Orthopedics (74)

Reoperations after lumbar disc surgery: a population‐based study of regional and interspecialty variations. (National Research and Development Center for Welfare and Health (STAKES), Helsinki, Finland) Spine 2000;25:1500–1507. This study aimed to explore rates of reoperation after lumbar disc surgery and their regional and interspecialty variations. Patients who underwent lumbar spine surgery from 1987 to 1995 were identified in the Finnish Hospital Discharge Register. Data on the patient's initial disc operations, subsequent operations, and cause‐of‐death records were linked using personal identification codes. The Kaplan‐Meier method and proportional hazard model were used to analyze risks of reoperation after initial surgery and for neurosurgical and orthopedic patients of university hospitals. Out of 25,359 surgical patients with herniated lumbar discs, 12.3% underwent subsequent lumbar operations corresponding to the cumulative risk of 18.9% in the 9‐year follow‐up. Reoperation rates increased during the study period with the recent patient cohorts exhibiting risks. The reoperation risk showed a systematic geographic variation: the higher the regional disc surgery rate, the higher the reoperation risk. Overall, neurosurgical patients had a higher reoperation risk than orthopedic patients, but it was not a uniform finding. Conclude that the reoperation risk after disc surgery increased during the study period and was higher in hospital catchment areas with higher overall discectomy rates. The reoperation rates varied among the university hospitals, but tended to be higher for neurosurgical rather than for orthopedic patients.