Our Summary

This research aimed to figure out how often complications requiring further surgery occur in patients who have already had a specific type of back surgery (one-segment lumbar decompression and fusion). The study also aimed to identify the risk factors that would increase the likelihood of these complications.

The researchers reviewed the medical histories of 161 patients who had this surgery, looking at a range of factors such as age, gender, body weight, the angle and orientation of certain bones in their spine, the degree of narrowing in their spinal canal, and the type of fusion surgery they had, among others.

The findings showed that about 14% of patients needed additional surgeries in the area near where the first surgery was performed. The study found that having a pre-existing narrowing of the spinal canal of 47% or more, a certain abnormality in the alignment of spinal bones (facet tropism), and being overweight (high BMI) significantly increased the risk of needing additional surgery.

Interestingly, the study found that one specific imaging technique, myelography (a type of X-ray used to visualize the spinal cord), was a more accurate method for identifying these risks than another common technique, MRI.

In simpler terms, if you’ve had this specific back surgery, you’re more likely to need additional surgery if you have a significantly narrowed spinal canal, if your spinal bones are not aligned as they typically should be, or if you’re overweight. Also, one type of X-ray may be better than an MRI at spotting these risks.

FAQs

  1. What were the main findings of this research on complications from a specific type of back surgery?
  2. What factors were identified as increasing the likelihood of needing additional surgery after a one-segment lumbar decompression and fusion?
  3. According to the study, which imaging technique was more accurate in identifying the risks of needing additional surgery: myelography or MRI?

Doctor’s Tip

Therefore, it’s important to maintain a healthy weight, follow your doctor’s recommendations for post-surgery care and rehabilitation, and discuss any concerns or symptoms with your healthcare provider promptly. Additionally, make sure to attend all follow-up appointments and imaging studies as recommended to monitor your spine and catch any potential issues early on. Remember, early detection and intervention can help prevent the need for additional surgeries in the future.

Suitable For

Patients who are typically recommended spinal surgery include those with severe back pain, radiculopathy (nerve pain), spinal stenosis (narrowing of the spinal canal), herniated discs, spinal deformities, spinal fractures, and other conditions that have not improved with conservative treatments such as physical therapy, medications, and injections. In the case of the specific type of surgery mentioned in the study, patients with pre-existing narrowing of the spinal canal, abnormal alignment of spinal bones, and high BMI may be at a higher risk of needing additional surgeries in the future.

Timeline

Before spinal surgery:

  1. Patient experiences back pain, numbness, weakness, or other symptoms that indicate a spinal issue.
  2. Patient undergoes diagnostic tests such as X-rays, MRIs, or CT scans to determine the cause of their symptoms.
  3. Patient consults with a spine specialist to discuss treatment options, including the possibility of surgery.
  4. Patient undergoes pre-operative evaluations and tests to ensure they are healthy enough for surgery.
  5. Surgery is scheduled, and the patient receives instructions on pre-operative care and what to expect during and after the procedure.

After spinal surgery:

  1. Patient undergoes the surgical procedure, which may involve decompression, fusion, or other techniques to address the spinal issue.
  2. Patient is monitored in the hospital for a period of time to ensure they are stable and recovering well.
  3. Patient may experience pain, discomfort, and limited mobility in the immediate post-operative period.
  4. Patient begins physical therapy and rehabilitation to regain strength and mobility in the spine.
  5. Patient follows up with their surgeon for post-operative appointments to monitor their progress and address any concerns.
  6. Patient gradually resumes normal activities and monitors for any signs of complications or the need for additional surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal surgery based on this research include:

  1. What are the potential complications that could require further surgery after my specific type of back surgery?
  2. Are there any risk factors that increase the likelihood of needing additional surgery, such as a narrowed spinal canal, abnormal spinal bone alignment, or being overweight?
  3. Will my doctor be using myelography or MRI imaging to assess my risk for complications that may require further surgery?
  4. What steps can I take to reduce my risk of needing additional surgery after my initial spinal surgery?
  5. How will my doctor monitor and follow up on my progress after the initial surgery to prevent the need for further procedures?
  6. Are there alternative treatment options or lifestyle changes that could help reduce the risk of complications that may require additional surgery?
  7. What is the typical recovery process like for patients who do need additional surgery after their initial spinal surgery?
  8. How will my doctor determine if additional surgery is necessary, and what are the potential outcomes of undergoing a second surgery in the same area of the spine?

Reference

Authors: Yugué I, Okada S, Masuda M, Ueta T, Maeda T, Shiba K. Journal: Eur Spine J. 2016 May;25(5):1542-1549. doi: 10.1007/s00586-015-4185-6. Epub 2015 Aug 14. PMID: 26272373