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Risk Factors for the Recurrent Herniation After Microendoscopic Discectomy
Yuan Yao1, Huan Liu1, Huiyu Zhang2
1Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China.
Background:
Microendoscopic discectomy (MED) has been widely accepted for its advantage of minimal injury in the treatment of lumbar disc herniation. Recurrence after successful MED has been reported; however, the risk factors responsible for the MED recurrence were still unclear.
Methods:
From April 2005 to April 2016, 111 patients with recurrent herniation after successful MED were included in this retrospective study. Kaplan-Meier methods and Cox regression analysis were used to identify the significant risk factors responsible for MED recurrence.
Results:
Univariate analysis demonstrated that age (≥50 years old), obesity (body mass index [BMI] ≥25), the treatment period (April 2005 to October 2010), modic change, nonmigrated herniation, and central herniation are identified as the potential risk factors for percutaneous endoscopic lumbar discectomy recurrence. Multivariate analysis suggested that age (≥50 years old), obesity (BMI ≥25), and modic change are identified as the significant risk factors responsible for MED recurrence.
Conclusions:
Age (≥50 years old) was the most robust risk factor for MED recurrence. Obesity (BMI ≥25) and modic change were also highly involved in the recurrent herniation after successful MED. Taking these risk factors into consideration before surgery may be instrumental in pursuing a personalized operative method, which may lead to a more satisfactory operative outcome and a relatively lower recurrence rate.
Insights
Older age (≥50), obesity (BMI ≥25), and modic changes are key risk factors for recurrence after microendoscopic discectomy (MED) for lumbar disc herniation. Understanding these factors aids personalized treatment and better outcomes.
Area of Science:
- Neurosurgery
- Orthopedics
- Spinal Surgery
Background:
- Microendoscopic discectomy (MED) is a minimally invasive technique for lumbar disc herniation.
- Recurrence of herniation after successful MED has been observed, but risk factors remain unclear.
Purpose of the Study:
- To identify significant risk factors for recurrence after microendoscopic discectomy (MED) for lumbar disc herniation.
Main Methods:
- Retrospective study of 111 patients with recurrent herniation post-MED.
- Kaplan-Meier methods and Cox regression analysis were employed.
Main Results:
- Univariate analysis identified age (≥50), obesity (BMI ≥25), treatment period, modic change, nonmigrated herniation, and central herniation as potential risk factors.
- Multivariate analysis confirmed age (≥50), obesity (BMI ≥25), and modic change as significant risk factors for recurrence.
Conclusions:
- Age (≥50 years old) is the most robust predictor of MED recurrence.
- Obesity (BMI ≥25) and modic changes are also significantly associated with recurrent lumbar disc herniation.
- Considering these risk factors preoperatively can guide personalized surgical approaches for improved outcomes and reduced recurrence rates.
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