Long-term reoperation rates and causes for reoperations following lumbar microendoscopic discectomy and decompression: 10-year follow-up

Object The aim of this study was to report the long-term outcomes of patients receiving endoscopic ventriculocystocisternostomy (VCC) for suprasellar arachnoid cysts (SACs), and to analyze all published reports on outcomes of ventriculocystostomy (VC) versus VCC to compare the effectiveness of the 2 techniques. Methods Eleven consecutive patients with previously untreated SACs were surgically treated using endoscopic VCC. Another 2 patients were treated with VCC following ventriculoperitoneal shunt placement. Clinical imaging data were recorded. An analysis was performed of all published patient outcomes following endoscopic VC or VCC for an SAC. Results Developmental delay and progressive macrocephaly were the most common preoperative symptoms. At a mean clinical follow-up interval of 63 months, 10 of 11 patients undergoing primary VCC did not require reoperation. An analysis of the literature suggests that VCC may be more effective than VC. Of the 44 reported patients that underwent VC as a first treatment, 7 (16%) required reoperation, and 7 (8%) of 86 patients who underwent VCC as a first treatment required reoperation. When VC or VCC was performed following a prior surgical procedure, 4 of 11 patients undergoing VC had a treatment failure requiring reoperation. In contrast, only 2 of the 17 reported cases of VCC following a prior procedure required further treatment. The difference in reoperation rates following either primary or secondary VC was significantly higher than following primary or secondary VCC (p = 0.04). Conclusions The authors conclude that VCC is an effective and durable treatment for symptomatic SACs in most cases.

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Characteristics and reoperation rates of paediatric tarsal coalitions: a population-based study

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.14.200177 ◽

2020 ◽

Vol 14 (6) ◽

pp. 537-543

Author(s):

Taylor J. Jackson ◽

Smitha E. Mathew ◽

A. Noelle Larson ◽

Anthony A. Stans ◽

Todd A. Milbrandt

Keyword(s):

Statistical Significance ◽

Population Based ◽

Population Based Study ◽

Persistent Symptoms ◽

Initial Surgery ◽

Tarsal Bones ◽

Operation Rate ◽

Reoperation Rates

Purpose Tarsal coalitions are congenital fusions of two or more tarsal bones and can lead to foot pain and stiffness. Few studies examine the long-term reoperation rates following paediatric tarsal coalition surgery. Methods A population-based database, linking medical records at all medical centres to capture the entire medical history of the full population of a Midwest county, was used to identify tarsal coalitions in children between 1966 and 2018. Records were reviewed for clinical data, surgical records and followed up to identify any subsequent surgical interventions. Results A total of 58 patients (85 coalitions) were identified; 46 calcaneonavicular (CN) coalitions, 30 talocalcaneal (TC) coalitions and nine other coalitions (seven talonavicular, one naviculocuboid, one naviculocuneiform). In all, 46 coalitions were treated surgically (43 coalition resections, three arthrodeses) and 39 were treated nonoperatively. Patients treated surgically were less likely to report ongoing symptoms at final follow-up compared with patients managed nonoperatively (33% versus 67%; p = 0.0017). With a median 14.4 years (interquartile range 9.3 to 19.7) follow-up, there was an overall re-operation rate of 8.7% (4/46). Differences in reoperation rates by initial surgery (resection versus arthrodesis; p = 0.2936), coalition type (CN versus TC versus Other; p = 0.6487) or composition (osseous versus fibrocartilaginous; p = 0.29) did not reach statistical significance. Conclusion This is the first population-based study demonstrating the durability of surgical management of tarsal coalitions in a paediatric population. At final follow-up, patients treated surgically are less likely to report persistent symptoms compared with patients managed nonoperatively. Long-term reoperation rates appear to be low (8.7%). Level of evidence: III

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Long-term Outcomes of MCP Surface Replacement Arthroplasty in Patients With Rheumatoid Arthritis

Hand ◽

10.1177/1558944720926631 ◽

2020 ◽

pp. 155894472092663

Author(s):

Matthew R. Claxton ◽

Eric R. Wagner ◽

Marco Rizzo

Keyword(s):

