Incidence of Revision Surgery Within Five Years of the Index Procedure for Grade 1 Spondylolisthesis: An analysis from the QOD Spondylolisthesis Data

Saturday, May 4, 2024

3:47 PM – 3:49 PM CT

Location: S403ab

Presenting Author(s)

Andrew K. Chan, MD

Assistant Professor of Neurological Surgery
Columbia University Irving Medical Center
New York, NY, US

Co-Author(s)

Jacob Birlingmair, MD

Spine Fellow
Norton Leatherman Spine Center
Anthony L. Asher, MD

President AANS, Clinical Professor
Neuroscience Institute, Carolina Neurosurgery & Spine Associates
Charlotte, North Carolina, United States
Erica F. Bisson, MD, MPH

Professor
University of Utah
Salt Lake City, UT, US
Mohamad Bydon, MD, FAANS

Professor of Neurosurgery
Mayo Clinic
Rochester, MN, US
LC

Leah Carreon, MD, MSc

Clinical Research Director
Norton Leatherman Spine Center
Louisville, Kentucky, United States
Dean Chou, MD

Chief of the Spine Division, Professor, and Vice Chair of Neurosurgery
Columbia University
New York, New York, United States
Domagoj Coric, MD

Neurosurgeon
Carolina Neurosurgery & Spine Associates
Charlotte, NC, US
Mladen Djurasovic, MD (he/him/his)

Attending Surgeon
Norton Leatherman Spine Center
Louisville, KY, US
Kevin T. Foley, MD

Professor
Semmes-Murphey Neurologic and Spine Institute, University of Tennessee
Memphis, TN, US
KF

Kai-Ming Fu, MD, PhD

Associate Professor
Weill Cornell Medical Center
New York, NY, US
Steven D. Glassman, MD (he/him/his)

Medical Director
Norton Leatherman Spine Center
Louisville, KY, US
Regis William Haid, Jr., MD

Neurosurgeon
Atlanta Brain and Spine
Atlanta, GA, US
John Knightly, MD, FAANS (he/him/his)

Vice President
AANS
Cedar Knolls, NJ, US
VL

Vivian P. Le, MPH

Clinical Research Coordinator Supervisor
University of California, San Francisco
Praveen V. Mummaneni, MD, MBA

Joan O'Reilly Endowed Professor and Vice Chair of Neurosurgery
Department of Neurological Surgery, University of California, San Francisco
San Francisco, CA, US
PP

Paul Park, MD

Professor of Neurosurgery
Semmes-Murphey Neurologic and Spine Institute
MEMPHIS, TN, US
Eric Potts, MD

Neurosurgeon
Goodman Campbell Brain and Spine
Carmel, IN, US
Christopher I. Shaffrey, MD

Professor of Spine Surgery
Duke University Medical Center
Durham, NC, US
MS

Mark Shaffrey, MD

Chair - Department of Neurosurgery
University of Virginia
Charlottesville, VA, US
JS

Jonathan R. Slotkin, MD

Surgeon
Geisinger Health
Danville, Pennsylvania, United States
MV

Michael S. Virk, MD, PhD

Assistant Professor
Weill Cornell Medical Center
New York, New York, United States
Michael Y. Wang, MD

Professor
University of Miami
Miami, FL, US

Disclosure(s):

Andrew K. Chan, MD: No financial relationships to disclose

Jacob Birlingmair, MD: No financial relationships to disclose

Anthony L. Asher, MD: Globus: Royalty Recipient (Ongoing)

Erica F. Bisson, MD, MPH: No financial relationships to disclose

Mohamad Bydon, MD, FAANS: No financial relationships to disclose

Dean Chou, MD: Cerapedics: Grant/Research Support (Ongoing); Cervical Scoliosis Research Society: Grant/Research Support (Ongoing); Globus Medical: Research Grant (Ongoing); Medtronic: Research Grant (Ongoing); Nuvasive: Research Grant (Ongoing); Royal Biologics: Consultant (Ongoing); Spine Committee: Board Member/Officer/Trustee (Ongoing); Spinevision: Consultant (Ongoing); SpineWave: Consultant (Ongoing); Terumo: Consultant (Ongoing)

Domagoj Coric, MD: 3Spine: Stock Shareholder (excluding mutual funds) (Ongoing); Globus Medical: Royalty Recipient (Ongoing); Medtronic: Consultant (Ongoing), Royalty Recipient (Ongoing); Premia Spine: Consultant (Ongoing), Stock Shareholder (excluding mutual funds) (Ongoing); Pressio: Stock Shareholder (excluding mutual funds) (Ongoing); Spine Wave: Consultant (Ongoing), Royalty Recipient (Ongoing), Stock Shareholder (excluding mutual funds) (Ongoing)

