Skip to main content

Advertisement

SpringerLink
Log in

Reoperations Following Lumbar Spinal Canal Stenosis

  • Review Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

In the current clinical scenario, restenosis following the primary surgical procedure for lumbar canal stenosis is being frequently noticed. A number of studies have evaluated the reoperation rates following different surgical procedures for lumbar canal stenosis. However, a dilemma still exists about the surgical procedures, associated comorbidities and reoperation rates. In this study, we have reviewed the existing literature for lumbar canal stenosis surgery and their reoperation rates. A PubMed search for all papers stating “reoperation after spinal stenosis,” “revision surgery after spinal stenosis,” and “reoperations and lumbar canal stenosis” were explored. A total of 440 publications were found, of which 23 publications were shortlisted. The existing literature on reoperation rates after surgery for lumbar canal stenosis was reviewed and analyzed. From the literature search, 29680 patients who underwent surgeries for spinal stenosis have been included in the review. 11.65% ± 4.25% of them underwent reoperations following the primary procedure with a followup period of 6.80 ± 3.90 years. Fenestration surgeries showed an average reoperation rate of 7.58% ± 5.29% in 8.28 ± 6.26 years followup as compared to laminectomy alone (12.70% ± 7.49%, 6.50 ± 2.12 years followup). Laminectomy with or without fusion showed a reoperation rate of 11.22% ± 4.25% in 6.00 ± 2.60 years followup period. The comparative results of these studies were however not significant. The causes of reoperation were multifactorial ranging from the type of procedure performed, associated comorbidities or smoking. Statistical data do not indicate the superiority of any particular type of surgery, which reduces the rate of reoperation. The causes for reoperation are inadequate decompression or instability. The literature does not give statistics for these complications in the papers. Smoking is an independent risk factor for revision surgery. Diabetes reduces the time interval between the initial surgery and the revision surgery. This review highlights the causes of reoperations in various lumbar stenosis surgeries, associated comorbidities and expected outcome.

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. Oertel MF, Ryang YM, Korinth MC, Gilsbach JM, Rohde V. Long term results of microsurgical treatment of lumbar spinal stenosis by unilateral laminotomy for bilateral decompression. Neurosurgery 2006;59:1264–9.

    Article  Google Scholar 

  2. Thomé C, Zevgaridis D, Leheta O, Bäzner H, Pöckler-Schöniger C, Wöhrle J, et al. Outcome after less-invasive decompression of lumbar spinal stenosis: A randomized comparison of unilateral laminotomy, bilateral laminotomy, and laminectomy. J Neurosurg Spine 2005;3:129–41.

    Article  Google Scholar 

  3. Lauryssen C, Berven S, Mimran R, Summa C, Sheinberg M, Miller LE, et al. Facet-sparing lumbar decompression with a minimally invasive flexible MicroBlade shaver® versus traditional decompression: Quantitative radiographic assessment. Clin Interv Aging 2012;7:257–66.

    PubMed  PubMed Central  Google Scholar 

  4. Wang H, Ma L, Yang D, Wang T, Yang S, Wang Y, et al. Incidence and risk factors for the progression of proximal junctional kyphosis in degenerative lumbar scoliosis following long instrumented posterior spinal fusion. Medicine (Baltimore) 2016;95:e4443.

  5. Narverud SF, Ramli NB, Chandran H, Ganesan D. Calcified pseudomeningocele of the lumbar spine: A review. Eur Spine J 2013;22 Suppl 3:S443–9.

  6. Akhaddar A, Boulahroud O, Boucetta M. Nerve root herniation into a calcified pseudomeningocele after lumbar laminectomy. Spine J 2012;12:273.

    Article  Google Scholar 

  7. Keskimäki I, Seitsalo S, Osterman H, Rissanen P. Reoperations after lumbar disc surgery: A population-based study of regional and interspecialty variation. Spine (Phila Pa 1976) 2000;25:1500–8.

    Article  Google Scholar 

  8. Waddell G, Kummel EG, Lotto WN, Graham JD, Hall H, McCulloch JA, et al. Failed lumbar disc surgery and repeat surgery following industrial injuries. J Bone Joint Surg Am 1979;61:201–7.

    Article  CAS  Google Scholar 

  9. Bydon M, Macki M, De la Garza-Ramos R, Sciubba DM, Wolinsky JP, Gokaslan ZL, et al. Smoking as an independent predictor of reoperation after lumbar laminectomy: A study of 500 cases. J Neurosurg Spine 2015;22:288–93.

    Article  Google Scholar 

  10. Jönsson B, Strömqvist B. Repeat decompression of lumbar nerve roots. A prospective two-year evaluation. J Bone Joint Surg Br 1993;75:894–7.

    Article  Google Scholar 

  11. Arinzon Z, Adunsky A, Fidelman Z, Gepstein R. Outcomes of decompression surgery for lumbar spinal stenosis in elderly diabetic patients. Eur Spine J 2004;13:32–7.

