Object:

Evaluate the impacts of a recent history of Total Hip Arthroplasty (THA) on Primary Lumbar Spine Fusion (LSF) for concurrent hip and spine pathology.

Methods:

98,242 patient records from the PearlDiver Database were evaluated and divided into three cohorts: 1) patients with a history of LSF alone, 2) patients with a history of LSF for newly diagnosed lumbar disease after having a THA > 2 years prior, and 3) patients with a history of LSF after having THA < 2 years prior to LSF who initially presented with concurrent hip and lumbar spine pathology and underwent THA before LSF. Postoperative outcomes were assessed with multivariable logistic regression to determine the effect of THA on outcomes following LSF with respect to postoperative complications, LSF revision rates, and opioid-use.

Results:

Patients that had LSF after a recent THA had increased risk of deep venous thrombosis (DVT) (aOR=1.39, p=0.0191), neurologic complications (aOR=1.81, p=0.0459), prolonged opioid use (aOR=1.22, p=0.0032) and revision LSF (12.8%, p=0.0004 vs. 9.9%; OR=1.41, p<0.0001; HR=1.69, p<0.0001). Patients that underwent LSF after a remote history of THA had no significant difference in DVT (4.2% vs. 2.6%, aOR=1.31, p=0.2190), neurologic complications (1.0% s. 0.5%, aOR=2.02, p=0.1220), revision surgery (9.6% vs. 9.9%, aOR=1.06, p=0.7197), or prolonged opioid use (36.5% vs. 24.4%, aOR=1.17, p=0.1120).

Conclusions:

Patients who undergo LSF with a history of THA may be at increased risk of postoperative complications, revision LSF, and prolonged opioid use if their THA was performed for concurrent hip-spine pathology in the recent past (<2 years).