Repeat decompression and fusions following posterolateral fusion versus posterior/transforaminal lumbar interbody fusion for lumbar spondylosis: a national database study

Abstract

There is a low incidence of reoperation after surgery. It is difficult to detect statistical differences between reoperation rates of different lumbar fusion surgeries. National population-based databases provide large, longitudinally followed cohorts that may help overcome this challenge. The purpose is to compare the repeat decompression and fusion rate after surgery for degenerative lumbar diseases according to different surgical fusion procedures based on national population-based databases and elucidate the risk factor for repeat decompression and fusions. The Korean Health Insurance Review & Assessment Service database was used. Patients diagnosed with degenerative lumbar diseases and who underwent single-level fusion surgeries between January 1, 2011, and June 30, 2016, were included. They were divided into two groups based on procedure codes: posterolateral fusion or posterior/transforaminal lumbar interbody fusion. The primary endpoint was repeat decompression and fusion. Age, sex, the presence of diabetes, osteoporosis, associated comorbidities, and hospital types were considered potential confounding factors. The repeat decompression and fusion rate was not different between the patients who underwent posterolateral fusion and those who underwent posterior/transforaminal lumbar interbody fusion. Old age, male sex, and hospital type were noted to be risk factors. The incidence of repeat decompression and fusion was independent on the fusion method.