In-depth analysis of risk factors for recurrence of lumbar 5-sacral 1 disc herniation after Percutaneous endoscopic transforaminal discectomy

Abstract

Background:This retrospective study aimed to investigate the risk factors associated with the recurrence of L5-S1 disc herniation after percutaneous endoscopic transforaminal discectomy (PETD). Material/Methods:There were 484 patients L5-S1 disc herniation who underwent PETD who were divided into the recurrence group (n=46) and the non-recurrence group (n=438). Transforaminal endoscopic approaches included modifications of the Yeung endoscopy spine system (YESS) (the intraforaminal intradiscal approach) and the transforaminal endoscopic spine system (TESSYS) (intraforaminal extradiscal approach). Demographic and clinical characteristics and imaging data were analyzed. The two study groups were compared to determine the factors associated with the recurrence of L5-S1 disc herniation. The patients underwent postoperative follow-up for between one and four years. Results:At follow-up, 9.504% of patients (46/484) with the recurrence of L5-S1 disc herniation following PETD when compared with the non-recurrence group showed no significant difference for time to return to work, gender, history of diabetes mellitus, trauma, duration of symptoms, smoking and alcohol history, hypertension, location of disc herniation, transverse process length, intervertebral space height, and pelvic incidence angle (P>0.05). However, age, body mass index (BMI), the degree of disc degeneration, sagittal range of motion, lumbar lordosis angle, and sacral slope were significantly associated with the recurrence of L5-S1 disc herniation following PETD (P<0.05). Logistic regression analysis supported these main associations. Conclusions:The recurrence of L5-S1 disc herniation following PETD was significantly associated with increased age and BMI, more severe disc degeneration, increased sagittal range of motion, increased lumbar lordosis, and sacral slope.

<p>Risk Factors for Recurrent L4-5 Disc Herniation After Percutaneous Endoscopic Transforaminal Discectomy: A Retrospective Analysis of 654 Cases</p>

“…The present study found that the incidence of rLDH was higher in discs with moderate degeneration (grade III) than discs with mild degeneration (grade II), which is consistent with previous correlational research. 20 Severely degenerated discs (grades IV and V) also experienced infrequent rLDH in the present study. Relevant cadaveric and clinical studies demonstrated that the range of segmental motion in degenerated and collapsed discs decreased in proportion to the degree of degeneration.…”

A Postoperative Phenomenon of Percutaneous Endoscopic Lumbar Discectomy: Rebound Pain

“…A possible explanation is that returning to work and activity prematurely may increase lumbar loading and stimulate inflammatory responses in the surgical area, contributing to the development of postoperative rebound pain. Maybe because of busy work, the average return‐to‐work time in the rebound pain group was 29.0 ± 7.9 days, which was much shorter than 6–16 weeks reported in other research 30 , 31 . It also reminded us that we should be alert to related complications, while achieving enhanced recovery after surgery.…”

Percutaneous transforaminal endoscopic discectomy for different types of lumbar disc herniation: A retrospective study

“…A previous study reported that the growth of scar tissue after surgery can surround and protect the nucleus pulposus tissue. 29 Undoubtedly, this procedure helps stabilize the intervertebral space. Care should be taken to maintain the lumbar spine after surgery, such as not bending frequently, not lifting heavy objects and not maintaining the same position for long periods of time.…”