What are the predictors of nonroutine discharge after surgery for grade 2 lumbar spondylolisthesis? A Spine CORe™ analysis of QOD data.
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2026-05
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Abstract
Discharge to an inpatient rehabilitation facility or other acute care facility is a significant driver of healthcare costs. The authors sought to identify predictors of nonroutine discharge after surgery for grade 2 lumbar spondylolisthesis. The Quality Outcomes Database from the 14 highest enrolling sites (Spine CORe™ study group) was queried for adult patients who underwent surgery for grade 2 lumbar spondylolisthesis. Nonroutine discharge was defined as discharge to a postacute or nonacute care setting or transfer to another acute care facility. Univariate analysis and multivariate logistic regression were utilized to identify predictors of nonroutine discharge. The follow-up rate at 5 years was 81%. Of the 328 patients identified, 47 (14.3%) had nonroutine discharge. On univariate analysis, patients with nonroutine discharge were more likely to be older (67.4 ± 11.3 years vs 59.4 ± 12.2 years, p < 0.0001), be female (85.1% vs 65.5%, p = 0.007), have diabetes (36.2% vs 12.1%, p < 0.0001), have osteoporosis (21.3% vs 8.2%, p = 0.02), have a higher mean baseline numeric rating scale (NRS) leg pain score (7.5 ± 2.2 vs 6.6 ± 2.8, p = 0.04), and have a higher mean baseline Oswestry Disability Index (ODI) score (55.4 ± 15.7 vs 46.5 ± 16.5, p = 0.0006) compared to patients with a routine discharge. Patients who had completed a 4-year college degree, were employed and working, and were independently ambulatory were more likely to have a routine discharge (p < 0.0001). Multivariate analysis showed that older age (OR 1.06, 95% CI 1.01-1.11, p = 0.01), female sex (OR 2.64, 95% CI 1.01-6.87, p = 0.04), need for an assistive device to ambulate preoperatively (OR 3.01, 95% CI 1.02-7.36, p = 0.02), and diabetes (OR 2.80, 95% CI 1.20-6.56, p = 0.02) were independently associated with nonroutine discharge. Patients with a nonroutine discharge had significantly greater length of stay compared to patients with a routine discharge (4.7 ± 2.2 vs 3.2 ± 2.1 days, p < 0.0001). In this large, prospective, multicenter study, patients with nonroutine discharge after surgery for grade 2 lumbar spondylolisthesis were more likely to be older, female, have diabetes, and require an assistive device to ambulate preoperatively.
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Linzey, Joseph R, Allie Harbert, Aaron Gelinne, Cheerag D Upadhyaya, Jay D Turner, Juan S Uribe, Anthony L Asher, Paul K Kim, et al. (2026). What are the predictors of nonroutine discharge after surgery for grade 2 lumbar spondylolisthesis? A Spine CORe™ analysis of QOD data. Neurosurgical focus, 60(5). p. E16. 10.3171/2025.12.focus25955 Retrieved from https://hdl.handle.net/10161/34625.
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Scholars@Duke
Christopher Ignatius Shaffrey
I have more than 25 years of experience treating patients of all ages with spinal disorders. I have had an interest in the management of spinal disorders since starting my medical education. I performed residencies in both orthopaedic surgery and neurosurgery to gain a comprehensive understanding of the entire range of spinal disorders. My goal has been to find innovative ways to manage the range of spinal conditions, straightforward to complex. I have a focus on managing patients with complex spinal disorders. My patient evaluation and management philosophy is to provide engaged, compassionate care that focuses on providing the simplest and least aggressive treatment option for a particular condition. In many cases, non-operative treatment options exist to improve a patient’s symptoms. I have been actively engaged in clinical research to find the best ways to manage spinal disorders in order to achieve better results with fewer complications.
Oren N Gottfried
I specialize in the surgical management of all complex cervical, thoracic, lumbar, or sacral spinal diseases by using minimally invasive as well as standard approaches for arthritis or degenerative disease, deformity, tumors, and trauma. I have a special interest in the treatment of thoracolumbar deformities, occipital-cervical problems, and in helping patients with complex spinal issues from previously unsuccessful surgery or recurrent disease.I listen to my patients to understand their symptoms and experiences so I can provide them with the information and education they need to manage their disease. I make sure my patients understand their treatment options, and what will work best for their individual condition. I treat all my patients with care and concern – just as I would treat my family. I am available to address my patients' concerns before and after surgery. I aim to improve surgical outcomes for my patients and care of all spine patients with active research evaluating clinical and radiological results after spine surgery with multiple prospective databases. I am particularly interested in prevention of spinal deformity, infections, complications, and recurrent spinal disease. Also, I study whether patient specific variables including pelvic/sacral anatomy and sagittal spinal balance predict complications from spine surgery.
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