Rheumatoid Arthritis ◽

Revision Arthroplasty ◽

Metacarpophalangeal Joint ◽

Surface Replacement ◽

Joint Registry ◽

Surface Replacement Arthroplasty ◽

Replacement Arthroplasty ◽

Reoperation Rates

Background: Surface replacement arthroplasty (SRA) can be used in the treatment of rheumatoid arthritis (RA) affecting the metacarpophalangeal (MCP) joint. The authors of this study sought to investigate the outcomes of MCP SRA in patients with RA. Methods: Retrospective review of medical records and an institutional joint registry were used to gather data on 80 MCP SRAs performed in 27 patients with RA. Data collected included demographics, SRA revisions, reoperations, complications, pain, and MCP arc of motion. Results: The mean postoperative follow-up was 9.5 years (range, 2.1-20.5 years), with all SRAs achieving at least 2 years of follow-up. Thirteen digits (16%) underwent revision arthroplasty, and 29 (36%) required reoperation. The 5-, 10-, 15-, and 20-year rates of survival from implant revision were 95%, 85%, 80%, and 69%, respectively. The 5-, 10-, 15-, and 20-year rates of survival from overall reoperation were 80%, 65%, 55%, and 46%, respectively. Metacarpophalangeal joint arc of motion, grip strength, and pain levels significantly improved following surgery. Conclusions: Metacarpophalangeal SRA can offer benefit to patients with RA for improvement in function and pain. High overall reoperation rates remain concerning; however, most do not involve arthroplasty revision.

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OUTCOMES OF DISCOID MENISCUS REPAIRS IN CHILDREN AND ADOLESCENTS

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00030 ◽

2019 ◽

Vol 7 (3_suppl) ◽

pp. 2325967119S0003

Author(s):

Crystal Perkins ◽

Michael Busch ◽

Melissa Christino ◽

S. Clifton Willimon

Keyword(s):

Lateral Meniscus ◽

Meniscus Repair ◽

Meniscus Tear ◽

Discoid Lateral Meniscus ◽

Discoid Meniscus ◽

Tear Pattern ◽

Reoperation Rates ◽

Meniscus Surgery

Background: Discoid meniscus tear patterns vary, but typically involve horizontal cleavage tears of the central discoid component with or without anterior or posterior meniscocapsular tears. Classically, the central discoid component is saucerized and meniscocapsular tears are repaired. Recent data suggests that meniscal preservation provides long-term benefits over resection1-2. However, many meniscal transplants are performed secondary to unsalvaged or unsalvageable discoid meniscus tears3. Reoperation rates after meniscus repairs vary greatly4-6, with some series reporting high rates of reinjury and reoperation, but there are no large series of pediatric discoid meniscus repairs in the literature. The purpose of this study is to describe the outcomes of meniscus repair and saucerization in pediatric patients with symptomatic discoid menisci. Methods: A single-institution retrospective review was performed of consecutive pediatric patients with surgical treatment of a discoid meniscus tear over a five-year period. Inclusion criteria were age less than 18 years, a symptomatic torn discoid meniscus treated with knee arthroscopy with meniscus repair, and minimum 4-month follow-up. A chart review was performed to describe tear location, tear pattern, and repair type (inside-out, outside-in, all-inside, and hybrid). Hybrid repair constructs were defined as those that used 2 or more repair types. The primary outcome was revision meniscus surgery. Results: Forty-four patients were identified to meet inclusion criteria. There were 23 males and 21 females with a mean age of 12.4 years (range 5 – 17 years). The right knee was affected in 61% of patients. The lateral meniscus was involved in all patients. Tear patterns included anterior meniscocapsular (19 patients, 43%), posterior meniscocapsular (14 patients, 30%), radial (7 patients, 16%), and bucket-handle (5 patients, 11%). Tears most commonly involved the posterior horn and body (21 patients, 48%) or posterior horn (16 patients, 36%) Arthroscopic meniscus repair was performed in all patients. Forty-three patients (98%) also underwent saucerization. Marrow stimulation, as a biological approach to improve repair healing, was performed in 14 patients (32%). The distribution of repair types and number of sutures for each type is listed in the table below. Mean follow-up was 19 months (range 4 – 70 months). Four patients (9%) underwent revision meniscus surgery following the primary repair, including 2 all-inside repairs and 2 partial meniscectomies. There were no statistically significant differences between patients who did or did not require a secondary surgery with respect to sex, age, tear location, tear pattern, repair type, or number of sutures. During follow-up, 9 patients (20%) had surgery for a symptomatic discoid meniscus in the contralateral knee. Conclusions: Saucerization and repair of discoid lateral meniscus tears in the pediatric population have good outcomes with low rates of reoperation. Appropriate saucerization, followed by an arthroscopic assessment of stability and tear patterns is critical to successful treatment of symptomatic discoid menisci. If tissue quality permits, meniscal preservation should be considered in all patients to avoid the consequences of subtotal meniscectomy. [Table: see text] Manzione M, Pizzutillo PD, Peoples AB, et al. Meniscectomy in children: a long-term follow-up study. Am J Sports Med 1983;11:111-115. Ahn JH, Kim KI, Wang JH, et al. Long-term results of arthroscopic reshaping for symptomatic discoid lateral meniscus in children. Arthroscopy 2015;31(5):867-873. Kocher MS, Tepolt FA, Vavken P. Meniscus transplantation in skeletally immature patients. J Pediatr Orthop B 2016;25(4)343-348. Steadman JR, Matheny LM, Singleton SB, et al. Meniscus suture repair: minimum 10-year outcomes in patients younger than 40 years compared with patients 40 and older. Am J Sports Med 2015;43(9):2222-2227. Paxton ES, Stock MV, Brophy RH. Meniscal repair versus partial meniscectomy: a systematic review comparing reoperation rates and clinical outcomes. Arthroscopy 2011;27(9):1275-1288. Shieh AK, Edmonds EW, Pennock AT. Revision meniscal surgery in children and adolescents: risk factors and mechanisms for failure and subsequent management. Am J Sports Med 2016;44(4):838-843.

