Complications, reoperations, readmissions, and length of hospital stay in 34 639 surgical cases of lumbar disc herniation

Bone Joint J. 2019 Apr;101-B(4):470-477. doi: 10.1302/0301-620X.101B4.BJJ-2018-1184.R1.

Abstract

Aims: The aims of this study were to determine the rates of surgical complications, reoperations, and readmissions following herniated lumbar disc surgery, and to investigate the impact of sociodemographic factors and comorbidity on the rate of such unfavourable events.

Patients and methods: This was a longitudinal observation study. Data from herniated lumbar disc operations were retrieved from a large medical database using a combination of procedure and diagnosis codes from all public hospitals in Norway from 1999 to 2013. The impact of age, gender, geographical affiliation, education, civil status, income, and comorbidity on unfavourable events were analyzed by logistic regression.

Results: Of 34 639 operations, 2.7% (95% confidence interval (CI) 2.6 to 2.9) had a surgical complication, 2.1% (95% CI 2.0 to 2.3) had repeat surgery within 90 days, 2.4% (95% CI 2.2 to 2.5) had a non-surgical readmission within 90 days, and 6.7% (95% CI 6.4 to 6.9) experienced at least one of these unfavourable events. Unfavourable events were found to be associated with advanced age and comorbidity.

Conclusion: The results suggest that surgical complications are less frequent than previously suggested. There are limited associations between sociodemographic patient characteristics and unfavourable events. Cite this article: Bone Joint J 2019;101-B:470-477.

Keywords: Adverse events; Complications; Discectomy; Lumbar disc herniation; Reoperations; Sciatica; Surgery.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Databases, Factual
  • Diskectomy / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Intervertebral Disc Displacement / surgery*
  • Length of Stay
  • Lumbar Vertebrae*
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Patient Readmission / trends*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / surgery
  • Reoperation / statistics & numerical data*
  • Retrospective Studies
  • Spinal Fusion / adverse effects*
  • Treatment Outcome
  • Young Adult