Smoking as an independent predictor of reoperation after lumbar laminectomy: a study of 500 cases

Mohamad Bydon, Mohamed Macki, Rafael De la Garza-Ramos, Daniel Sciubba, Jean Paul Wolinsky, Ziya L. Gokaslan, Timothy F Witham, Ali Bydon

Research output: Contribution to journalArticle

Abstract

CONCLUSIONS: Smoking was the strongest predictor of reoperation in patients who had undergone single-level laminectomy, multilevel laminectomy, or reoperation for progression of spinal degeneration. These findings suggest that smokers have worse outcomes of lumbar decompression than nonsmokers.

OBJECT: This study aimed to identify the factors predicting an increased risk for reoperation in patients who had undergone a lumbar laminectomy.

METHODS: The authors retrospectively reviewed the electronic medical records of all patients who had undergone firsttime, bilateral laminectomy at 1, 2, or 3 levels for lumbar spondylosis at the authors' institution. Patients who underwent fusion, laminotomy, discectomy, or complete facetectomy were excluded. The patients' preoperative symptoms and comorbidities were also obtained from their medical records.

RESULTS: Over an average follow-up period of 46.8 months, of 500 patients who had undergone laminectomy at 1, 2, or 3 levels, 81 patients (16.2%) developed subsequent spinal disorders that required a reoperation. A multiple logistic regression analysis identified smoking as an independent predictor of reoperation (OR 2.15, p = 0.01). Smoking was also an independent predictor of reoperation after a single-level laminectomy (OR 11.3, p = 0.02) and after a multilevel (that is, involving 2 or 3 levels) laminectomy (OR 1.98, p = 0.05). For 72 patients undergoing reoperation only for spinal degeneration, smoking remained an independent, statistically significant predictor of reoperation (OR 2.06, p = 0.04). Nine patients underwent reoperation for nondegenerative conditions (hematoma, wound infection, or wound dehiscence), and in these patients, chronic obstructive pulmonary disease was the only statistically significant predictor of reoperation (OR 8.92, p = 0.03).

Original languageEnglish (US)
Pages (from-to)288-293
Number of pages6
JournalJournal of Neurosurgery: Spine
Volume22
Issue number3
DOIs
StatePublished - Mar 1 2015

Fingerprint

Laminectomy
Reoperation
Smoking
Spondylosis
Diskectomy
Electronic Health Records
Wound Infection
Decompression
Hematoma
Chronic Obstructive Pulmonary Disease
Medical Records
Comorbidity
Logistic Models
Regression Analysis

Keywords

  • COPD = chronic obstructive pulmonary disease
  • decompression
  • laminectomy
  • lumbar
  • predictor
  • reoperation
  • smoking
  • spinal disorders

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Smoking as an independent predictor of reoperation after lumbar laminectomy : a study of 500 cases. / Bydon, Mohamad; Macki, Mohamed; De la Garza-Ramos, Rafael; Sciubba, Daniel; Wolinsky, Jean Paul; Gokaslan, Ziya L.; Witham, Timothy F; Bydon, Ali.

In: Journal of Neurosurgery: Spine, Vol. 22, No. 3, 01.03.2015, p. 288-293.

Research output: Contribution to journalArticle

Bydon, Mohamad ; Macki, Mohamed ; De la Garza-Ramos, Rafael ; Sciubba, Daniel ; Wolinsky, Jean Paul ; Gokaslan, Ziya L. ; Witham, Timothy F ; Bydon, Ali. / Smoking as an independent predictor of reoperation after lumbar laminectomy : a study of 500 cases. In: Journal of Neurosurgery: Spine. 2015 ; Vol. 22, No. 3. pp. 288-293.
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abstract = "CONCLUSIONS: Smoking was the strongest predictor of reoperation in patients who had undergone single-level laminectomy, multilevel laminectomy, or reoperation for progression of spinal degeneration. These findings suggest that smokers have worse outcomes of lumbar decompression than nonsmokers.OBJECT: This study aimed to identify the factors predicting an increased risk for reoperation in patients who had undergone a lumbar laminectomy.METHODS: The authors retrospectively reviewed the electronic medical records of all patients who had undergone firsttime, bilateral laminectomy at 1, 2, or 3 levels for lumbar spondylosis at the authors' institution. Patients who underwent fusion, laminotomy, discectomy, or complete facetectomy were excluded. The patients' preoperative symptoms and comorbidities were also obtained from their medical records.RESULTS: Over an average follow-up period of 46.8 months, of 500 patients who had undergone laminectomy at 1, 2, or 3 levels, 81 patients (16.2{\%}) developed subsequent spinal disorders that required a reoperation. A multiple logistic regression analysis identified smoking as an independent predictor of reoperation (OR 2.15, p = 0.01). Smoking was also an independent predictor of reoperation after a single-level laminectomy (OR 11.3, p = 0.02) and after a multilevel (that is, involving 2 or 3 levels) laminectomy (OR 1.98, p = 0.05). For 72 patients undergoing reoperation only for spinal degeneration, smoking remained an independent, statistically significant predictor of reoperation (OR 2.06, p = 0.04). Nine patients underwent reoperation for nondegenerative conditions (hematoma, wound infection, or wound dehiscence), and in these patients, chronic obstructive pulmonary disease was the only statistically significant predictor of reoperation (OR 8.92, p = 0.03).",
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T1 - Smoking as an independent predictor of reoperation after lumbar laminectomy

