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Factors associated with lumbar disc hernia recurrence after microdiscectomy
G Camino Willhuber1, G Kido1, M Mereles1
1Instituto de Ortopedia y Traumatología Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Introduction:
Lumbar disc hernias are a common cause of spinal surgery. Hernia recurrence is a prevalent complication.
Objective:
To analyse the risk factors associated with hernia recurrence in patients undergoing surgery in our institution.
Materials And Methods:
Lumbar microdiscectomies between 2010 and 2014 were analysed, patients with previous surgeries, extraforaminales and foraminal hernias were excluded. Patients with recurrent hernia were the case group and those who showed no recurrence were the control group.
Results:
177 patients with lumbar microdiscectomy, of whom 30 experienced recurrence (16%), and of these 27 were reoperated. Among the risk factors associated with recurrence, we observed a higher rate of disc height, higher percentage of spinal canal occupied by the hernia and presence of degenerative facet joint changes; we observed no differences in sex, body mass index or age.
Discussion:
Previous studies show increased disc height and young patients as possible factors associated with recurrence.
Conclusion:
In our series we found that the higher rate of disc height, the percentage of spinal canal occupied by the hernia and degenerative facet joint changes were associated with hernia recurrence.
Insights
Lumbar disc hernia recurrence after surgery is common. Higher disc height, greater spinal canal occupation by the hernia, and facet joint degeneration increase recurrence risk.
Area of Science:
- Neurosurgery
- Orthopedics
- Spinal Surgery
Background:
- Lumbar disc hernias frequently necessitate surgical intervention.
- Hernia recurrence presents a significant post-operative complication.
Purpose of the Study:
- To identify risk factors linked to lumbar disc hernia recurrence.
- Analysis focused on patients undergoing surgery at our institution.
Main Methods:
- Retrospective analysis of lumbar microdiscectomies (2010-2014).
- Exclusion of patients with prior surgeries, extraforaminal, or foraminal hernias.
- Comparison between recurrent hernia (case) and non-recurrent (control) groups.
Main Results:
- 16% recurrence rate (30/177 patients), with 27 reoperations.
- Associated risk factors included increased disc height, greater spinal canal occupation by the hernia, and degenerative facet joint changes.
- No significant differences observed in sex, body mass index, or age.
Conclusions:
- Findings indicate increased disc height and spinal canal occupation are key predictors of recurrence.
- Degenerative facet joint changes also correlate with higher recurrence rates.
- These factors are crucial for surgical planning and patient counseling.
