In a recent study published in Spine ( http://bit.ly/17d1CqS ), researchers performed a subgroup analysis of the Spine Patient Outcomes Research Trial (SPORT) to determine the risk of same segment or adjacent segment reoperation after lumbar stenosis surgery.
The study included 413 patients who underwent surgery for spinal stenosis, 13 percent of which required reoperation within four years.
“The study concluded that lumbar fusion and instrumentation were not associated with increased rate of reoperation at same level or adjacent levels compared with nonfusion surgery techniques. The only specific risk factor for reoperation after treatment of spinal stenosis was duration of pretreatment symptoms more than 12 months. The overall incidence of reoperations for spinal stenosis surgery was 13%, and reoperations were equally distributed between index and adjacent lumbar levels. Reoperation may be related to the natural history of spinal degenerative disease.” (credits to the authors)
It is feasible that current minimally invasive fusion techniques will further lessen re-operation rates by preservation of supporting tissues and more selective positioning of instrumentation to secure the index level and protect the adjacent levels.