Predictors of Reoperation in Lumbar Stenosis and Degenerative Spondylolisthesis Surgery: A Subgroup Analysis of the SPORT Study

Abstract

smoking, diabetes, heart problems, intestinal problems, sensory deficit, L5S1 stenosis, neuroforaminal stenosis, predominant leg pain, and a job without lifting requirements predicted larger TEs in the minimally adjusted analyses. Multivariate analysis demonstrated that not smoking (TE 11.8 vs. 1.6 for smokers, p!.001), lower baseline ODI score (TE 16.3 for ODI!30 vs. 4.8 for ODIO56, p!.001), heart problems (TE 13.3 vs. 9.5 for patients without heart problems, p5.041), predominant leg pain (TE 11.5 vs. 7.3 for predominant back pain, p5.035), and a job without lifting (TE5-12.5 vs. 8.5 for a job with lifting, p5.017) were independent TE modifiers. CONCLUSIONS: SPORT SpS patients met specific inclusion criteria and improved more with surgery than with nonoperative treatment in all evaluated subgroups other than smokers. However, TE varied significantly among subgroups; non-smokers, patients with lower baseline ODI scores, heart problems, predominant leg pain, and a job without lifting benefited more from surgery relative to nonoperative treatment. Due to their poor surgical outcomes that were not significantly better than nonoperative outcomes, smokers with SpS should be advised that they may not substantially benefit from surgery. FDA DEVICE/DRUG STATUS: This abstract does not discuss or include any applicable devices or drugs.