Spine 2025;50:1392–1399
This large retrospective study found that within two years of lumbar microdiscectomy, 5.5% required revision surgery and 6.6% required spinal fusion. Age 40–59, female sex, and at least one Charlson Comorbidity Index (CCI) comorbidity significantly increased the risk of subsequent fusion, but not revision microdiscectomy.
Revision microdiscectomy rates after index lumbar microdiscectomy were 3.5% at one year and 5.5% at two years.
• Lumbar fusion rates were 2.9% at one year and 6.6% at two years after index surgery.
• Age 40–59, female sex, and presence of at least one Charlson Comorbidity Index (CCI) comorbidity significantly increased risk of lumbar fusion, but not revision microdiscectomy.
• Having ≥1 CCI comorbidity increased the likelihood of needing fusion by about 80%.
• Specific comorbidities (e.g., congestive heart failure, peripheral/cerebrovascular disease, diabetes) were strong predictors for time-to-fusion.
• Age, sex, and CCI score were not predictive of time-to-revision microdiscectomy.
• Results suggest CCI may help identify patients at higher risk for spinal fusion after microdiscectomy.
• Findings may guide surgeons in perioperative decision-making and patient counseling.
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