Risk Management and Healthcare Policy (Nov 2022)
Early Readmission and Reoperation After Percutaneous Transforaminal Endoscopic Decompression for Degenerative Lumbar Spinal Stenosis: Incidence and Risk Factors
Abstract
Aobo Wang,* Fangda Si,* Tianyi Wang, Shuo Yuan, Ning Fan, Peng Du, Lei Wang, Lei Zang Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lei Zang, Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, People’s Republic of China, Tel +86 13601252787, Email [email protected]: To identify the incidence rates and risk factors for early readmission and reoperation after percutaneous transforaminal endoscopic decompression (PTED) for degenerative lumbar spinal stenosis (DLSS).Patients and Methods: A total of 1011 DLSS patients who underwent PTED were retrospectively evaluated. Of them, 58 were readmitted, and 31 underwent reoperation. The patients were matched with 174 control patients to perform case-control analyses. The clinical and preoperative imaging data of each patient were recorded. Univariate analyses were performed using independent sample t-tests and Fisher’s exact tests. Furthermore, the risk factors for early readmission and reoperation were analyzed using multivariate logistic regression analyses.Results: The incidence rates of readmission and reoperation within 90 days after PTED were 5.7% and 3.1%, respectively. Age (odds ratio [OR]=1.054, p=0.001), BMI (OR=1.104, p=0.041), a history of lumbar surgery (OR=3.260, p=0.014), and the number of levels with radiological lumbar foraminal stenosis (LFS, OR=2.533, p< 0.001) were independent risk factors for early readmission. The number of levels with radiological LFS (OR=5.049, p< 0.001), the grade of surgical-level facet joint degeneration (OR=2.010, p=0.023), and a history of lumbar surgery (OR=10.091, p< 0.001) were independent risk factors for early reoperation.Conclusion: This study confirmed that aging, a higher BMI, a history of lumbar surgery, and more levels with radiological LFS were associated with a higher risk of early readmission. More levels with radiological LFS, a higher grade of surgical-level facet joint degeneration, and a history of lumbar surgery were predictors of early reoperation. These results are helpful in patient counseling and perioperative evaluation of PTED.Keywords: spinal stenosis, minimally invasive, readmission, reoperation, risk factor
