• Takayoshi Shimizu, Shunsuke Fujibayashi, Mitsuru Takemoto, Bungo Otsuki, Hiroaki Kimura, Masato Ota, Akira Kusuba, Youngwoo Kim, Tsunemitsu Soeda, Kei Watanabe, Takeshi Sakamoto, Akira Uchikoshi, Naoya Tsubouchi, and Shuichi Matsuda.
• Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto, 606-8507, Japan. takayosh@kuhp.kyoto-u.ac.jp.
• Eur Spine J. 2016 Mar 1; 25 (3): 828-35.

PurposeTo investigate the incidence and causes of reoperations within 30 days of spine surgery.MethodsPatients who underwent spine surgery between 2002 and 2012, at one of 9 institutions, were enrolled. The causes of all reoperations, within 30 days of the index surgery, were reviewed. The incidence of reoperations within 30 days were calculated and compared according to the preoperative diagnosis, use of instrumentation, surgical level, and approach. Moreover, the distribution of the causes for reoperations within the 30-day period was also assessed.ResultsThe overall incidence of reoperations, within 30 days of spine surgery, was 1.6% (175/10,680). Patients who underwent instrumentation procedures demonstrated a higher incidence of reoperations than patients who underwent procedures without instrumentation (P < 0.001). Moreover, patients diagnosed with preoperative trauma had a higher incidence of reoperation than those with other diagnoses (P < 0.001). Surgical site infection (SSI), postoperative epidural hematoma, pedicle screw malposition, and inadequate decompression were the four main causes of reoperation. Motor paralysis, due to epidural hematoma, was the predominant cause of reoperations during the hyper-acute phase (0-1 days, postoperatively), whereas SSI was the dominant cause during the sub-acute phase (11-30 days, postoperatively).ConclusionsThis large, multi-center study indicated the causes and incidence of reoperations, within 30 days of the initial spinal surgery. Based on these data, spinal surgeons can provide patients with information that allows them to better understand the surgical risk and expected post-surgical management.

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