Introduction: This study aims to describe predictors of reoperation in patients who have undergone lumbar laminectomy.
Methods: We retrospectively reviewed electronic medical records of all patients undergoing first-time, 1-3 level bilateral laminectomy for lumbar spondylosis at a single institution. Patients with fusion, laminotomy, discectomy, and complete facetectomy were excluded. Preoperative symptoms and comorbidities were ascertained from patient records.
Results: Of the 500 patients undergoing 1-3 level laminectomy, 81 patients (16.20%) required reoperation over an average of 47 months. Following a multiple logistical regression, smoking was an independent predictor of reoperation (OR=2.27, p=0.01). Smoking was also an independent predictor of reoperation following a single level laminectomy (OR=11.20, p=0.02) and multi-level (2-3 level) laminectomy (OR=1.98, p=0.05). Of the 72 patients undergoing reoperation only for degenerative etiologies, smoking remained an independent statistical predictor of reoperation (OR=2.06, p=0.04). Nine patients underwent reoperation for non-degenerative causes (hematoma, wound infection, and wound dehiscence); COPD was the only statistical predictor of reoperation (OR=8.92, p=0.03) in that cohort.
Conclusions: Following a first-time lumbar laminectomy, smoking was the strongest predictor of reoperation in four cohorts: 1-3 level laminectomy, single level laminectomy, multi-level laminectomy, and reoperation for progression of degenerative disease. These findings suggest that smokers may have worse surgical outcomes after lumbar decompression.
Patient Care: This manuscript will provide evidence that smoking leads to poor surgical outcomes.
Learning Objectives: 1. Smoking was an independent predictor of reoperation following a 1-3 level first-time, bilateral, laminectomy.
2. Smoking was an independent predictor of reoperation following a single level laminectomy and multi-level laminectomy.
3. Among patients who underwent reoperation for non-degenerative causes (hematoma, wound infection, and wound dehiscence), COPD was the only statistical predictor of reoperation following a 1-3 level first-time, bilateral, laminectomy.