Characteristics in Medicare beneficiaries associated with reoperation after lumbar spine surgery.
METHODS
A cohort study was undertaken using medical claims of Medicare beneficiaries.


OBJECTIVE
Factors associated with reoperation after lumbar spine surgery were identified.


BACKGROUND
Repeat spine surgery is one outcome measure of surgical success, but little is known about clinical or demographic factors associated with repeat surgery.


METHODS
Medicare beneficiaries who had surgery in 1985 were included in follow-up through 1989. Time between the first operation and a lumbar spine reoperation, death, or end of follow-up period was recorded. Survival analysis (time-to-event) techniques were used to test the association of baseline characteristics with reoperation.


RESULTS
Higher reoperation rates were associated (P < 0.05) with previous back surgery, younger age, recent hospitalization, white race, and diagnosis of herniated disc (compared with other diagnoses). Fusion alone or combined with other procedures did not lower the reoperation rate.


CONCLUSIONS
Reoperation rates are affected not only by technical factors, but also by demographic and clinical characteristics that are often omitted from reports of surgical case series.
Ciol
M A
MA
Department of Health Services, University of Washington, Seattle.
Deyo
R A
RA
Kreuter
W
W
Bigos
S J
SJ
D000367:Age Factors; D000368:Aged; D001416:Back Pain / Q000601:surgery*; D015331:Cohort Studies; D015897:Comorbidity; D003627:Data Interpretation, Statistical; D003710:Demography; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D006278:Medicare; D044469:Racial Groups; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000601:surgery*; D013997:Time Factors; D014481:United States