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Long-term Results after Repair of Isolated Meniscus Tears in Patients 18 Years and Younger: An 18-Year Follow-up Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00333 ◽

2019 ◽

Vol 7 (7_suppl5) ◽

pp. 2325967119S0033

Author(s):

Michella Hagmeijer ◽

Nicholas I. Kennedy ◽

Adam J. Tagliero ◽

Bruce A. Levy ◽

Michael J. Stuart ◽

...

Keyword(s):

Pediatric Population ◽

Meniscus Repair ◽

Long Term Results ◽

Meniscus Tear ◽

Meniscus Tears ◽

Long Term Follow Up ◽

Final Followup ◽

Reoperation Rates

Objectives: Meniscus repair is desirable over resection to prevent post-meniscectomy arthritis, especially in young and active patients. However, long-term data is currently lacking following isolated meniscus repair, particularly in the pediatric population. The purpose of this study was to report long-term follow-up of isolated meniscus tears treated by meniscus repair in a pediatric population, and to compare those results to previous mid-term follow-up data reported. We hypothesized that these patients would have satisfactory function and reoperation rates at long-term follow-up. Methods: Patients less than 18 undergoing repair of an isolated (without concomitant ACL injury) meniscus tear performed between 1990 and 2005 were included. At the time of final followup, recurrent tear, reoperations, and IKDC and Tegner scores were determined. With logistic regression, the overall failure between different tear types was calculated. Wilcoxon signed ranks tests were performed to calculate the differences in clinical outcome for different time-points, and Spearman coefficients were calculated for Tegner and IKDC with different variables. Results: At an average followup of 17.6 years (13.1 - 26.0 years), 32 patients with 33 isolated meniscus repairs (29 M: 3F) with an average age of 16.1 (9.9 - 18.7) were included in this study. At early follow-up, complex tears (80%) had a higher overall failure rate compared to simple tears (18.2%). However, no further failures occurred since mid-term follow-up with any tear type. At final follow-up, the average IKDC score was 92.3, which was significantly increased when compared to both preoperative 65.3 (p< 0.0001) and mid-term scores, 90.2 (p= 0.01). However, the average Tegner score (6.5) was significantly lower than both pre-operative 8.3 (p< 0.0001) and mid-term 8.4 (p< 0.0001) scores. There was no correlation for Tegner or IKDC values with any risk factors. Conclusion: In conclusion, this study demonstrates overall good to excellent long-term clinical outcomes following isolated meniscus repair in a pediatric population. Early failure and reoperation rates were variable depending on tear type, with complex multiplanar tears having more failures at short-term follow-up. However, at long-term follow-up, IKDC and Tegner scores were not significantly different for those with complex tears compared to other tear types.

