Department of Neurosurgery, Osmaniye State Hospital, Merkez-Osmaniye, Turkey.
Department of Neurosurgery, University of Health Sciences, Bakırköy Research and Training Hospital for Neurology Neurosurgery, and Psychiatry, Bakırköy-Istanbul, Turkey.
Neurol Res. 2022 Sep;44(9):830-846. doi: 10.1080/01616412.2022.2056340. Epub 2022 Mar 22.
Many risk factors associated with recurrent lumbar disk herniation (RLDH) following lumbar discectomy (LD) have been reported. This study aimed to elucidate the biomechanicalradiological, clinical, and demographic factors that affect symptomatic RLDH prospectively.We collected prospective data of 988 consecutive patients with LDH who underwent LD at our department from January 2014 to December 2015. Patients who met the study criteria and were followed up postoperatively for more than 5 years were included (n = 816). Patients were divided into 3 groups; group 1 included patients who experienced symptomatic RLDH within the first postoperative 24 months (PO24M), group 2 included patients with symptomatic RLDH after PO24M, and group 3 included the patients who hadn't experienced symptomatic RLDH/LDH. The preoperative biomechanicalradiological, clinical, and the patients' demographic characteristics were compared among the groups.A total of 816 patients with 842 LDH met our study criteria. The mean age at the first LD was 46.9 years. The mean follow-up period was 72.8 months. The preoperative trauma history, postoperative trauma history, and BMI > 24.5 kg/m were independent risk factors for RLDH. Large sROM at the L4-5 level and a higher intervertebral disk height index (IDH) were significantly higher in groups 1 and 2.Biomechanical-radiological and demographic factors can affect the incidence of symptomatic RLDH. To reduce the risk of RLDH, patients with these risk factors should receive more attention during surgical interventions. The patients should avoid gaining weight and potential traumatic accidents.
许多与腰椎间盘切除术后（LD）复发性腰椎间盘突出症（RLDH）相关的风险因素已被报道。本研究旨在阐明影响症状性 RLDH 的生物力学、放射学、临床和人口统计学因素。
我们收集了 2014 年 1 月至 2015 年 12 月在我科接受 LD 的 988 例连续腰椎间盘突出症患者的前瞻性数据。符合研究标准并在术后随访超过 5 年的患者（n=816）被纳入研究。患者被分为 3 组；第 1 组患者在术后 24 个月内出现症状性 RLDH（PO24M），第 2 组患者在 PO24M 后出现症状性 RLDH，第 3 组患者未出现症状性 RLDH/LDH。比较了 3 组患者术前的生物力学、放射学、临床和患者的人口统计学特征。
共有 816 例患者的 842 个腰椎间盘符合我们的研究标准。第一次 LD 的平均年龄为 46.9 岁。平均随访时间为 72.8 个月。术前创伤史、术后创伤史和 BMI>24.5kg/m2 是 RLDH 的独立危险因素。L4-5 水平的大 sROM 和较高的椎间盘高度指数（IDH）在第 1 组和第 2 组中显著升高。
生物力学-放射学和人口统计学因素可能影响症状性 RLDH 的发生率。为降低 RLDH 的风险，应在手术干预期间对具有这些风险因素的患者给予更多关注。患者应避免体重增加和潜在的创伤事故。
