[Revision surgery after previous spinal decompression and fusion for lumbar spinal stenosis].

Abstract

Nowadays, vertebral stenosis is the most common indication for surgical treatment in patients over 65 years old in spine surgery. According to the literature, there are conflicting data on the incidence and indications for revision surgery after previous spinal decompression and fusion for lumbar spinal stenosis.

Objective: To evaluate the incidence and indications for revision surgery after previous spinal decompression and fusion for lumbar spinal stenosis.

Material and methods: A retrospective single-center study enrolled 1233 patients with lumbar spine stenosis who underwent spinal decompression and fusion surgery between 2014 and 2018. The number and causes of readmission were evaluated.

Results: There were 164 readmissions. Revision surgery at the same level was performed in 63 patients (38.4%), at the higher level - 72 (43.9%), at the lower level - in 29 (17.7%) patients. The most common indication for readmission was spondyloarthrosis with facet joint syndrome (94 (57.3%) patients). The second common complication was pseudoarthrosis (26 (15.9%) patients). These ones comprised 2.1% of all patients with lumbar spine stenosis.

Conclusion: The most common indication for readmission was adjacent segment degeneration. The most severe complications requiring complex and even multiple stage revision surgery were pseudoarthrosis and postoperative spondylodiscitis. Causes of readmission are significantly changing at different periods after surgery.