title: Unplanned Reoperation of Lumbar Spinal Surgery During the Primary Admission: A Multicenter Study Based on a Large Patient Population.
abstract: METHODS
  A retrospective study.
  
  
  OBJECTIVE
  The purpose of this study was to identify the rates and reasons, and the risk factors for unplanned reoperation of lumbar spinal surgery during the primary admission in terms of a multicenter and a large patient population study.
  
  
  BACKGROUND
  Unplanned reoperation is suggested to be a useful quality indicator for spinal surgery. However, the rates of unplanned reoperation in patients underwent lumbar spinal surgery during the primary admission are not well established.
  
  
  METHODS
  This study was performed to review all the patients who underwent lumbar spinal surgery at three institutions from January 2010 to April 2015. Patients with unplanned reoperations after primary surgery during the same admission were included in this study. The demographics, diagnosis, surgical procedure, and complications of patients were reviewed and statistical analysis was performed to investigate the incidences and risk factors of unplanned revision.
  
  
  RESULTS
  A total of 3936 patients who underwent lumbar spinal surgery from three institutions were reviewed, and 82 (2.08%) required unplanned reoperation during the primary admission because of wound infection (0.94%), screw misplacement (0.53%), cerebrospinal fluid leakage (0.27%), wound hematoma (0.18%), and neurologic deficit (0.15%). For the diagnosis, patients with lumbar spinal spondylolisthesis had a much higher rate of reoperation (4.3%) than those of lumbar stenosis (2.3%), vertebral tumor (2.2%), vertebral fracture (1.2%), and disc herniation (1.1%) with a significant difference (P < 0.001). The revision rate was significantly higher in patients underwent posterior lumbar interbody fusion than those received transforaminal lumbar interbody fusion (P = 0.007).
  
  
  CONCLUSIONS
  Unplanned reoperation rate of lumbar spinal surgery was 2.08% and the most common reasons for it were wound infection and screw misplacement. Patients with a diagnosis of lumbar spinal spondylolisthesis or who underwent posterior lumbar interbody fusion were more likely to required unplanned reoperation during the primary admission.
  
  
  METHODS
  4.
authors.affiliation: Department of Orthopedic Surgery, the First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Jia-Ming
authors.initials: JM
authors.lastname: Liu
authors.affiliation: Department of Orthopedic Surgery, the First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Hui-Lin
authors.initials: HL
authors.lastname: Deng
authors.affiliation: Jiangxi University of Traditional Chinese Medicine, Nanchang, China.
authors.forename: Ai-Fen
authors.initials: AF
authors.lastname: Peng
authors.affiliation: Department of Orthopedic Surgery, Jiangxi Provincial People's Hospital, Nanchang, China.
authors.forename: Jian-Ying
authors.initials: JY
authors.lastname: He
authors.affiliation: Department of Orthopedic Surgery, Chinese People's Liberation Army No. 94 Hospital, Nanchang, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopedic Surgery, the First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Shan-Hu
authors.initials: SH
authors.lastname: Huang
authors.affiliation: Department of Orthopedic Surgery, the First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Zhi-Li
authors.initials: ZL
authors.lastname: Liu
mesh_terms: D001863:Bone Screws; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013122:Spinal Diseases / Q000601:surgery*