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Long-term Follow Up of Arthroscopically Repaired Meniscal Tears in a Pediatric Population

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118s00125 ◽

2018 ◽

Vol 6 (7_suppl4) ◽

pp. 2325967118S0012

Author(s):

Michella Hagmeijer ◽

Nicholas I. Kennedy ◽

Adam J. Tagliero ◽

Michael J. Stuart ◽

Diane L. Dahm ◽

...

Keyword(s):

Pediatric Population ◽

Statistical Significance ◽

Meniscal Repair ◽

Meniscus Tear ◽

Repair Procedure ◽

Long Term Follow Up ◽

Tegner Score ◽

Reoperation Rates

Background: Meniscal repair is desirable over resection to prevent post-meniscectomy arthritis, especially in young and active patients. However, long-term data is currently lacking following meniscus repair, particularly in the pediatric population. Purpose: To report long-term follow-up of isolated meniscus tears treated by meniscal repair in a pediatric population, and to compare those results to previous mid-term follow-up data reported. We hypothesized that these patients would have satisfactory function and reoperation rates at long-term follow-up. Methods: Patients less than 18 that had a meniscal repair procedure performed between 1990 and 2005 were included. Concomitant ACL reconstructions were excluded from the present study. At the time of final follow-up, recurrent meniscus tear, reoperation rates, and IKDC and Tegner scores were determined. Wilcoxin signed ranks tests were performed to calculate the differences in clinical outcome for the 3 time points (pre-operative, average 7 years post-op, and average 18 years post-op) and Spearman coefficients were calculated for Tegner and IKDC with different variables. Results: At an average follow-up of 18 years (range 13.2 - 25.9 years), 34 patients with 35 isolated meniscus repairs (4F: 30 M) with an average age of 16 (9.9 - 18.7) were included in this study. Of the 35 knees (34 patients), none had “failed” or re-injured their affected meniscus since mid-term follow-up in 2008. The average IKDC score was 92.1 which was found to be significantly increased when compared to both preoperative IKDC 64.7 (P<.0001) and mid-term IKDC scores, 89.8 (p=.02). However, the average Tegner score (6.5) was significantly lower than both pre-operative 8.28 (p<.0001) and the mid-term Tegner average 8.25 (p<.0001). Patients with a meniscus re-tear and subsequent partial meniscectomy had lower IKDC scores than clinically successful repairs (88.9 vs 94.0), but this did not reach statistical significance (p=.09). There was no correlation for Tegner or IKDC values with 1) rim width, 2) current age, 3) time elapsed since surgery, or 4) time from injury to surgery. There were also no differences in Tegner or IKDC scores when comparing; medial versus lateral, left versus right, tear types, surgical repair technique, or male vs female. Conclusion: This study demonstrates very good clinical long-term outcomes following meniscal repair in a pediatric population.

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421 USE OF BIOABSORBABLE MESH TO REINFORCE HIATAL CLOSURE—EARLY RESULTS

Diseases of the Esophagus ◽

10.1093/dote/doab052.421 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Andre Brandalise ◽

Mauricio Azevedo ◽

Claudia Lorenzetti ◽

Guilherme Oliveira ◽

Nilton Aranha

Keyword(s):

Nissen Fundoplication ◽

Abdominal Pressure ◽

Hernia Surgery ◽

Absorbable Sutures ◽

Early Results ◽

Reoperation Rates ◽

Mild Dysphagia ◽

Frequent Reason

Abstract The hiatoplasty is one of the keypoints of hiatal hernia surgery. Reherniation is known to be a frequent reason for recurrence and reoperation. Biodegradable materials for reinforcement have been. shown in some series to reduce these outcomes with very low risks of mesh-related complications. Long term reports, however, have shown conflicting results. This may be because meshes have been used in complicated cases, in which other variables can be involved in unfavourable outcomes. Methods Based on the safe profile of absorbable meshes, we have used meshes to reinforce the hiatoplasty in patients with theoretical higher risks of hernia recurrence. Twenty four patients were operated using bioabsorbable mesh (Gore Bio A®), implanted as an onlay inverted C over a completely closed hiatus. Two surgeons were responsible for all the surgeries. There were 16 (66,6%) women and 8 (33,3%) men. The main reasons for using a mesh were: primary large hiatal hernias (4 cm or more)—14 cases; redo hiatal hernias—8 cases; increased abdominal pressure—2 cases. Results All surgeries were performed between April 2018 and January 2020. Meshes were fixed to the diaphragm using absorbable sutures, fibrin sealant or cyanoacrylate. In all cases, a Nissen fundoplication was performed. There were no conversions. Two (8,3%) patients complained of troublesome dysphagia requiring intervention. One had to be operated within the first 48 hours after surgery: 2 stitches of the hiatus were removed and the fundoplication was converted into a Toupet. The other patient was submitted to endoscopic dilatation and still referes mild dysphagia. In a short follow up period (1–19 months), 23 patients (95,8%) are asymptomatic. Conclusion The use of bioabsorbable mesh in the hiatus is safe and have shown good symptomatic outcomes in the short follow up period. Objective results and longer follow up are needed to see if additional reinforcement of hiatoplasty contributes to reduce recurrence and reoperation rates.

