A new study published in The Journal of Spinal Disorders and Techniques examines the risk factors for recurrent lumbar disc herniation at L5-S1 preoperatively.
The researchers examined 467 patients enrolled in a retrospective case control study. The researchers found:
1. Patients with recurrent lumbar disc herniation reported onset at 39.4±17.9 months after the primary surgery.
2. There were 39 patients who reported recurrent lumbar disc herniation included in the study and 29 of those patients had the herniation ipsilateral to the previous lumbar disc herniation. The second herniation was contralateral to the initial lumbar disc herniation in 10 patients.
3. The significant risk factors for recurrent lumbar disc herniation were:
• Moderate disc degeneration with preserved height
• Large sagittal range of motion
• Small relative width of L5 vertebral transverse process
• Low iliac crest height
• Male sex
4. The researchers concluded "having a large annular defect increase[s] recurrence after discectomy, especially in cases of ipsilateral rLDH."
5. A 2014 study published in The Spine Journal surveyed surgeons with 15 or more years in practice and found they were more likely to select revision microdiscectomy to treat patients with recurrent lumbar disc herniation. However, there was a 69 percent probability that two randomly-selected spine surgeons would disagree on how to treat two-time recurrent disc herniation.