Skip to main content

Advertisement

SpringerLink
Log in

Risk factors for ninety-day readmissions following full-endoscopic transforaminal lumbar discectomy for 1542 patients in the biggest spine institutes in Korea

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Introduction

Endoscopic techniques are becoming popular among spine surgeons because of their advantages. Though the advantages of endoscopic spine surgery are evident and patients can be discharged home within hours of surgery, readmissions can be sought for incomplete relief of leg pain, recurrent disc herniation, and recurrent leg pain. We aim to find out the factors related to the readmission of patients treated for lumbar pathologies.

Materials and methods

This is a retrospective analysis of the data between the time duration of 2012 and 2022. Patients in the age group of 18–85 years, with lumbar disc herniation treated by transforaminal endoscopic lumbar procedures, were included. The patients who were readmitted within 90 days were included in the R Group and those who were not were included in the NR group. Univariable and multivariable logistic regression analyses were used to find the risk factors for 90-day readmission.

Results

There were a total of 1542 patients enrolled in this study. Sex, number of episodes before admission, hypertension, smoking, BMI, migration, disc height, disc height index, spondylolisthesis, instability, pelvic tilt (PT), and disc cross-sectional area (CSA) were found significant on univariable analysis. Age, spondylolisthesis, instability and muscle CSA were the only variables that were found to be statistically significant on multivariable analysis.

Conclusions

This study shows that the elderly age group, presence of spondylolisthesis, segmental instability and decreased muscle cross-sectional area are independent risk factors for 90-day hospital readmissions. Patients having the above risk factors should be carefully counseled regarding the possibility of readmission in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Khandge AV, Sharma SB, Kim J-S (2021) The Evolution of Transforaminal Endoscopic spine surgery. World Neurosurg 145:643–656. https://doi.org/10.1016/j.wneu.2020.08.096

    Article  PubMed  Google Scholar 

  2. Choi KC, Kim J-S, Park C-K (2016) Percutaneous endoscopic lumbar discectomy as an alternative to open lumbar microdiscectomy for large lumbar disc herniation. Pain Phys 19:E291-300

    Article  Google Scholar 

  3. Gadjradj PS, Harhangi BS, Amelink J et al (2021) Percutaneous transforaminal endoscopic discectomy versus open microdiscectomy for lumbar disc herniation. Spine (Phila Pa 1976) 46:538–549. https://doi.org/10.1097/BRS.0000000000003843

    Article  PubMed  Google Scholar 

  4. Ahn Y (2019) Endoscopic spine discectomy: indications and outcomes. Int Orthop (SICOT) 43:909–916. https://doi.org/10.1007/s00264-018-04283-w

    Article  Google Scholar 

  5. Jitpakdee K, Liu Y, Kotheeranurak V, Kim J-S (2022) Transforaminal versus interlaminar endoscopic lumbar discectomy for lumbar disc herniation: a systematic review and meta-analysis. Global Spine J. https://doi.org/10.1177/21925682221120530

    Article  PubMed  PubMed Central  Google Scholar 

  6. Wang K, Hong X, Zhou B-Y et al (2015) Evaluation of transforaminal endoscopic lumbar discectomy in the treatment of lumbar disc herniation. Int Orthop (SICOT) 39:1599–1604. https://doi.org/10.1007/s00264-015-2747-1

    Article  Google Scholar 

  7. Bae J, Kim J-S (2022) Building a Successful Practice of Endoscopic Spine Surgery: Learning, Setting the Goal, and Expanding the Border. Neurospine 19:571–573. https://doi.org/10.14245/ns.2244712.356

    Article  PubMed  PubMed Central  Google Scholar 

  8. McCormack RA, Hunter T, Ramos N et al (2012) An analysis of causes of readmission after spine surgery. Spine (Phila Pa 1976) 37:1260–1266. https://doi.org/10.1097/BRS.0b013e318245f561

    Article  PubMed  Google Scholar 

  9. Zhao C, Zhang H, Wang Y et al (2021) Nomograms for predicting recurrent herniation in PETD with preoperative radiological factors. J Pain Res 14:2095–2109. https://doi.org/10.2147/JPR.S312224

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ahn Y, Jang I-T, Kim W-K (2016) Transforaminal percutaneous endoscopic lumbar discectomy for very high-grade migrated disc herniation. Clin Neurol Neurosurgery. https://doi.org/10.1016/j.clineuro.2016.05.016

    Article  Google Scholar 

  11. Akeda K, Yamada T, Inoue N et al (2015) Risk factors for lumbar intervertebral disc height narrowing: a population-based longitudinal study in the elderly. BMC Musculoskelet Disord. https://doi.org/10.1186/s12891-015-0798-5

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bae J, Sathe A, Lee S-M et al (2021) Correlation of paraspinal muscle mass with decompensation of sagittal adult spinal deformity after setting of fatigue post minute walk. Neurospine 18:495–503. https://doi.org/10.14245/ns.2142510.255

    Article  PubMed  PubMed Central  Google Scholar 

  13. Concato J, Feinstein AR, Holford TR (1993) The risk of determining risk with multivariable models. Ann Int Med 118:201–210. https://doi.org/10.7326/0003-4819-118-3-199302010-00009

