European Spine Journal

, Volume 28, Issue 6, pp 1371–1385 | Cite as

Reoperation of decompression alone or decompression plus fusion surgeries for degenerative lumbar diseases: a systematic review

  • Zhao Lang
  • Jing-Sheng Li
  • Felix Yang
  • Yan Yu
  • Kamran Khan
  • Louis G. Jenis
  • Thomas D. Cha
  • James D. Kang
  • Guoan LiEmail author



The objective of this paper was to compare the reoperation rates, timing and causes between decompression alone and decompression plus fusion surgeries for degenerative lumbar diseases through a systematic review of the published data.


A search of the literature was conducted on PubMed/MEDLINE, EMBASE and the Cochrane Collaboration Library. Reports that included reoperations after decompression alone and/or decompression plus fusion surgeries were selected using designed eligibility criteria. Comparative analysis of reoperation rates, timing and causes between the two surgeries was conducted.


Thirty-two retrospective and three prospective studies were selected from 6401 papers of the literature search. The analysis of data reported in these studies revealed that both surgeries resulted in similar reoperation rates after the primary surgery. However, majority of reoperations following the fusion surgeries were due to adjacent-segment diseases, and following the decompression alone surgeries were due to the same-segment diseases. Reoperation rates were not found to decrease in patients operated more recently than those operated in early times.


Reoperation rates were similar following decompression alone or plus fusion surgeries for degenerative lumbar diseases. However, different underlying major causes exist between the two surgeries. There is no evidence showing that the reoperation rate has a trend to decline with newer surgical techniques used. The exact mechanisms of reoperation after both surgeries are still unclear. Further researches are necessary to investigate the mechanisms of reoperation for improvement of surgical techniques that aim to delay or prevent reoperation after lumbar surgery.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Reoperation Degenerative lumbar diseases Spinal decompression Spinal fusion Adjacent-segment diseases 



This research was partially supported by National Institute of Health (R21AR057989).

Compliance with ethical standards

Conflict of interest

Thomas D. Cha has received research grants from North American Spine Society and Gordon and Betty Moore Foundation. Other authors declare that they have no conflict of interest.

Supplementary material

586_2018_5681_MOESM1_ESM.pptx (242 kb)
Supplementary material 1 (PPTX 241 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Orthopaedic Bioengineering Research Center, Department of Orthopaedic SurgeryNewton-Wellesley Hospital and Harvard Medical SchoolNewtonUSA
  2. 2.Department of Spine Surgery, Beijing Jishuitan HospitalFourth Clinical Medical College of Peking UniversityBeijingChina
  3. 3.College of Health and Rehabilitation Sciences, Sargent CollegeBoston UniversityBostonUSA
  4. 4.Department of Spine Surgery, Tongji HospitalTongji University School of MedicineShanghaiChina
  5. 5.Department of Orthopaedic SurgeryMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  6. 6.Department of Orthopaedic SurgeryBrigham and Women’s Hospital/Harvard Medical SchoolBostonUSA

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