title: Risk Factors for Reoperation in Patients Treated Surgically for Lumbar Stenosis: A Subanalysis of the 8-year Data From the SPORT Trial.
abstract: METHODS
  A retrospective subgroup analysis was performed on surgically treated patients from the lumbar spinal stenosis (SpS) arm of the Spine Patient Outcomes Research Trial (SPORT), randomized, and observational cohorts.
  
  
  OBJECTIVE
  To identify risk factors for reoperation in patients treated surgically for SpS and compare outcomes between patients who underwent reoperation with those who did not.
  
  
  BACKGROUND
  SpS is one of the most common indications for surgery in the elderly; however, few long-term studies have identified risk factors for reoperation.
  
  
  METHODS
  A post-hoc subgroup analysis was performed on patients from the SpS arm of the SPORT, randomized and observational cohorts. Baseline characteristics were analyzed between reoperation and no-reoperation groups using univariate and multivariate analysis on data 8 years postoperation.
  
  
  RESULTS
  Of the 417 study patients, 88% underwent decompression only, 5% noninstrumented fusion, and 6% instrumented fusion. At the 8-year follow-up, the reoperation rate was 18%; 52% of reoperations were for recurrent stenosis or progressive spondylolisthesis, 25% for complication or other reason, and 16% for new condition. Of patients who underwent a reoperation, 42% did so within 2 years, 70% within 4 years, and 84% within 6 years. Patients who underwent reoperation were less likely to have presented with any neurological deficit (43% reop vs. 57% no reop, P = 0.04). Patients improved less at follow-up in the reoperation group (P < 0.001).
  
  
  CONCLUSIONS
  In patients undergoing surgical treatment for SpS, the reoperation rate at 8-year follow-up was 18%. Patients with a reoperation were less likely to have a baseline neurological deficit. Patients who did not undergo reoperation had better patient reported outcomes at 8-year follow-up compared with those who had repeat surgery.
  
  
  METHODS
  2.
authors.affiliation: *Department of Orthopaedic Surgery, New York University Langone Medical Center, New York, NY †State University of New York, Downstate Medical Center, Brooklyn, NY ‡Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH §The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH ¶Rothman Institute of Thomas Jefferson University, Philadelpha, PA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Gerling
authors.forename: Dante
authors.initials: D
authors.lastname: Leven
authors.forename: Peter G
authors.initials: PG
authors.lastname: Passias
authors.forename: Virginie
authors.initials: V
authors.lastname: Lafage
authors.forename: Kristina
authors.initials: K
authors.lastname: Bianco
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lee
authors.forename: Jon D
authors.initials: JD
authors.lastname: Lurie
authors.forename: Tor D
authors.initials: TD
authors.lastname: Tosteson
authors.forename: Wenyan
authors.initials: W
authors.lastname: Zhao
authors.forename: Kevin F
authors.initials: KF
authors.lastname: Spratt
authors.forename: Kristen
authors.initials: K
authors.lastname: Radcliff
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Errico
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic / Q000379:methods; D064887:Observational Studies as Topic / Q000379:methods; D010147:Pain Measurement / Q000379:methods / Q000639:trends; D017060:Patient Satisfaction; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012086:Reoperation / Q000639:trends*; D012189:Retrospective Studies; D012307:Risk Factors; D013130:Spinal Stenosis / Q000175:diagnosis / Q000601:surgery*; D013223:Statistics as Topic / Q000379:methods / Q000639:trends*