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International Orthopaedics
Published in: International Orthopaedics 4/2019

01-04-2019 | Original Paper

Risk factors for recurrent lumbar disc herniation after discectomy

Authors: Eun-Ho Shin, Kyu-Jung Cho, Young-Tae Kim, Myung-Hoon Park

Published in: International Orthopaedics | Issue 4/2019

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Abstract

Purpose

There are many reports about the risk factors for recurrence after lumbar disc surgery.
However, there are none about whether lumbosacral transitional vertebrae (LSTV) are associated with recurrent lumbar disc herniation (LDH). We investigated various risk factors for recurrent LDH after discectomy including LSTV.

Methods

A total of 119 patients who had undergone a discectomy for L4–5 disc herniation were evaluated with a minimum follow-up of two years. Clinical parameters including age, gender, body mass index (BMI), and smoking status, and radiological parameters including type of herniated disc, degree of disc degeneration, LSTV, and sagittal range of motion (SROM) in flexion-extension radiography were evaluated. SROM was measured by the difference of the lordotic angle between the flexion and extension view.

Results

Recurrent disc herniation at L4–5 developed in 21 (17.6%) of the 119 patients. The mean period between primary surgery and recurrence was 17.6 ± 21.1 months. LSTV was found in 11 (52.4%) of the 21 patients who had recurrence and seven (7.1%) of the 98 patients in the non-recurrent group. SROM at L4–5 was 11.68 ± 4.24° in the recurrent group and 9.04 ± 3.65° in the non-recurrent group with a significant difference (p = 0.004). Multiple logistic regression analyses confirmed that LSTV and a larger SROM were significant risk factors for recurrent disc herniation at L4–5.

Conclusions

Lumbosacral transitional vertebrae and a hypermobile disc in flexion-extension radiography were found to be risk factors for recurrent lumbar disc herniation.
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Metadata
Title
Risk factors for recurrent lumbar disc herniation after discectomy
Authors
Eun-Ho Shin
Kyu-Jung Cho
Young-Tae Kim
Myung-Hoon Park
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 4/2019
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-4201-7

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