Objective:

Identify factors impacting long-term complications, reoperations/readmission rates and healthcare utilization in OP patients following lumbar fusions.

Materials and methods:

We used ICD9/10 and CPT codes to extract data from MarketScan (2000-2016). Lumbar spine fusion patients were divided into two groups based on preoperative diagnosis: Osteoporosis (OP) or non-Osteoporosis (n-OP). We used Multivariable generalized linear regression models to analyze outcomes of interest (re-operation rates, re-admission, complications, healthcare utilization) at 1-, 6-, 12- and 24-months following discharge.

Results:

MarketScan identified 116,749 patients who underwent lumbar fusion with ≥24 months follow-up. 6% had OP. OP patients: higher incidence of complications (14% vs. 9%), less likely to be discharged home (77% vs. 86%, p<0.05), had more new fusion or re-fusion at 6-months (2.9% vs. 2.1%), 12-months (5% vs. 3.8%) and 24-months (8.5% vs. 7.4%), incurred more outpatient services at 12-months (80 vs. 61) and 24-months (148 vs. 115), incurred higher overall costs at 12-months ($22,932 vs. $17,017) and 24-months ($48,379 vs. $35,888). Elderly OP patients (>65 years) who underwent multilevel lumbar fusions were associated with longer LOS, higher complication rates and incurred lower costs at 6-, 12- and 24-months, compared to young n-OP patients who underwent single level lumbar fusion.

Conclusion:

Patients of all ages with OP had higher complication rates and required revision surgeries at 6-, 12- and 24-months compared to non-OP patients. Elderly OP patients having multilevel lumbar fusions were twice as likely to have complications and lower healthcare utilization compared to n-OP younger patients who underwent single level fusion.