![]() ![]() The data have information of roughly 51 million patients in the Republic of Korea and contain all inpatient and outpatient data reported according to diagnosis and procedure codes. The Korean Health Insurance Review & Assessment Service (HIRA) is a national database, which has a prospectively collected set of data. Since previous studies are designed with the most effective study design for the elucidation of the reoperation rate after surgeries, we have applied the designs, data source, and surgical indications of the previous studies to the current one. The hypothesis is that the reoperation rates may be different between the two regions due to the different anatomical and biomechanical features. The purpose is to compare reoperation rates after fusion surgeries for degenerative spinal diseases according to cervical and lumbar regions with national population-based databases. ![]() National population-based databases provide a large cohort that may help overcome this challenge and a complete follow-up of reoperations without the follow-up loss, even after the patients were discharged from the hospital. It might be due to the difficulty to compare the reoperation rates because of a relatively low incidence of reoperation after fusion surgeries. ![]() However, to the best of our knowledge, no study has evaluated the difference in reoperation rates between the two groups. In contrast, the reoperation rates of lumbar fusion surgeries might be different from those of cervical fusion surgeries due to the anatomical and biomechanical differences. The degeneration requires surgical procedures not only for cervical spine but also for lumbar spine. ![]() The degeneration of intervertebral disc is the main pathogenesis of spinal diseases and the disc degeneration in the cervical spine is correlated with that in the lumbar spine. In the case of cervical degenerative diseases, reoperation rates after fusion surgeries were found from 4.8 to 15%. The reoperation rate after fusion surgeries for lumbar degenerative diseases varied from 10.3 to 19.3% depending on the definition of reoperation, the follow-up period, or surgical procedures. Reoperation is one of the key parameters showing postoperative clinical outcomes. The patients are likely to have concomitant cervical and lumbar surgeries due to the advance of diagnostic modalities and the aging society. The patients who underwent concomitant cervical and lumbar surgeries had satisfactory clinical results after the operations. have found that in a study population of 200 patients who underwent cervical spine surgery, thirty-one percent required additional surgeries in the lumbar spine. The incidence of reoperation was higher in the patients who underwent lumbar fusion surgery than those who underwent cervical fusion surgery for degenerative spinal diseases.Ĭoncomitant cervical and lumbar surgeries are not uncommon. Associated comorbidities and hospital type were noted to be risk factors for reoperation. However, in the early period, there was no difference in reoperation rates between the two groups. A similar pattern was found during the late period ( p = 0.0468). The reoperation rate was higher in the patients who underwent lumbar fusion surgery than in the patients who underwent cervical fusion surgery during the entire follow up period ( p = 0.0275). Age, gender, presence of diabetes, associated comorbidities, and hospital types were considered potential confounding factors. The primary endpoint of reoperation was the repeat of any aforementioned fusion procedures. We assigned the patients into two groups based on anatomical regions: cervical and lumbar fusion group ( n = 11,784 vs 30,276). Subjects were included if they had any of the primary procedures of fusion combined with the procedure of decompression procedures under the diagnosis of degenerative diseases ( n = 42,060). We used the Korean Health Insurance Review & Assessment Service national database. The purpose is to compare reoperation rates after fusion surgeries for degenerative spinal diseases depending on the anatomic region of cervical and lumbar spines. However, there has been no study to compare the reoperation rate between them. The reoperation rates of cervical surgeries might be different from those of lumbar surgeries due to the anatomical and biomechanical differences. Reoperation is one of the key factors affecting postoperative clinical outcomes. ![]()
0 Comments
Leave a Reply. |