Predictive Factors of Surgical Reoperation after Surgery for Degenerative Lumbar Spine Diseases: A Retrospective Cohort Study in Antananarivo

Degenerative lumbar spine diseases represent a leading cause of chronic pain and functional impairment worldwide. Despite significant progress in surgical techniques, reoperations remain relatively frequent and continue to pose a major therapeutic and socioeconomic challenge, particularly in low-resource settings. This retrospective single-center cohort study was conducted in the Department of Neurosurgery of Antananarivo between January 2021 and December 2024 and included 165 adult patients who underwent surgery for degenerative lumbar spine pathologies. Patients treated for trauma, tumors, infections, or severe scoliosis were excluded. Sociodemographic variables, comorbidities (obesity, diabetes, gout, smoking), clinical and radiological characteristics, surgical details, and postoperative rehabilitation were analyzed. Univariate analysis followed by multivariate logistic regression was performed to identify independent predictors of surgical reoperation. Among the 165 patients, 29 underwent reoperation, corresponding to a rate of 17.6%. Multivariate analysis revealed three independent predictors of reoperation: female sex (aRR =1.99; 95% CI 1.07–3.68; p = 0.029), presence of gout (aRR = 1.96; 95% CI 1.00–3.84; p = 0.049), and notably, the absence of postoperative functional rehabilitation (aRR = 4.64; 95% CI 2.15–9.98; p