T2 - a study of 500 cases

AU - Bydon, Mohamad

AU - Macki, Mohamed

AU - De la Garza-Ramos, Rafael

AU - Sciubba, Daniel

AU - Wolinsky, Jean Paul

AU - Gokaslan, Ziya L.

AU - Witham, Timothy F

AU - Bydon, Ali

PY - 2015/3/1

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N2 - CONCLUSIONS: Smoking was the strongest predictor of reoperation in patients who had undergone single-level laminectomy, multilevel laminectomy, or reoperation for progression of spinal degeneration. These findings suggest that smokers have worse outcomes of lumbar decompression than nonsmokers.OBJECT: This study aimed to identify the factors predicting an increased risk for reoperation in patients who had undergone a lumbar laminectomy.METHODS: The authors retrospectively reviewed the electronic medical records of all patients who had undergone firsttime, bilateral laminectomy at 1, 2, or 3 levels for lumbar spondylosis at the authors' institution. Patients who underwent fusion, laminotomy, discectomy, or complete facetectomy were excluded. The patients' preoperative symptoms and comorbidities were also obtained from their medical records.RESULTS: Over an average follow-up period of 46.8 months, of 500 patients who had undergone laminectomy at 1, 2, or 3 levels, 81 patients (16.2%) developed subsequent spinal disorders that required a reoperation. A multiple logistic regression analysis identified smoking as an independent predictor of reoperation (OR 2.15, p = 0.01). Smoking was also an independent predictor of reoperation after a single-level laminectomy (OR 11.3, p = 0.02) and after a multilevel (that is, involving 2 or 3 levels) laminectomy (OR 1.98, p = 0.05). For 72 patients undergoing reoperation only for spinal degeneration, smoking remained an independent, statistically significant predictor of reoperation (OR 2.06, p = 0.04). Nine patients underwent reoperation for nondegenerative conditions (hematoma, wound infection, or wound dehiscence), and in these patients, chronic obstructive pulmonary disease was the only statistically significant predictor of reoperation (OR 8.92, p = 0.03).

AB - CONCLUSIONS: Smoking was the strongest predictor of reoperation in patients who had undergone single-level laminectomy, multilevel laminectomy, or reoperation for progression of spinal degeneration. These findings suggest that smokers have worse outcomes of lumbar decompression than nonsmokers.OBJECT: This study aimed to identify the factors predicting an increased risk for reoperation in patients who had undergone a lumbar laminectomy.METHODS: The authors retrospectively reviewed the electronic medical records of all patients who had undergone firsttime, bilateral laminectomy at 1, 2, or 3 levels for lumbar spondylosis at the authors' institution. Patients who underwent fusion, laminotomy, discectomy, or complete facetectomy were excluded. The patients' preoperative symptoms and comorbidities were also obtained from their medical records.RESULTS: Over an average follow-up period of 46.8 months, of 500 patients who had undergone laminectomy at 1, 2, or 3 levels, 81 patients (16.2%) developed subsequent spinal disorders that required a reoperation. A multiple logistic regression analysis identified smoking as an independent predictor of reoperation (OR 2.15, p = 0.01). Smoking was also an independent predictor of reoperation after a single-level laminectomy (OR 11.3, p = 0.02) and after a multilevel (that is, involving 2 or 3 levels) laminectomy (OR 1.98, p = 0.05). For 72 patients undergoing reoperation only for spinal degeneration, smoking remained an independent, statistically significant predictor of reoperation (OR 2.06, p = 0.04). Nine patients underwent reoperation for nondegenerative conditions (hematoma, wound infection, or wound dehiscence), and in these patients, chronic obstructive pulmonary disease was the only statistically significant predictor of reoperation (OR 8.92, p = 0.03).

KW - COPD = chronic obstructive pulmonary disease

KW - decompression

KW - laminectomy

KW - lumbar

KW - predictor

KW - reoperation

KW - smoking

KW - spinal disorders

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