120. Revision discectomy: analysis of 1-year incidence and risk factors

BACKGROUND CONTEXT Prior reports have noted rates of recurrent disc herniation following discectomy to be as high as 25%. As such, the primary cause of surgical failure and indication for revision following lumbar discectomy is recurrent disc herniation. However, information varies regarding the rate of incidence and timing of disc herniations following discectomies. PURPOSE The primary aim of this study was to determine the rate of revision discectomy following single-level lumbar discectomy at various postoperative time points. A secondary aim was to identify risk factors for revision discectomy. STUDY DESIGN/SETTING Retrospective review. PATIENT SAMPLE Patients from the Mariner Claims Database who underwent lumbar microdiscectomy between 2010 and 2018 with 1-year follow-up. OUTCOME MEASURES Rates of revision discectomy for reherniation at various postoperative intervals for up to a year following index surgery were calculated. METHODS The group was then followed up to one year after the initial indexed lumbar discectomy for revision according to the CPT codes (63030, 63047, 63042). The second part of the study assessed the independent effects of age, gender, and body mass index (BMI kg/m2) on rates of revision. Groups were separated by risk factors of interest and propensity score matched with respect to age, smoking, obesity, morbid obesity, Charlson Comorbidity Index (CCI). Risk factors for revision discectomy were determined using bivariate analyses following by multivariable logistic regression. Log rank test was used to construct Kaplan Meier survival curves. Significance was set at p Results Of 29,688 patients included in the analysis, 1.1% (N =325) underwent revision surgery for reherniation within seven days of index discectomy, and 18.5% (N=5,476) underwent revision surgery within a year of index discectomy. Compared to men, women had greater odds of revision (OR1.1, 95% CI 1.03-1.16, p 40, those aged Conclusions The overall rate of 1-year revision surgery for reherniation following lumbar discectomy is 18.5%, and the rate of revision surgery for reherniation within a week of index discectomy is low. These findings can assist surgeons in risk-stratifying patients based on the expected timing of postoperative reherniation in high-risk patients undergoing lumbar discectomy. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.