If you can believe this, both Mom and Dad had spinal surgery (lumbar fusion) on the same day. As the oldest daughter, I got recruited to be nurse maid. We are a month post-op and it’s been smooth sailing for Mom but Dad has been readmitted to the hospital twice now. They had the same surgeon and basically the same procedure. Why the difference in results?

That is a very good question and one that leaves even the surgeon’s scratching their heads. So much so that a group of surgeons from New York University Hospital for Joint Diseases went back through their patient records for a two-year period of time to see how often these unplanned readmissions occurred and why.

Patients included in the study had one of 12 common spine procedures (e.g., spinal fusion, kyphoplasty, laminectomy). There were a total of 3673 people operated on with 156 of these patients requiring return to the hospital. That works out to be a 3.8 per cent overall readmission rate.

Most of the readmissions (90 per cent) were unplanned. In the remaining 10 per cent, the patient was scheduled for a two-part (staged) procedure and came back for the second surgery. Lumbar stenosis (narrowing of the spinal canal) and disc herniation were the two most common problems patients were being treated surgically.

Taking a closer look at the data collected, the authors divided the readmissions into two groups: those who had surgical complications and those who had nonsurgical complications. Infection was definitely the biggest problem for both groups.

Surgical complications occurred most often in patients who had more spinal levels fused (average of six spinal segments). There were difficulties with implants (plates, screws) caused by infection or wound drainage in a smaller number of patients. Nonsurgical complications were most often related to GI problems and systemic illness with a few cases caused by heart, lung, or neurologic conditions.

Does any of this describe what might have contributed to your father’s difficulties? Patient factors such as general health, pre-existing conditions (heart disease, cancer) and obesity can make the difference between smooth sailing and problems that linger.