up studies focus mainly on repeated surgery for recurrent disease. The aim of this study was to analyze all reasons for additional surgery for patients operated on for a primary lumbar disc prolapse.METHODS: We retrieved data from the Swedish spine register about 3,291 patients who underwent primary surgery for a lumbar disc prolapse between January 2007 and December 2008. These patients were followed until December 2020 to record all additional lumbar spine operations and the reason for them.RESULTS: In total, 681 of the 3,291 patients (21%) needed one or more additional operations. More than three additional operations was uncommon (2%; 15/906). Overall, 906 additional operations were identified during the time period, with a mean time to the first of these of 3.7 years (SD 3.6). The most common reason for an additional operation was recurrent disc prolapse (47%; 426/906), followed by spinal stenosis or degenerative spondylolisthesis (19%; 176/906), and segmental pain (16%; 145/906). The most common surgical procedures were revision discectomy (43%; 385/906) and instrumented fusion (22%; 200/906). Degenerative spinal conditions other than disc prolapse became a more common reason for additional surgery with increasing length of follow-up. Most patients achieved the minimally important change (MIC) for the patient-reported outcomes after the index surgery. After the third additional spinal operation, only 20% (5/25) achieved the MIC in terms of leg pain, and 29% (7/24) in terms of the EuroQol five-dimension index questionnaire visual analogue scale.CONCLUSION: More than one in five patients operated on for a lumbar disc prolapse underwent further surgery during the 13-year follow-up period. Recurrent disc prolapse was the most common reason for additional surgery, followed by spinal stenosis and segmental pain. This study shows that additional operations after primary disc surgery are needed more frequently than previously reported, and that the outcome profoundly deteriorates after the second additional operation. The findings from this study can be used in the shared decision-making process. Cite this article: Bone Joint J 2022;104-B(5):627-632.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Complications
- Degenerative disc disease
- Degenerative spine
- Lumbar disc herniation
- Outcome
- Patient-reported outcome measures (PROMs)
- Recurrent disc herniation
- Reoperation
- degenerative spondylolisthesis
- discectomy
- leg pain
- lumbar disc
- lumbar spine
- primary surgery
- spinal stenosis
- spine
- visual analogue scale (VAS)
- Complications
- Degenerative disc disease
- Degenerative spine
- degenerative spondylolisthesis
- discectomy
- leg pain
- lumbar disc
- Lumbar disc herniation
- lumbar spine
- Outcome
- Patient-reported outcome measures (PROMs)
- primary surgery
- Recurrent disc herniation
- Reoperation
- spinal stenosis
- spine
- visual analogue scale (VAS)
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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