The study authors examined data from the National Neurosurgery Quality and Outcomes Database for patients who underwent repeat discectomy or instrumented fusion from 2012 to 2015. The procedures were performed at a single institution. There were 25 repeat discectomies and 12 instrumented fusions for recurrent disc herniation with follow-up records at three months and 12 months.
The researchers found:
1. Both groups reported similar Oswestry Disability Index and Visual Analog Scale scores. The quality-adjusted life years were similar at the three and 12 month follow-ups for both groups.
2. The patients who underwent instrumented fusion reported significantly longer hospital stays — 3.7 days, compared to one day for the repeat discectomy patients.
3. The instrumented fusion patients also had longer operative times — 229.6 minutes — compared to the repeat discectomy patients — 82.7 minutes.
4. Among the patients studied, the instrumented fusion group was more likely to be female and discharged to an inpatient rehabilitation facility instead of back home.
5. The hospital charges were $54,458 for the instrumented fusion group, compared to $11,567 for the repeat discectomy group. However, the repeat discectomy group had a higher reoperation rate — 12 percent — compared to 0 percent in the instrumented fusion group.
The study authors advised that the difference in reoperation rates wasn’t statistically significant.
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