    Article  CAS  PubMed  Google Scholar 

  14. Gadjradj PS, Depauw PR, Schutte PJ et al (2022) Body Image and cosmesis after percutaneous transforaminal endoscopic discectomy versus conventional open microdiscectomy for sciatica. Global Spine J. https://doi.org/10.1177/21925682221105271

    Article  PubMed  Google Scholar 

  15. Elsamadicy AA, Adogwa O, Vuong VD et al (2016) Patient body mass index is an independent predictor of 30-day hospital readmission after elective spine surgery. World Neurosurg 96:148–151. https://doi.org/10.1016/j.wneu.2016.08.097

    Article  PubMed  Google Scholar 

  16. Wang MC, Shivakoti M, Sparapani RA et al (2012) Thirty-day readmissions after elective spine surgery for degenerative conditions among US Medicare beneficiaries. Spine J 12:902–911. https://doi.org/10.1016/j.spinee.2012.09.051

    Article  PubMed  Google Scholar 

  17. Singhal A, Bernstein M (2002) Outpatient lumbar microdiscectomy: a prospective study in 122 patients. Can J Neurol Sci 29:249–252. https://doi.org/10.1017/S031716710000202X

    Article  PubMed  Google Scholar 

  18. Li Z-P, Liu L-L, Liu H et al (2022) Radiologic analysis of causes of early recurrence after percutaneous endoscopic transforaminal discectomy. Global Spine J. https://doi.org/10.1177/21925682221096061

    Article  PubMed  PubMed Central  Google Scholar 

  19. Wang F, Chen K, Lin Q et al (2022) Earlier or heavier spinal loading is more likely to lead to recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy. J Orthop Surg Res 17:356. https://doi.org/10.1186/s13018-022-03242-x

    Article  PubMed  PubMed Central  Google Scholar 

  20. Li Z, Yang H, Liu M et al (2018) Clinical characteristics and risk factors of recurrent lumbar disk herniation: a retrospective analysis of three hundred twenty-one cases. Spine 43:1463–1469. https://doi.org/10.1097/BRS.0000000000002655

    Article  PubMed  Google Scholar 

  21. Yao Y, Liu H, Zhang H et al (2017) Risk factors for recurrent herniation after percutaneous endoscopic lumbar discectomy. World Neurosurg 100:1–6. https://doi.org/10.1016/j.wneu.2016.12.089

    Article  PubMed  Google Scholar 

  22. Jenkins NW, Parrish JM, Nolte MT et al (2021) Charlson comorbidity index: an inaccurate predictor of minimally invasive lumbar spinal fusion outcomes. Int J Spine Surg 15:770–779. https://doi.org/10.14444/8099

    Article  PubMed  PubMed Central  Google Scholar 

  23. Shi H, Zhu L, Jiang Z-L, Wu X-T (2021) Radiological risk factors for recurrent lumbar disc herniation after percutaneous transforaminal endoscopic discectomy: a retrospective matched case-control study. Eur Spine J 30:886–892. https://doi.org/10.1007/s00586-020-06674-3

    Article  PubMed  Google Scholar 

  24. Zhou C, Zhang G, Panchal RR et al (2018) Unique complications of percutaneous endoscopic lumbar discectomy and percutaneous endoscopic interlaminar discectomy. Pain Phys 21:E105–E112

    Google Scholar 

  25. Cankurtaran D, Yigman ZA, Umay E (2021) Factors associated with paravertebral muscle cross-sectional area in patients with chronic low back pain. Korean J Pain 34:454–462. https://doi.org/10.3344/kjp.2021.34.4.454

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

No funds, grants, or other support was received.

Author information

Authors and Affiliations

  1. Wooridul Hospital, Cheongdam, Seoul, South Korea

    Junseok Bae, Syed Ifthekar, Sang-Ho Lee, Sang-Ha Shin, Han Joong Keum, Yong Soo Choi & Hyoung-Woo Lho

  2. All India Institute of Medical Sciences, Hyderabad, India

    Syed Ifthekar

  3. Spine Center, Department of Neurosurgery, St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Young-Jin Kim & Jin-Sung Kim

Authors
  1. Junseok Bae
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Syed Ifthekar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sang-Ho Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sang-Ha Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Han Joong Keum
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yong Soo Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hyoung-Woo Lho
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Young-Jin Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jin-Sung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jin-Sung Kim.

Ethics declarations

Conflict of interest

Dr Junseok Bae is Consultant in Joimax GmbH, Germany, Cousion Surgery, France Novapproach Spine, USA. Centinel, USA. Dr Jin-Sung Kim is consultant in RIWOSpine, GmbH, Germany Elliquence, LLC, USA.

Ethics Approval

Approval obtained from Institutional review board.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bae, J., Ifthekar, S., Lee, SH. et al. Risk factors for ninety-day readmissions following full-endoscopic transforaminal lumbar discectomy for 1542 patients in the biggest spine institutes in Korea. Eur Spine J 32, 2875–2881 (2023). https://doi.org/10.1007/s00586-023-07662-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-023-07662-z

Keywords

Search

Navigation