Abstract | BACKGROUND: OBJECTIVE: To test the hypothesis that select patients who underwent decompression with instrumented fusion for lumbar synovial cysts would be less likely to have subsequent surgery (SS) in a 2-year period than patients treated with laminectomy alone. METHODS: This retrospective cohort study was performed using IBM MarketScan Commercial Claims and Encounters Database. Patients who had a lumbar synovial cyst diagnosis and laminectomy surgery with or without fusion surgery were included in this study. Patients were tracked for SS 2 years after surgery. Laminectomy patients were propensity score-matched to laminectomy with fusion (LF) patients using a 2:1 ratio. The log-rank test and Cox regression were used to compare the cumulative incidence of SS between groups. RESULTS: There were 7664 and 1631 patients treated with laminectomy and LF before matching. After matching, there were 2212 laminectomy and 1631 LF patients and patient characteristics were balanced. The 2-year incidence of recurrent SS was 3.1% ([CI]: 2.2%, 4.0%) and 1.7% (95% CI: 0.9%, 2.5%) laminectomy and LF, respectively. Compared with laminectomy, LF had a statistically significant lower risk of recurrent SS (hazard ratio: 0.56 [95% CI: 0.32-0.97]; P -value: .04). CONCLUSION: All patients who had concomitant lumbar fusion showed decreased chance of having a cyst- or noncyst-related recurrence SS when compared with all patients undergoing laminectomy alone, regardless of diagnosis at the time of SS.
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Authors | Glenn A Gonzalez, Katherine Corso, Prerna Kothari, Daniel Franco, Guilherme Porto, Jingya Miao, John V Wainwright, Matthew O'Leary, Kevin Hines, Aria Mahtabfar, Mari Vanderkarr, Sara Thalheimer, Ashwini Sharan, Jack Jallo, James Harrop |
Journal | Neurosurgery
(Neurosurgery)
Vol. 92
Issue 5
Pg. 1013-1020
(05 01 2023)
ISSN: 1524-4040 [Electronic] United States |
PMID | 36700698
(Publication Type: Journal Article)
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Copyright | Copyright © Congress of Neurological Surgeons 2022. All rights reserved. |
Topics |
- Humans
- Decompression, Surgical
- Lumbosacral Region
(surgery)
- Retrospective Studies
- Treatment Outcome
- Laminectomy
(adverse effects)
- Spinal Fusion
- Synovial Cyst
(surgery, etiology, pathology)
- Lumbar Vertebrae
(surgery)
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