Incidence and Risk Factors for 30- and 90-day Reoperations Following Biportal Endoscopic Lumbar Discectomy for Single-Level Lumbar Disc Herniations

Study Design: Retrospective cohort study. Objectives: This study aims to investigate the incidence and risk factors for 30- and 90-day reoperations following biportal endoscopic lumbar discectomy for lumbar disc herniations. Methods: We retrospectively reviewed patients who underwent biportal endoscopic lumbar discectomy. We included cases of single-level, central, or paracentral lumbar disc herniations treated with biportal endoscopic lumbar discectomy. Patients were categorized according to whether reoperation occurred within 30 or 90 days after the initial surgery. Patient demographics, radiologic characteristics of disc herniations, and spinopelvic parameters were obtained. Results: A total of 1510 patients were included in the study. The 30- and 90-day reoperation rates were 2.1% (31/1510) and 3.0% (46/1510), respectively. The most common cause of reoperation at both 30 and 90 days was recurrent disc herniation. In the multivariable logistic regression analysis, diabetes mellitus (DM) (OR 2.83; 95% CI 1.22-6.52; P = .015 for 30-day; OR 2.31; 95% CI 1.12-4.75; P = .023 for 90-day) and prolonged length of postoperative hospital stay (LOS) (OR 1.36; 95% CI 1.22-1.51; P < .001 for 30-day; OR 1.44; 95% CI 1.31-1.60; P < .001 for 90-day) were significantly associated with both 30- and 90-day reoperations. Conclusion: The incidence of 30- and 90-day reoperations was 2.1% and 3.0%, respectively. Considering that prolonged LOS may be a consequence rather than a cause of reoperation, DM was the only significant independent risk factor associated with both 30- and 90-day reoperations.