J Korean Soc Spine Surg.  2004 Sep;11(3):161-167. 10.4184/jkss.2004.11.3.161.

Prognostic Factors Associated with Revision Operation of Spine (Second Review)

• Lee KY
• Sohn SK
• Kang DS
• Lee SW

• KMID: 1839987
• DOI: http://doi.org/10.4184/jkss.2004.11.3.161

Abstract

STUDY DESIGN: Patients who had had a revision operation were classified according to their outcome
OBJECTIVE
To review a consecutive series of patients who had had a revision operation on the lumbar spine and to determine which factors contributed to a successful outcome. SUMMARY OF LITERATURE REVIEW: The long-term failure rates after the primary surgery on the spine have been reported to be as high as 30 %. MATERALS AND METHODS: This study analyzed 57 patients who had had a revision operation on the lumbar spine between Sep-tember 1995 and December 2001, and had been followed for a minimum of two years and were available for analysis. All the patients had had a decompression and instrumented fusion except for two patients who had just undergone a bone graft. These patients were followed for an average of 39 months. There were 37 men and 20 women. The patients had undergone one or more surgical procedures and an average of 54 months had elapsed since the most recent operation. The average age at the time of the revision was 52 years. The outcome was considered to be successful if the patient had met the all three criteria (Ed note: What were the 3 criteria?). Several factors were evaluated using multiple regression (level of significance, P<0.05) to be determine which were related to a successful outcome.
RESULTS
Statistical analysis revealed that the factors associated with a successful outcome were a younger age (p<0.02), fewer spinal levels of revision surgery (p<0.05), pain-free interval after a previous operation (p<0.01). No significant relationship was observed between the outcome and gender, the number of prior procedures, the spinal level operated on, the presence of preoperative neurological signs and the intervals between the previous surgery and the revision.
CONCLUSION
These results suggest that the prognostic factors are useful for evaluating the successful outcome of revision surgery of the spine.

Keyword

Spine revision operation; Prognostic factors

MeSH Terms

Decompression
Female
Humans
Male
Spine*
Transplants

Figure

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  Fig. 1. (A) Preoperative radiographs show previous discectomy state at L3-4, L4-5. (B), (C) Preoperative Magnetic Resonance images show HNP in L3-4, L4-5. (D) In revision operation, posterior decompression and posterolateral fusion of L3-4, 4-5 were done. End result was poor according to three criteria for successful outcome. So this case was included to failure group.

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