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A systematic review and meta-analysis of risk factors for reoperation after degenerative lumbar spondylolisthesis surgery Research Article

Title: Delving into the Depths: Uncovering Risk Factors for Reoperation after Degenerative Lumbar Spondylolisthesis Surgery through a Comprehensive Review and Meta-analysis

Introduction:

Degenerative lumbar spondylolisthesis, a condition characterized by the displacement of one vertebra over another in the lumbar region, poses significant challenges for physicians and patients alike. Surgeons often perform surgical interventions to alleviate symptoms and restore spinal stability in affected individuals. However, despite substantial advancements in surgical techniques and postoperative care, reoperation rates remain a concern in this population.

In an effort to enhance our understanding of this critical issue, this comprehensive systematic review and meta-analysis scrutinizes the current body of research, aiming to identify the key risk factors associated with the need for reoperation following degenerative lumbar spondylolisthesis surgery.

Our article compiles and critically assesses existing studies, examining a diverse range of variables including patient demographics, surgical approach, preoperative and postoperative characteristics, and surgical outcomes. By employing a rigorous methodology, we aim to provide a comprehensive synthesis of the available evidence, presenting an accurate overview of the factors that impact the likelihood of reoperation.

This collaborative endeavor seeks to shed light on the potential contributors to the need for reoperation, enabling healthcare professionals to make informed decisions regarding patient selection, surgical techniques, and postoperative management protocols. Ultimately, this knowledge may pave the way for tailored interventions, reducing the incidence of reoperation, enhancing patient outcomes, and optimizing healthcare utilization.

As we delve into the depths of the existing literature, it becomes evident that a nuanced understanding of the risk factors associated with reoperation after degenerative lumbar spondylolisthesis surgery is crucial for advancing clinical practice. By bridging the gap between research findings and practical implications, this article aims to provide clinicians with a robust foundation from which to make evidence-based decisions, fostering more efficient and personalized patient care
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best rated spine clinic on Harley Street UK
Published article
CONCLUSIONS: We found a 10% of reoperation rate in DLS patients after lumbar surgeries. Obesity, diabetes, and smoking were risk factors for the reoperation.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
BMC Surg. 2023 Jul 5;23(1):192. doi: 10.1186/s12893-023-02082-8.ABSTRACTBACKGROUND: Considering the high reoperation rate in degenerative lumbar spondylolisthesis (DLS) patients undergoing lumbar surgeries and controversial results on the risk factors for the reoperation, we performed a systematic review and meta-analysis to explore the reoperation rate and risk factors for the reoperation in DLS patients undergoing lumbar surgeries.METHODS:,

BMC Surg. 2023 Jul 5;23(1):192. doi: 10.1186/s12893-023-02082-8.

ABSTRACT

BACKGROUND: Considering the high reoperation rate in degenerative lumbar spondylolisthesis (DLS) patients undergoing lumbar surgeries and controversial results on the risk factors for the reoperation, we performed a systematic review and meta-analysis to explore the reoperation rate and risk factors for the reoperation in DLS patients undergoing lumbar surgeries.

METHODS: Literature search was conducted from inception to October 28, 2022 in Pubmed, Embase, Cochrane Library, and Web of Science. Odds ratio (OR) was used as the effect index for the categorical data, and effect size was expressed as 95% confidence interval (CI). Heterogeneity test was performed for each outcome effect size, and subgroup analysis was performed based on study design, patients, surgery types, follow-up time, and quality of studies to explore the source of heterogeneity. Results of all outcomes were examined by sensitivity analysis. Publication bias was assessed using Begg test, and adjusted using trim-and-fill analysis.

RESULTS: A total of 39 cohort studies (27 retrospective cohort studies and 12 prospective cohort studies) were finally included in this systematic review and meta-analysis. The overall results showed a 10% (95%CI: 8%-12%) of reoperation rate in DLS patients undergoing lumbar surgeries. In surgery types subgroup, the reoperation rate was 11% (95%CI: 9%-13%) for decompression, 10% (95%CI: 7%-12%) for fusion, and 9% (95%CI: 5%-13%) for decompression and fusion. An increased risk of reoperation was found in patients with obesity (OR = 1.91, 95%CI: 1.04-3.51), diabetes (OR = 2.01, 95%CI: 1.43-2.82), and smoking (OR = 1.51, 95%CI: 1.23-1.84).

CONCLUSIONS: We found a 10% of reoperation rate in DLS patients after lumbar surgeries. Obesity, diabetes, and smoking were risk factors for the reoperation.

PMID:37407952 | PMC:PMC10324215 | DOI:10.1186/s12893-023-02082-8

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Read the original publication:
A systematic review and meta-analysis of risk factors for reoperation after degenerative lumbar spondylolisthesis surgery

Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.

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BMC Surg. 2023 Jul 5;23(1):192. doi: 10.1186/s12893-023-02082-8.ABSTRACTBACKGROUND: Considering the high reoperation rate in degenerative lumbar spondylolisthesis (DLS) patients undergoing lumbar surgeries and controversial results on the risk factors for the reoperation, we performed a systematic review and meta-analysis to explore the reoperation rate and risk factors for the reoperation in DLS patients undergoing lumbar surgeries.METHODS:

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