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Related Concept Videos

Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

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Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
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Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...
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Degenerative Disc Disease ll: Pathophysiology01:23

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The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
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Related Experiment Video

Updated: May 5, 2026

Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
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Facet Angle and Disc Base Width: Hidden Risk Factors for Recurrence in Midline Lumbar Disc Herniation Surgery?

Eyüp Varol1, Cumhur Kaan Yaltırık2, Mustafa Umut Etli3

  • 1Department of Neurosurgery, Medicana Ataköy Hospital, İstanbul, Turkey.

World Neurosurgery
|August 2, 2025
PubMed
Summary

Facet joint angle and disc width predict recurrence after lumbar discectomy. A facet joint angle ≥53° or disc midpoint distance <1 mm increases complication risk for midline lumbar disc herniation surgery.

Keywords:
Disc base widthFacet angleLumbar disc herniationLumbar discectomyMidline herniationPostoperative complicationsRecurrence

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spinal Surgery

Background:

  • Midline lumbar disc herniation frequently causes low back pain and neurological deficits, often requiring surgery.
  • Recurrence and complications after lumbar discectomy are significant concerns for patient outcomes.
  • Predictive factors for surgical success in these cases require further investigation.

Purpose of the Study:

  • To determine if preoperative facet joint angle and disc base width predict recurrence and complications after discectomy for midline lumbar disc herniation.
  • To identify independent risk factors for adverse outcomes in this patient population.

Main Methods:

  • Retrospective review of 125 patients undergoing single-level discectomy for midline lumbar disc herniation.
  • Exclusion of patients with spondylolisthesis, prior surgery, or multilevel herniations.
  • Preoperative MRI/CT analysis for disc base width and facet joint angle; ROC and logistic regression for predictive analysis.

Main Results:

  • Recurrence (20.8%) and complications (8%) were observed, with cerebrospinal fluid fistula being most common.
  • A facet joint angle ≥53° (OR=7.81) and disc midpoint-to-midline distance <1 mm (OR=2.99) independently predicted complications.
  • Disc midpoint distance <1 mm also predicted recurrence (OR=2.99), as did chronic disease (OR=2.80).

Conclusions:

  • Facet joint angle ≥53° and disc midpoint distance <1 mm are significant predictors of recurrence and complications.
  • Preoperative assessment of these anatomical factors can aid surgical planning.
  • Improved surgical planning may lead to better postoperative outcomes for patients with midline lumbar disc herniation.