Kai-Ming Fu, MD, PhD: ATEC: Consultant (Terminated, December 1, 2023); Bioventus: Consultant (Ongoing); DePuy: Consultant (Ongoing)

Steven D. Glassman, MD: No financial relationships to disclose

Regis William Haid, MD, Jr.: Globus Medical: Royalty Recipient (Ongoing), Stock Shareholder (excluding mutual funds) (Ongoing); MDT: Royalty Recipient (Ongoing)

John Knightly, MD, FAANS: No financial relationships to disclose

Praveen V. Mummaneni, MD, MBA: AO Spine: Grant/Research Support (Ongoing); BK Medical: Speaker/Honoraria (Ongoing); Brainlab: Speaker/Honoraria (Ongoing); Depuy Synthes: Consultant (Ongoing); DOD: Research Grant (Ongoing); Globus: Consultant (Ongoing); ISSG: Grant/Research Support (Ongoing); NIH: Research Grant (Ongoing); NREF: Grant/Research Support (Ongoing); Pacira: Grant/Research Support (Ongoing); PCORI: Grant/Research Support (Ongoing); SI Bone: Speaker/Honoraria (Ongoing); SLIP II: Grant/Research Support (Ongoing); Springer Publisher: Royalty Recipient (Ongoing); Thieme Publisher: Royalty Recipient (Ongoing)

Paul Park, MD: Accelus: Consultant (Ongoing); Cerapedics: Grant/Research Support (Terminated, July 15, 2022); Depuy Spine: Consultant (Terminated, July 15, 2022), Grant/Research Support (Terminated, July 15, 2022); Globus Medical: Consultant (Ongoing), Royalty Recipient (Ongoing); ISSG: Grant/Research Support (Ongoing); Medtronic: Consultant (Ongoing); Nuvasive: Consultant (Ongoing); SI Bone: Grant/Research Support (Terminated, July 15, 2022); SMISS: Grant/Research Support (Ongoing)

Eric Potts, MD: Medtronic: Consultant (Ongoing), Royalty Recipient (Ongoing)

Christopher I. Shaffrey, MD: No financial relationships to disclose

Mark Shaffrey, MD: No financial relationships to disclose

Michael Y. Wang, MD: Depuy-Synthes: Consultant (Ongoing), Royalty Recipient (Ongoing); ISD: Stock Shareholder (excluding mutual funds) (Ongoing); Kinesiometrics: Stock Shareholder (excluding mutual funds) (Ongoing); Medical Device Partners: Stock Shareholder (excluding mutual funds) (Ongoing); NuVasive: Consultant (Ongoing); Pacira Pharmaceuticals: Consultant (Ongoing); Spineology: Consultant (Ongoing); Stryker: Consultant (Ongoing)

Introduction: Controversy remains as to whether fusion is necessary in patients undergoing decompression for grade 1 spondylolisthesis (G1S), with concerns for instability with decompression only and adjacent segment degeneration (ASD) with fusion. The purpose of this study was to determine the incidence of revision surgery in patients undergoing Decompression only and decompression and fusion (D+F) for G1S within five years of the index surgery.

Methods: Patients enrolled in QOD with a diagnosis of G1S were identified and the incidence of revision surgery between the Decompression only and D+F patients were compared.

Results: Of 608 cases identified, 42 had one revision and 2 had two revisions within five years of the index surgery. The proportion of revisions in the Decompression only group (13 of 127, 10%) was similar to the D+F group (31/468, 6%, p=0.338). There were no revision surgeries in the Decompression only group at 30 days. The most common reason for reoperation at 30 days was irrigation and debridement (5/10) in the D+F group. The most common reason for reoperation at 1 year was repeat decompression (7/8) in the Decompression only group and ASD (3/6) in the D+F group. The most common reason for reoperation at 2 years was ASD (2/3) in the Decompression only group and ASD (3/6) in the D+F group. The most common reason for reoperation at 3 years was ASD (2/2) in the Decompression only group and non-union (4/6) in the D+F group.

Conclusion : Repeat decompression was the most common reason for reoperation within 3 years in the Decompression only group. Adjacent segment degeneration was the most common reason for reoperation within 3 years in the DF group. Surgeons should use this information to educate patients of the relevant risks associated with their index operation for treatment of Grade 1 Spondylolisthesis.