CHARACTERISTICS IN MEDICARE BENEFICIARIES ASSOCIATED WITH REOPERATIONAFTER LUMBAR SPINE SURGERY

Study Design. A cohort study was undertaken using medical claims of Me dicare beneficiaries. Objectives. Factors associated with reoperation after lumbar spine surgery were identified. Summary of Background Data . Repeat spine surgery is one outcome measure of surgical success, but little is known about clinical or demographic factors associated with repeat surgery. Methods. Medicare beneficiaries who had surgery in 19 85 were included in follow-up through 1989. Time between the first ope ration and a lumbar spine reoperation, death, or end of follow-up peri od was recorded. Survival analysis (time-to-event) techniques were use d to test the association of baseline characteristics with reoperation . Results. Higher reoperation rates were associated (P < 0.05) with pr evious back surgery, younger age, recent hospitalization, white race, and diagnosis of herniated disc (compared with other diagnoses). Fusio n alone or combined with other procedures did not lower the reoperatio n rate. Conclusion. Reoperation rates are affected not only by technic al factors, but also by demographic and clinical characteristics that are often omitted from reports of surgical cass series.