Risk Factors for Recurrent Lumbar Disk Herniation

Abstract

Objective: to investigate the frequency of recurrent lumbar disk herniation (rLDH) and evaluated risk factors of rLDH in Russian population. Methods: this was a retrospective clinical study. From January 2015 to March 2022, 218 patients having single-level LDH at three institutes were included in this clinical study and who were then observed for a minimum of 5 years postoperatively. All the patients or relatives gave informed consent to participate in this study. The levels of disk herniation were L4-L5 in 132 cases (60.5 %), and L5-S1 in 86 cases (39.4 %). Results: The rLDH group was composed of 31 male and 12 female, whose ages ranged from 18 to 57 years (34.8±9.5 years). The non-rLDH group was composed of 97 male and 78 female, whose ages ranged from 19 to 73 years (47.5±9.8 years). According to the constructed binary logistic model, body mass index (p=0.021), current smoking (p=0.017), stage of disk degeneration (p=0.043), facet tropism (p=0.037), disk height index (p=0.018) and apparent diffusion coefficient (p=0.009) are significantly associated with incidence of rLDH. Conclusions: patients with these risk factors should be paid more attention for prevention of rLDH. Level of Evidence III; Retrospective Study.

Hernia Discal Lumbar: factores de riesgo, diagnóstico y tratamiento en adultos

“…Enfermedades subyacentes: los estudios toman en cuenta las limitaciones funcionales de los pacientes, ya sea para caminar o enfermedades musculoesqueléticas como un factor de riesgo de padecer de hernias discales a nivel lumbar (1,2,(5)(6)(7)(8)(9).…”

“…La columna vertebral está constituida por 24 vértebras, las cinco vértebras de la parte inferior de la espalda forman la columna lumbar cuya función es la protección de la médula espinal, así como del soporte y movilidad del cuerpo humano (1)(2)(3)(4)(5)(6). Los huesos lumbares se caracterizan por sus cuerpos vertebrales, ya que estructuralmente soportan cargas pesadas; y, por los discos intervertebrales, estructuras que separan las vértebras brindando espacio al igual que amortiguamiento (7)(8)(9).Cada disco consta de un centro, el núcleo pulposo, el cual contiene abundante agua, mucoproteínas y polisacáridos y es el responsable de distribuir la presión que soporta el disco durante el movimiento (10-14).…”

Management of recurrent lumbar disc herniation: a comparative analysis of posterior lumbar interbody fusion and repeat discectomy

“…However, the recurrence rate following discectomy can be as high as 30%, and instability progression rates are around 25% 6 , 7 . Risk factors for recurrence include smoking, young age, being overweight, and increased disc height 8 , 9 . Although repeat discectomy is a commonly recommended approach due to its minimal invasiveness, shorter hospital stays, and cost-effectivenes 10 , 11 , it still carries the risk of reherniation and progression to instability.…”

Repeat discectomy and spinal fusion in the treatment of recurrent lumbar disc herniation: systematic review of the literature

“…К факторам, связанным с рецидивирующей грыжей межпозвонкового диска, относят курение, молодой возраст, избыточный вес, сохранение высоты диска и т.д. [8,9].…”

“…Некоторые авторы [10,11] рекомендуют повторную дискэктомию из-за ее малой травматичности, сокращения сроков пребывания в стационаре, низкой стоимости и высокой эффективности. Однако этот метод все-таки связан с риском повторного образования грыжи и прогрессирования нестабильности, что может привести к ухудшению [6][7][8].…”