One out of 10 Patients Face Reoperation within 5 Years after lumbar Herniated Intervertebral Disc Surgery
One out of 10 Patients Face Reoperation within 5
Years after lumbar Herniated Intervertebral Disc Surgery
About
one out of ten patients proved to undergo reoperation within five years after
the initial intervertebral disc surgery. Intervertebral disc disorder is the
most commonplace in spine surgery, and many worry over its recurrence. Despite
of advances in surgical techniques and instruments, reoperation is unavoidable
for some patients. According to foreign literature, 6%~24% have reoperation
after the initial intervertebral disc surgery.
In Korea where
there was no nationwide survey on such reoperation rates, it was yet hard for
doctors or patients to predict the prognosis after spine surgery. Teaming up
with the Health Insurance Review & Assessment Service, the spine research
team, Dept. of Neurosurgery, SNU Hospital (Chung, Chun Kee and Kim, Chi Heon)
hereby kept track of 18,590 patients for 5 years who underwent their first lumbar
herniated intervertebral disc surgery in 2003.
Consequently, 13.4%
(2,485 patients) had reoperation within 5 years after the initial surgery. About
half of them underwent reoperation within 1 year.
4.1% (768 people),
7.4% (1,384 people), 9% (1,678 people), 10.5% (1,948 people), 12.1% (2,246 people),
and 13.4% (2,485 people) had reoperation within 1 month, 1 year, 2 years, 3
years, 4 years, and 5 years respectively after the initial spine surgery. (This
figure (%) is cumulative reoperation rate.) This nearly coincided with that
of the U.S. known as a nation of advanced medicine. In the U.S., the ratio of
reoperation within 5 years reportedly stood at 13%~18%.
Reoperation
is an additional surgery to the lumbar spine including the operated area, thereby
being construed as something different from recurrence.
The causes of
reoperation can be largely classified into two cases. First, reoperation is
attributable to the problem with the operated area. Here, reoperation within
1 month after the initial surgery occurs when the initial surgery fails to solve
the problem (about 4.1%) or when degenerative changes progress in the operated
area. Second, reoperation takes place due to the problem with another area except
the operated area, and this is distinct from recurrence. Herniated Intervertebral
disc disease is basically a degenerative process, so it includes reoperation
that is inevitable in the course of natural history.
This study
is based on analysis of those patients who underwent surgery 10 years ago (2003),
so it cannot give an accurate portrayal of recent circumstances. Even though
many medical institutions report spine surgery results, a nationwide data analysis
like this study should be regularly undertaken to improve medical quality and
management at a national level.
Professor Chung, Chun-Kee (Corresponding
Author) said, “This study should lay the foundation for
us to actively analyze medical problems of vague concerns and offer the optimum
medical services through development of merits and complementation of demerits.”
He also stressed the proper use of spine surgery, adding that it is desirable
to implement surgery only when it is inevitable despite its proven track record
of success.
This study was published in the April
2013 edition of 'Spine' globally acclaimed as an international journal of spine
surgery.