Study on the risk factors of recurrence of lumbar disc herniation after percutaneous transforaminal endoscopic discectomy

ObjectiveTo investigate the risk factors of recurrence of lumbar disc herniation(LDH) after percutaneous transforaminal endoscopic discectomy(PTED).

MethodsA total of 186 patients with LDH treated with PTED were followed up for 2 to 4 years.The recurrence rates of patients were compared among the different clinical characteristics, and the logistic regression analysis was used to investigate the independent risk factors of postoperative recurrence.

ResultsTwenty cases of 186 LDH patients recured after PTED, the recurrence rate of which was 10.75%.The differences of the postoperative recurrence rates among the patients with different sizes of fibrous ring rupture, long-term smoking, LDH type, postoperative activity, age, postoperative segmental mobility and body mass index were statistically significant(P < 0.05 to P < 0.01), and the differences of the postoperative recurrence rates among the patients with different genders, combined diabetes and course of disease were not statistically significant(P>0.05).The results of logistic regression analysis showed that the long-term smoking after surgery, fibrous ring rupture more than 5 mm, free-out LDH, postoperative activity score more than 6 points and age more than 70 years were the independent risk factors of recurrence of LDH after PTED(P < 0.05).

ConclusionsThe recurrence of LDH after PTED is obviously correlated with the fibrous ring rupture size, LDH type, postoperative activity degree and age.The preoperative examination should be strengthened, and the intraoperative procedures and postoperative rehabilitation should be paid attention to reduce LDH recurrence.