José C Pérez-López, Gerardo Olivella, Miguel Cartagena, Christian Nieves-Ríos, José Acosta-Julbe, Norman Ramírez, José Massanet-Volrath, José Montañez-Huertas, Enrique Escobar
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引用次数: 1
Abstract
Purpose: The aim of this study was to evaluate the associated factors of patients with LSS who undergo reoperation after a PLSF in a Hispanic-American population.
Methods: A retrospective single-center review was performed from all non-age-related Hispanic-Americans with LSS who underwent one or two-level PLSF from 2008 to 2018. Baseline characteristics were analyzed between the reoperation and no-reoperation group using a bivariate and multivariate analyses.
Results: Out of 425 patients who underwent PLSF, 38 patients underwent reoperation. At a two-year follow-up, the reoperation rate was 6.1% (26/425), mostly due to pseudoarthrosis (39.5%), recurrent stenosis (26.3%), new condition (15.8%), infection (10.5%), hematoma (5.3%), and dural tear (2.6%). Patients who underwent reoperation were more likely to have a preoperative history of epidural steroid injection (ESI) (OR 5.18, P = 0.009), four or more comorbidities (OR 2.69, P = 0.028), and operated only with a posterolateral fusion without intervertebral fusion (OR 2.15, P = 0.032). Finally, the multivariable analysis showed that ESI was the only independent associated factor in patients who underwent reoperation after a PLSF in our group.
Conclusion: Among this population who underwent surgery, a reoperation rate at two years of follow-up was less than ten percent. Our study did not find any associated factor inherent to Hispanic-Americans, as ethnic group, who were reoperated after LSS.
目的:本研究的目的是评估西班牙裔美国人群中PLSF后再手术的LSS患者的相关因素。方法:对2008年至2018年所有非年龄相关的LSS西班牙裔美国人进行回顾性单中心评价,他们接受了一级或二级PLSF。采用双变量和多变量分析分析再手术组和非再手术组的基线特征。结果:425例PLSF患者中,38例再次手术。在两年的随访中,再手术率为6.1%(26/425),主要是由于假关节(39.5%)、复发性狭窄(26.3%)、新情况(15.8%)、感染(10.5%)、血肿(5.3%)和硬脑膜撕裂(2.6%)。再次手术的患者术前有硬膜外类固醇注射(ESI)史(OR 5.18, P = 0.009), 4种及以上合并症(OR 2.69, P = 0.028),且仅行后外侧融合而无椎间融合(OR 2.15, P = 0.032)。最后,多变量分析显示ESI是本组PLSF再手术患者中唯一的独立相关因素。结论:在接受手术的人群中,两年随访的再手术率不到10%。我们的研究没有发现拉美裔美国人作为种族群体在LSS后再手术的任何相关因素。