• Michael C Gerling, Dante Leven, Peter G Passias, Virginie Lafage, Kristina Bianco, Alexandra Lee, Jon D Lurie, Tor D Tosteson, Wenyan Zhao, Kevin F Spratt, Kristen Radcliff, and Thomas J Errico.
• *Department of Orthopaedic Surgery, New York University Langone Medical Center, New York, NY †State University of New York, Downstate Medical Center, Brooklyn, NY ‡Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH §The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH ¶Rothman Institute of Thomas Jefferson University, Philadelpha, PA.
• Spine. 2016 May 1; 41 (10): 901-9.

Study DesignA retrospective subgroup analysis was performed on surgically treated patients from the lumbar spinal stenosis (SpS) arm of the Spine Patient Outcomes Research Trial (SPORT), randomized, and observational cohorts.ObjectiveTo identify risk factors for reoperation in patients treated surgically for SpS and compare outcomes between patients who underwent reoperation with those who did not.Summary Of Background DataSpS is one of the most common indications for surgery in the elderly; however, few long-term studies have identified risk factors for reoperation.MethodsA post-hoc subgroup analysis was performed on patients from the SpS arm of the SPORT, randomized and observational cohorts. Baseline characteristics were analyzed between reoperation and no-reoperation groups using univariate and multivariate analysis on data 8 years postoperation.ResultsOf the 417 study patients, 88% underwent decompression only, 5% noninstrumented fusion, and 6% instrumented fusion. At the 8-year follow-up, the reoperation rate was 18%; 52% of reoperations were for recurrent stenosis or progressive spondylolisthesis, 25% for complication or other reason, and 16% for new condition. Of patients who underwent a reoperation, 42% did so within 2 years, 70% within 4 years, and 84% within 6 years. Patients who underwent reoperation were less likely to have presented with any neurological deficit (43% reop vs. 57% no reop, P = 0.04). Patients improved less at follow-up in the reoperation group (P < 0.001).ConclusionIn patients undergoing surgical treatment for SpS, the reoperation rate at 8-year follow-up was 18%. Patients with a reoperation were less likely to have a baseline neurological deficit. Patients who did not undergo reoperation had better patient reported outcomes at 8-year follow-up compared with those who had repeat surgery.Level Of Evidence2.

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