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A 10-Year Retrospective Study of 490 Hip Fracture Patients: Reoperations, Direct Medical Costs, and Survival

Scandinavian Journal of Surgery ◽

10.1177/1457496918798197 ◽

2018 ◽

Vol 108 (2) ◽

pp. 178-184 ◽

Cited By ~ 2

Author(s):

R. Tiihonen ◽

R. Alaranta ◽

T. Helkamaa ◽

I. Nurmi-Lüthje ◽

J.-P. Kaukonen ◽

...

Keyword(s):

Hip Fracture ◽

Diagnosis Related Groups ◽

Hospital Costs ◽

Primary Operation ◽

The Mean ◽

The Cost ◽

Reoperation Rates ◽

Primary Fracture

Background and Aims: Reoperations after operative treatment of hip fracture patients may be associated with higher costs and inferior survival. We examined the acute hospital costs, long-term reoperation rates, and survival of patients with a new hip fracture. Materials and Methods: A total of 490 consecutive new hip fracture patients treated at a single center between 31 December 2004 and 6 December 2006 were analyzed retrospectively. Fractures were classified according to Garden and AO. All medical records were checked manually. The costs of reoperations were calculated using the diagnosis-related groups (DRG)-based prices. Survival analysis was performed using the life-table method. The follow-up time was 10 years. Results: In all, 70/490 patients (14.3%) needed reoperations. Of all reoperations, 34.2% were performed during the first month and 72.9% within 1 year after the primary operation. The hemiarthroplasty dislocation rate was 8.5%, and mechanical failures of osteosynthesis occurred in 6.2%. Alcohol abuse was associated with a heightened risk of reoperation. The mean direct costs of primary fracture care were lower than the mean costs of reoperations (€7500 vs €9800). The mortality rate at 10 years was 79.8% among non-reoperated patients and 62.9% among reoperated patients. Conclusions: According to our hypothesis, the cost per patient of reoperation in acute care was 31% higher than the corresponding cost of a primary operation. Reoperations increased the overall immediate costs of index fractures by nearly 20%. One-third of all reoperations were performed during the first month and almost 75% within 1 year after the primary operation.

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Long-term Results After Repair of Isolated Meniscal Tears Among Patients Aged 18 Years and Younger: An 18-Year Follow-up Study

The American Journal of Sports Medicine ◽

10.1177/0363546519826088 ◽

2019 ◽

Vol 47 (4) ◽

pp. 799-806 ◽

Cited By ~ 6

Author(s):

Michella H. Hagmeijer ◽

Nicholas I. Kennedy ◽

Adam J. Tagliero ◽

Bruce A. Levy ◽

Michael J. Stuart ◽

...

Keyword(s):

