Shepard Nicholas, Cho Woojin
New York University Hospital for Joint Diseases, New York, NY USA.
Montefiore Medical Center, Bronx, NY, USA.
Global Spine J. 2019 Apr;9(2):202-209. doi: 10.1177/2192568217745063. Epub 2017 Dec 18.
Narrative review.
To identify the risk factors and surgical management for recurrent lumbar disc herniation using a systematic review of available evidence.
We conducted a review of PubMed, MEDLINE, OVID, and Cochrane Library databases using search terms identifying recurrent lumbar disc herniation and risk factors or surgical management. Abstracts of all identified articles were reviewed. Detailed information from articles with levels I to IV evidence was extracted and synthesized.
There is intermediate levels III to IV evidence detailing perioperative risk factors and the optimal surgical technique for recurrent lumbar disc herniations.
Multiple risk factors including smoking, diabetes mellitus, obesity, intraoperative technique, and biomechanical factors may contribute to the development of recurrent disc disease. There is widespread variation regarding optimal surgical management for recurrent herniation, which often include revision discectomies with or without fusion via open and minimally invasive techniques.
叙述性综述。
通过对现有证据进行系统评价，确定复发性腰椎间盘突出症的危险因素及外科治疗方法。
我们使用识别复发性腰椎间盘突出症及危险因素或外科治疗方法的检索词，对PubMed、MEDLINE、OVID和Cochrane图书馆数据库进行了检索。对所有检索到的文章摘要进行了审查。提取并综合了来自具有I至IV级证据文章的详细信息。
有III至IV级中等证据详细说明了复发性腰椎间盘突出症的围手术期危险因素及最佳手术技术。
包括吸烟、糖尿病、肥胖、手术技术及生物力学因素在内的多种危险因素可能导致椎间盘疾病复发。对于复发性椎间盘突出症的最佳外科治疗方法存在广泛差异，通常包括采用开放和微创技术进行有或无融合的翻修椎间盘切除术。
