Smoking as an independent predictor of reoperation after lumbar laminectomy: A study of 500 cases

Mohamad Bydon, Mohamed Macki, Rafael De La Garza-Ramos, Daniel M. Sciubba, Jean Paul Wolinsky, Ziya L. Gokaslan, Timothy F. Witham, Ali Bydon*

*Corresponding author for this work

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

OBJECT: This study aimed to identify the factors predicting an increased risk for reoperation in patients who had undergone a lumbar laminectomy. METHODS: The authors retrospectively reviewed the electronic medical records of all patients who had undergone first-time, bilateral laminectomy at 1, 2, or 3 levels for lumbar spondylosis at the authors' institution. Patients who underwent fusion, laminotomy, discectomy, or complete facetectomy were excluded. The patients' preoperative symptoms and comorbidities were also obtained from their medical records. RESULTS: Over an average follow-up period of 46.8 months, of 500 patients who had undergone laminectomy at 1, 2, or 3 levels, 81 patients (16.2%) developed subsequent spinal disorders that required a reoperation. A multiple logistic regression analysis identified smoking as an independent predictor of reoperation (OR 2.15, p = 0.01). Smoking was also an independent predictor of reoperation after a single-level laminectomy (OR 11.3, p = 0.02) and after a multilevel (that is, involving 2 or 3 levels) laminectomy (OR 1.98, p = 0.05). For 72 patients undergoing reoperation only for spinal degeneration, smoking remained an independent, statistically significant predictor of reoperation (OR 2.06, p = 0.04). Nine patients underwent reoperation for nondegenerative conditions (hematoma, wound infection, or wound dehiscence), and in these patients, chronic obstructive pulmonary disease was the only statistically significant predictor of reoperation (OR 8.92, p = 0.03). CONCLUSIONS: Smoking was the strongest predictor of reoperation in patients who had undergone single-level laminectomy, multilevel laminectomy, or reoperation for progression of spinal degeneration. These findings suggest that smokers have worse outcomes of lumbar decompression than nonsmokers.

Original languageEnglish (US)
Pages (from-to)288-293
Number of pages6
JournalJournal of Neurosurgery: Spine
Volume22
Issue number3
DOIs
StatePublished - Mar 1 2015

Keywords

  • Decompression
  • Laminectomy
  • Lumbar
  • Predictor
  • Reoperation
  • Smoking
  • Spinal disorders

ASJC Scopus subject areas

  • Medicine(all)

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