Failure Rate ◽

Meniscal Repair ◽

Meniscal Tears ◽

Early Failure ◽

Long Term Follow Up ◽

Ikdc Score ◽

The Mean ◽

Reoperation Rates

Background: Meniscal repair is desirable over resection to prevent postmeniscectomy arthritis, especially among young and active patients. However, long-term data are currently lacking following isolated meniscal repair, particularly in the pediatric population. Purpose/Hypothesis: To report long-term follow-up of isolated meniscal tears treated by meniscal repair in a pediatric and adolescent population and to compare those results with previous midterm follow-up data reported. The authors hypothesized that these patients would have satisfactory function and reoperation rates at long-term follow-up. Study Design: Case series; Level of evidence, 4. Methods: Forty-four patients aged ≤18 years undergoing repair of an isolated meniscal tear (without concomitant anterior cruciate ligament injury) between 1990 and 2005 were included. At the time of final follow-up, recurrent tear, reoperations, and International Knee Documentation Committee (IKDC) and Tegner scores were determined. With logistic regression, the overall failure among tear types was calculated. Wilcoxon rank sum analysis were performed to calculate the differences in clinical outcome for different time points, and Spearman coefficients were calculated for Tegner and IKDC with different variables. Results: At a mean follow-up of 17.6 years (range, 13.1-25.9 years), 32 patients with 33 isolated meniscal repairs (29 male, 3 female) with a mean age of 16.1 years (range, 9.9-18.7 years) at surgery were included in this study. At early follow-up, the overall failure rate was 14 of 33 (42%); complex tears (80%) and bucket-handle tears (47%) had higher overall failure rates when compared with simple tears (18.2%), although only complex tears had a significantly higher failure rate. However, no further failures occurred since midterm follow-up with any tear type. At final follow-up, the mean IKDC score was 92.3, which was significantly increased when compared with preoperative (65.3, P < .0001) and midterm (90.2, P = .01) scores. The mean Tegner score (6.5) was significantly lower than both preoperative (8.3, P < .0001) and midterm (8.4, P < .0001) scores. There was no difference in Tegner or IKDC score for patients with successful versus failed repair. Conclusion: In conclusion, while there was a high early failure rate, this study demonstrated overall good to excellent long-term clinical outcomes after isolated meniscal repair in an adolescent population, even for those requiring reoperation. Early failure and reoperation rates were variable, depending on tear type, with complex multiplanar tears having more failures at short-term follow-up. However, at long-term follow-up, IKDC and Tegner scores were not significantly different for those with complex tears as compared with other tear types.

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Revision surgery following minimally invasive decompression for lumbar spinal stenosis with and without stable degenerative spondylolisthesis: a 5- to 15-year reoperation survival analysis

Journal of Neurosurgery Spine ◽

10.3171/2021.6.spine2144 ◽

2021 ◽

pp. 1-7

Author(s):

Nizar Moayeri ◽

Y. Raja Rampersaud

Keyword(s):

Minimally Invasive ◽

Spinal Stenosis ◽

Lateral Recess ◽

Lateral Recess Stenosis ◽

The Mean ◽

Lumbar Spinal ◽

Reoperation Rates ◽

Minimally Invasive Decompression

OBJECTIVE Minimally invasive decompression (MID) is an effective procedure for lumbar spinal stenosis (LSS). Long-term follow-up data on reoperation rates are lacking. The objective of this retrospective cohort study was to evaluate reoperation rates in patients with LSS who underwent MID, stratified for degenerative lumbar spondylolisthesis (DLS), with a follow-up between 5 and 15 years. METHODS All consecutive patients with LSS who underwent MID between 2002 and 2011 were included. All patients had neurogenic claudication from central and/or lateral recess stenosis, without or with up to 25% of slippage (grade I spondylolisthesis), and no obvious dynamic instability on imaging (increase in spondylolisthesis by ≥ 5 mm demonstrated on supine-to-standing or flexion-extension imaging). Reoperation rates defined as any operation on the same or adjacent level were assessed. Revision decompression alone was considered if the aforementioned clinical and radiographic criteria were met; otherwise, patients underwent a minimally invasive posterior fusion. RESULTS A total of 246 patients (mean age 66 years) were included. Preoperative spondylolisthesis was present in 56.9%. The mean follow-up period was 8.2 years (range 5.0−14.9 years). The reoperation rates in patients with and without spondylolisthesis were 15.7% and 15.1%, respectively; fusion was required in 7.1% and 7.5%, with no significant difference (redecompression only, p = 0.954; fusion, p = 0.546). For decompression only, the mean times to reoperation were 3.9 years (95% CI 1.8−6.0 years) for patients with DLS and 2.8 years (95% CI 1.3−4.2 years) for patients without DLS; for fusion, the mean times to reoperation were 3.1 years (95% CI 1.0−5.3 years) and 3.1 years (95% CI 1.1−5.1 years), respectively. CONCLUSIONS In highly selected patients with stable DLS and leg-dominant pain from central or lateral recess stenosis, the long-term reoperation rate is similar between DLS and non-DLS patients undergoing MIS decompression.

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