    Article  Google Scholar 

  12. Goffin J. Comment with regard to “outcomes of decompression surgery for lumbar spinal stenosis in elderly diabetic patients” (Z. Arinzon et al.). Eur Spine J 2004;13:38.

    Article  Google Scholar 

  13. Hee HT, Wong HK. The long term results of surgical treatment for spinal stenosis in the elderly. Singapore Med J 2003;44:175–80.

    CAS  PubMed  Google Scholar 

  14. Kelleher MO, Timlin M, Persaud O, Rampersaud YR. Success and failure of minimally invasive decompression for focal lumbar spinal stenosis in patients with and without deformity. Spine (Phila Pa 1976) 2010;35:E981–7.

  15. Malmivaara A, Slätis P, Heliövaara M, Sainio P, Kinnunen H, Kankare J, et al. Surgical or nonoperative treatment for lumbar spinal stenosis? A randomized controlled tria. Spine (Phila Pa 1976) 2007;32:1–8.

    Article  Google Scholar 

  16. Jansson KA, Németh G, Granath F, Blomqvist P. Spinal stenosis re-operation rate in Sweden is 11% at 10 years – A national analysis of 9,664 operations. Eur Spine J 2005;14:659–63.

    Article  Google Scholar 

  17. Hansraj KK, Cammisa FP Jr., O’Leary PF, Crockett HC, Fras CI, Cohen MS, et al. Decompressive surgery for typical lumbar spinal stenosis. Clin Orthop Relat Res 2001;384:10–7.

    Article  Google Scholar 

  18. Herno A, Airaksinen O, Saari T. Long term results of surgical treatment of lumbar spinal stenosi. Spine (Phila Pa 1976) 1993;18:1471–4.

    Article  CAS  Google Scholar 

  19. Jönsson B, Annertz M, Sjöberg C, Strömqvist B. A prospective and consecutive study of surgically treated lumbar spinal stenosi. Part II: Five-year followup by an independent observer. Spine (Phila Pa 1976) 1997;22:2938–44.

    Google Scholar 

  20. Radcliff K, Curry P, Hilibrand A, Kepler C, Lurie J, Zhao W, et al. Risk for adjacent segment and same segment reoperation after surgery for lumbar stenosis: A subgroup analysis of the spine patient outcomes research trial (SPORT. Spine (Phila Pa 1976) 2013;38:531–9.

    Article  Google Scholar 

  21. Guigui P, Ulivieri JM, Lassale B, Deburge A. Reoperations after surgical treatment of lumbar stenosis. Rev Chir Orthop Reparatrice Appar Mot 1995;81:663–71.

    CAS  PubMed  Google Scholar 

  22. Hu RW, Jaglal S, Axcell T, Anderson G. A population-based study of reoperations after back surger. Spine (Phila Pa 1976) 1997;22:2265–70.

    Article  CAS  Google Scholar 

  23. Malter AD, McNeney B, Loeser JD, Deyo RA. 5-year reoperation rates after different types of lumbar spine surger. Spine (Phila Pa 1976) 1998;23:814–20.

    Article  CAS  Google Scholar 

  24. Hwang HJ, Park HK, Lee GS, Heo JY, Chang JC. Predictors of reoperation after microdecompression in lumbar spinal stenosis. Korean J Spine 2016;13:183–9.

    Article  Google Scholar 

  25. Deyo RA, Martin BI, Kreuter W, Jarvik JG, Angier H, Mirza SK, et al. Revision surgery following operations for lumbar stenosis. J Bone Joint Surg Am 2011;93:1979–86.

    Article  Google Scholar 

  26. Aizawa T, Ozawa H, Kusakabe T, Tanaka Y, Sekiguchi A, Hashimoto K, et al. Reoperation rates after fenestration for lumbar spinal canal stenosis: A 20-year period survival function method analysis. Eur Spine J 2015;24:381–7.

    Article  Google Scholar 

  27. Nakashima H, Kawakami N, Tsuji T, Ohara T, Suzuki Y, Saito T, et al. Adjacent segment disease after posterior lumbar interbody fusion: Based on cases with a minimum of 10 years of followup. Spine (Phila Pa 1976) 2015;40:E831–41.

  28. Javalkar V, Cardenas R, Tawfik TA, Khan IR, Bollam P, Banerjee AD, et al. Reoperations after surgery for lumbar spinal stenosis. World Neurosurg 2011;75:737–42.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Spine Surgery, Zydus Hospitals and Healthcare Research Pvt. Ltd., Ahmedabad, Gujarat, India

    Shakti A. Goel &  Hitesh N. Modi

Authors
  1. Shakti A. Goel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hitesh N. Modi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hitesh N. Modi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Goel, S.A., Modi, H.N. Reoperations Following Lumbar Spinal Canal Stenosis. IJOO 52, 578–583 (2018). https://doi.org/10.4103/ortho.IJOrtho_380_17

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ortho.IJOrtho_380_17

Keywords

MeSH terms

Search

Navigation