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Updated: Feb 12, 2026

Full-Endoscopic Isolation Zone Technique for the Treatment of Lumbar Disc Herniation
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Preoperative Clinical and Radiographic Risk Factors for Recurrent Lumbar Disc Herniation: Systematic Review and

Mohamed A R Soliman1,2, Hendrick Francois2, Alexander O Aguirre2

  • 1Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt.

Neurospine
|February 10, 2026
PubMed
Summary
This summary is machine-generated.

Recurrent lumbar disc herniation is a significant risk after surgery. High body mass index, diabetes, increased sagittal range of motion, and Modic changes are key predictors of recurrence.

Keywords:
Body mass indexDiabetesModic changesRecurrent disc herniationRisk factorsSagittal range of motionSmoking

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Area of Science:

  • Neurosurgery and Orthopedics
  • Spinal Surgery
  • Radiology

Background:

  • Lumbar discectomy is a common procedure for lumbar disc herniation.
  • Recurrent disc herniation complicates up to 25% of these procedures.
  • Identifying risk factors for recurrence is crucial for patient management.

Purpose of the Study:

  • To conduct the largest systematic review to date.
  • To analyze clinical and radiographic risk factors for recurrent disc herniation after lumbar discectomy.

Main Methods:

  • Systematic literature search of Embase and PubMed/Medline.
  • Included case-control or cohort studies reporting risk factors.
  • Performed meta-analysis for risk factors reported in 3+ studies.

Main Results:

  • Analyzed 51 studies with 52,479 patients; 12.9% experienced recurrence.
  • Significant risk factors identified: high body mass index (BMI), diabetes, increased sagittal range of motion, and Modic changes.
  • No other significant predictors were found.

Conclusions:

  • Patients with high BMI, diabetes, increased sagittal range of motion, and Modic changes face higher risk of recurrent disc herniation.
  • Further prospective studies are recommended to validate these findings.
  • These risk factors can inform clinical decision-making and patient counseling.