Aydın Talat BAYDAR, Baran TAŞKALA
Journal of Turkish Spinal Surgery - 2026;37(3):97-104
Objective: This study evaluated the 30-day incidence, mechanisms, and timing of unplanned reoperation after surgery for spinal metastases. Materials and Methods: This retrospective cohort study included adults who underwent surgery for spinal metastases between June 2020 and September 2025. Patients who died within 30 postoperative days were excluded because complete ascertainment of observed 30-day reoperations was not possible. Intradural metastases were also excluded. Thirty-day returns to the operating room were adjudicated as planned staged procedures or unplanned reoperations. Unplanned reoperations were further classified as technical, tumor-related, mechanical, or wound-related after a review of clinical notes and imaging. Continuous variables were compared using the Wilcoxon rank-sum test, and categorical variables were compared using Fisher's exact test. Results: A total of 127 patients met the eligibility criteria. Six procedures that occurred within 30 days were adjudicated as planned, staged operations, leaving 121 patients in the analytic cohort. Eighteen patients (14.9%) underwent an unplanned reoperation within 30 days. The median time to unplanned reoperation was 14.5 days (Q1-Q3, 2.5-26.5). Technical events occurred earliest [n=4; median postoperative day (POD) 2], followed by tumor-related events (n=4; median POD 6), mechanical events (n=5; median POD 22), and wound-related events (n=5; median POD 25). Timing differed across mechanisms (p=0.023). Metastatic spinal tumor frailty index >1 was more frequent in the reoperation group (83.3% vs. 42.7%, p=0.0018). Conclusion: Unplanned early reoperation after spinal metastasis surgery showed distinct mechanism-specific timing patterns. Technical failures clustered earliest, whereas mechanical and wound-related failures occurred later. A mechanism-based description may provide a more precise framework for reporting very early postoperative returns to the operating room.
