Thirty-day Unplanned Reoperations After Posterior Surgery for Thoracic Spinal Stenosis: A Single-center Study Based on 1948 Patients

Yuanyu Hu, Hanqiang Ouyang, Kaifeng Ye, Junbo Qi, Yanlei Dong, Xianlong Peng, Xin Zhang, Shu Dong, Zhongqiang Chen, Zhongjun Liu, Xiaoguang Liu, Chuiguo Sun, Weishi Li, Yun Tian, Yuanyu Hu, Hanqiang Ouyang, Kaifeng Ye, Junbo Qi, Yanlei Dong, Xianlong Peng, Xin Zhang, Shu Dong, Zhongqiang Chen, Zhongjun Liu, Xiaoguang Liu, Chuiguo Sun, Weishi Li, Yun Tian

Abstract

Study design: A retrospective study.

Objective: The purpose of this study is to identify the incidences, causes, and risk factors of 30-day unplanned reoperation of posterior surgery for thoracic spinal stenosis (TSS) based on 1948 patients in a single center.

Summary of background data: Unplanned reoperation is suggested to be a useful quality indicator for spine surgery. However, the incidences, causes, and risk factors of 30-day unplanned reoperation in patients who underwent posterior spinal surgery for TSS have not been well-established.

Materials and methods: We retrospectively analyzed the clinical data of patients who underwent posterior spinal surgery for TSS from January 2011 to December 2021. Statistical methods including univariate and multivariate analyses were performed to assess the incidences, causes, and risk factors.

Results: A total of 1948 patients who underwent posterior spinal surgery for TSS in our institution were reviewed, and 77 (3.95%) required unplanned reoperations within 30 days because of epidural hematoma (1.64%), wound-related complications (1.02%), inadequate decompression (0.41%), and implant malposition or failure (0.36%), neurological deficit (0.26%), and other causes (0.26%). After univariate analysis, seven clinical factors were associated with unplanned reoperation ( P <0.05). Multivariate logistic regression analysis showed that upper thoracic spine surgery ( P =0.010), thoracic kyphosis ≥45° ( P =0.039), and intraoperative dural injury ( P =0.047) were independent risk factors for 30-day unplanned reoperation of posterior surgery for TSS.

Conclusions: The incidence of 30-day unplanned reoperations after posterior surgical treatment for TSS was 3.95%. The most common causes were epidural hematoma, wound-related complications, inadequate decompression, and implant malposition or failure. Upper thoracic spine surgery, thoracic kyphosis ≥45°, and intraoperative dural injury led to an increased risk of unplanned reoperation within 30 days after posterior spinal surgery for TSS.

Level of evidence: 4.

Conflict of interest statement

The authors report no conflicts of interest.

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.

Figures

Figure 1
Figure 1
Proportion of causes of 30-day unplanned reoperation after posterior surgery for thoracic spinal stenosis.
Figure 2
Figure 2
Distribution of main types of 30-day unplanned reoperation in different time periods after posterior surgery for thoracic spinal stenosis.

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