Recurrent Lumbar Disc Herniation after Microendoscopic Discectomy

Takahashi, Hiroshi; Iida, Yusuke; Yokoyama, Yuichiro; Takamatsu, Ryo; Fukutake, Katsunori; Wada, Akihito; Hasegawa, Katsuhiko

doi:10.4172/2325-9701.1000141

Cited by 4 publications

(7 citation statements)

References 15 publications

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“…4 Our data showed an LDH recurrence reoperation rate of 5.5%. This value compares favourably with the literature, which describes different values ranging from 3 to 13% [2][3][4][5][6]. We have previously analysed the effect of surgeon experience with rates of recurrent LDH [15].…”

Section: Discussionsupporting

confidence: 74%

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Association of age with incidence and timing of recurrence after microdiscectomy for lumbar disc herniation

2020

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Objective Recurrent lumbar disc herniation (LDH) is the most frequent reason for reoperation after lumbar microdiscectomy. While several risk factors for recurrent LDH have been well-described, the effect of age on recurrence remains unclear, especially concerning the timing of recurrent LDH. Methods From a prospective registry, we identified all patients who underwent tubular microdiscectomy for LDH. Recurrent LDH was defined as reoperation for LDH at the same index level and side. The associations among age and incidence of recurrent LDH as well as on time to recurrent LDH were statistically evaluated using multivariable analysis of covariance, linear regression, and Cox proportional hazards modelling. Results Of the 3013 patients who underwent surgery for LDH, 166 (5.5%) had to undergo reoperation due to LDH recurrence. Uni- and multivariable analysis revealed no influence of age on the incidence of recurrent LDH (both p > 0.05). Linear regression indicated earlier reoperation in older patients, both with (β = −0.248) and without (β = −0.374) correction for confounders (both p < 0.05). An additional survival analysis found that patients aged over 35 years had recurrent LDH significantly earlier (hazard ratio 0.617, p = 0.013). Conclusion In an analysis of a large prospective database of patients undergoing microdiscectomy for lumbar disc herniation, we found that younger patients do not have a higher reoperation probability than their older counterparts, even after correcting for multiple confounders. However, older patients tend to experience recurrent LDH significantly earlier after the index surgery compared to younger patients.

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Section: Discussionsupporting

confidence: 74%

“…Lumbar disc herniation (LDH) is one of the most common indications for lumbar spine surgery [1]. Although minimally invasive surgical techniques are becoming more and more common in lumbar neurosurgery, the current literature suggests that 3 to 13% of all patients undergo redo surgery because of a LDH recurrence [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Association of age with incidence and timing of recurrence after microdiscectomy for lumbar disc herniation

2020

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“…[11][12][13][14] Despite the good outcomes of MED, many investigators have stated their concerns regarding recurrent herniation. 2,3 The recurrence rate of open surgery was reported to be 1%e21% 15,16 and the recurrence rate of MED surgery were reported to range from 8.58% to 10.8%. 3,4 In the present study, the reoperation rate after successful MED surgery in our department was 3.0%.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 The recurrence rate of open surgery was reported to be 1%e21% 15,16 and the recurrence rate of MED surgery were reported to range from 8.58% to 10.8%. 3,4 In the present study, the reoperation rate after successful MED surgery in our department was 3.0%. Given that not every patient who suffered MED recurrence would come back to our department for reoperation, the real MED recurrence rate should be higher than the reoperation rate.…”

Section: Discussionmentioning

confidence: 99%

“…Several researchers have stated concerns regarding the MED recurrence rate. 2,3 Therefore, the risk factors predicting the MED recurrence rate warrant further study to obtain optimal personalized therapy. Several studies 4 have explored the risk factors for MED recurrence, yet little comprehensive research has been performed in which the patients who suffer from the MED recurrence are regarded as a separate group with a systematic statistical method.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for the Recurrent Herniation After Microendoscopic Discectomy

et al. 2016

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Overweight and smoking promote recurrent lumbar disk herniation after discectomy

et al. 2022

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Purpose Recurrent lumbar disk herniation (rLDH) following lumbar microdiscectomy is common. While several risk factors for primary LDH have been described, risk factors for rLDH have only sparsely been investigated. We evaluate the effect of Body mass index (BMI) and smoking on the incidence and timing of rLDH. Methods From a prospective registry, we identified all patients undergoing primary tubular microdiscectomy (tMD), with complete BMI and smoking data, and a minimum 12-month follow-up. We defined rLDH as reherniation at the same level and side requiring surgery. Overweight was defined as BMI > 25, and obesity as BMI > 30. Intergroup comparisons and age- and gender-adjusted multivariable regression were carried out. We conducted a survival analysis to assess the influence of BMI and smoking on time to reoperation. Results Of 3012 patients, 166 (5.5%) underwent re-microdiscectomy for rLDH. Smokers were reoperated more frequently (6.4% vs. 4.0%, p = 0.007). Similarly, rLDH was more frequent in obese (7.5%) and overweight (5.9%) than in normal-weight patients (3.3%, p = 0.017). Overweight smokers had the highest rLDH rate (7.6%). This effect of smoking (Odds ratio: 1.63, 96% CI: 1.12–2.36, p = 0.010) and BMI (Odds ratio: 1.09, 95% CI: 1.02–1.17, p = 0.010) persisted after controlling for age and gender. Survival analysis demonstrated that rLDH did not occur earlier in overweight patients and/or smokers. Conclusions BMI and smoking may directly contribute to a higher risk of rLDH, but do not accelerate rLDH development. Smoking cessation and weight loss in overweight or obese patients ought to be recommended with discectomy to reduce the risk for rLDH.

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Recurrent Lumbar Disc Herniation after Microendoscopic Discectomy

Cited by 4 publications

References 15 publications

Association of age with incidence and timing of recurrence after microdiscectomy for lumbar disc herniation

Association of age with incidence and timing of recurrence after microdiscectomy for lumbar disc herniation

Risk Factors for the Recurrent Herniation After Microendoscopic Discectomy

Overweight and smoking promote recurrent lumbar disk herniation after discectomy

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