Multilevel fusions for patients having lumbar decompressions are associated with increased odds for postoperative adverse events, readmissions and reoperations, according to a study in the July 1 issue of Spine.
Four notes:
1. Researchers used data from the PearlDiver M165Orto database to evaluate outcomes for patients who had 3-level lumbar decompressions and a 3-level fusion relative to 1-level fusion.
2. The study measured incidence and odds of 90-day postoperative adverse events and comparative 5-year survival to lumbar spinal reoperation was determined.
3. Patients having 3-level fusion had higher odds of several 90-day adverse events (odds ratio of 1.42) and readmissions (odds ratio of 1.51). Five-year survival to reoperation was also lower for the 3-level fusion group.
4. The study concluded, “Patients undergoing 3-level lumbar decompression who underwent 3-level fusion were found to be at significantly greater odds of 90-day postoperative adverse events, readmissions, and 5-year reoperations relative to those undergoing 1-level fusion. The current data support the concept of limiting fusion to the levels with specific indications in the setting of multilevel lumbar decompressions and not needing to match the decompression and fusion levels.”
