Risk Factors for Recurrent L4-5 Disc Herniation After Percutaneous Endoscopic Transforaminal Discectomy: A Retrospective Analysis of 654 Cases
Meng Kong,1,2,* Derong Xu,1,* Changtong Gao,3 Kai Zhu,1 Shuo Han,1,2 Hao Zhang,1,2 Chuanli Zhou,1 Xuexiao Ma1 1Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qing’dao, Shandong Province 266000, People’s Republic of China; 2Department of Medicine, Qin...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-12-01
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| Series: | Risk Management and Healthcare Policy |
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| Online Access: | https://www.dovepress.com/risk-factors-for-recurrent-l4-5-disc-herniation-after-percutaneous-end-peer-reviewed-article-RMHP |
| _version_ | 1819072892123480064 |
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| author | Kong M Xu D Gao C Zhu K Han S Zhang H Zhou C Ma X |
| author_facet | Kong M Xu D Gao C Zhu K Han S Zhang H Zhou C Ma X |
| author_sort | Kong M |
| collection | DOAJ |
| description | Meng Kong,1,2,* Derong Xu,1,* Changtong Gao,3 Kai Zhu,1 Shuo Han,1,2 Hao Zhang,1,2 Chuanli Zhou,1 Xuexiao Ma1 1Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qing’dao, Shandong Province 266000, People’s Republic of China; 2Department of Medicine, Qingdao University, Qing’dao, Shandong Province 266000, People’s Republic of China; 3Minimally Invasive Interventional Therapy Center, Qingdao Municipal Hospital, Qing’dao, Shandong Province 266000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xuexiao Ma Tel +8618661807895Email ma_xuexiao@126.comChuanli ZhouDepartment of Spinal Surgery, The Affiliated Hospital of Qingdao University, No. 59, Hai Er Road, Qing’dao, Shandong Province 266000, People’s Republic of ChinaTel +86 18661809796Email justin_5257@hotmail.comBackground: Percutaneous endoscopic lumbar discectomy (PELD) is an increasingly applied minimally invasive procedure that has several advantages in the treatment of lumbar disc herniation (LDH). However, recurrent LDH (rLDH) has become a concerning postoperative complication. It remains difficult to establish a consensus and draw reliable conclusions regarding the risk factors for rLDH.Purpose: This retrospective study aimed to investigate the risk factors associated with rLDH at the L4-5 level after percutaneous endoscopic transforaminal discectomy (PETD).Methods: A total of 654 patients who underwent the PETD procedure at the L4-5 level from October 2013 to January 2020 were divided into a recurrence (R) group (n=46) and a nonrecurrence (N) group (n=608). Demographic and clinical data and imaging parameters were collected and analyzed using univariate and multiple regression analyses.Results: The current study found a 7% rate of rLDH at the L4/5 level after successful PETD. Univariate analysis showed that older age, high BMI, diabetes mellitus history, smoking, large physical load intensity, moderate disc degeneration, small muscle–disc ratio (M/D), more fat infiltration, large sagittal range of motion (sROM), scoliosis, small disc height index (DHI), small intervertebral space angle (ISA), and small lumbar lordosis (LL) were potential risk factors (P < 0.10) for LDH recurrence after PETD at the L4-5 level. Multivariate analysis suggested that high BMI, large physical load intensity, moderate disc degeneration, small M/D, more fat infiltration, large sROM, small ISA, and small LL were independent significant risk factors for recurrence of LDH after PETD.Conclusion: Consideration of disc degeneration, M/D, fat infiltration of the paravertebral muscles, sROM, ISA, LL, BMI, and physical load intensity prior to surgical intervention may contribute to the prevention of rLDH following PETD and lead to a more satisfactory operative outcome and the development of a reasonable rehabilitation program after discharge.Keywords: percutaneous endoscopic transforaminal discectomy, recurrent LDH, risk factor |
| first_indexed | 2024-12-21T17:44:56Z |
| format | Article |
| id | doaj.art-974641e2984b4531ae565b1d6a577cdc |
| institution | Directory Open Access Journal |
| issn | 1179-1594 |
| language | English |
| last_indexed | 2024-12-21T17:44:56Z |
| publishDate | 2020-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Risk Management and Healthcare Policy |
| spelling | doaj.art-974641e2984b4531ae565b1d6a577cdc2022-12-21T18:55:32ZengDove Medical PressRisk Management and Healthcare Policy1179-15942020-12-01Volume 133051306560504Risk Factors for Recurrent L4-5 Disc Herniation After Percutaneous Endoscopic Transforaminal Discectomy: A Retrospective Analysis of 654 CasesKong MXu DGao CZhu KHan SZhang HZhou CMa XMeng Kong,1,2,* Derong Xu,1,* Changtong Gao,3 Kai Zhu,1 Shuo Han,1,2 Hao Zhang,1,2 Chuanli Zhou,1 Xuexiao Ma1 1Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qing’dao, Shandong Province 266000, People’s Republic of China; 2Department of Medicine, Qingdao University, Qing’dao, Shandong Province 266000, People’s Republic of China; 3Minimally Invasive Interventional Therapy Center, Qingdao Municipal Hospital, Qing’dao, Shandong Province 266000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xuexiao Ma Tel +8618661807895Email ma_xuexiao@126.comChuanli ZhouDepartment of Spinal Surgery, The Affiliated Hospital of Qingdao University, No. 59, Hai Er Road, Qing’dao, Shandong Province 266000, People’s Republic of ChinaTel +86 18661809796Email justin_5257@hotmail.comBackground: Percutaneous endoscopic lumbar discectomy (PELD) is an increasingly applied minimally invasive procedure that has several advantages in the treatment of lumbar disc herniation (LDH). However, recurrent LDH (rLDH) has become a concerning postoperative complication. It remains difficult to establish a consensus and draw reliable conclusions regarding the risk factors for rLDH.Purpose: This retrospective study aimed to investigate the risk factors associated with rLDH at the L4-5 level after percutaneous endoscopic transforaminal discectomy (PETD).Methods: A total of 654 patients who underwent the PETD procedure at the L4-5 level from October 2013 to January 2020 were divided into a recurrence (R) group (n=46) and a nonrecurrence (N) group (n=608). Demographic and clinical data and imaging parameters were collected and analyzed using univariate and multiple regression analyses.Results: The current study found a 7% rate of rLDH at the L4/5 level after successful PETD. Univariate analysis showed that older age, high BMI, diabetes mellitus history, smoking, large physical load intensity, moderate disc degeneration, small muscle–disc ratio (M/D), more fat infiltration, large sagittal range of motion (sROM), scoliosis, small disc height index (DHI), small intervertebral space angle (ISA), and small lumbar lordosis (LL) were potential risk factors (P < 0.10) for LDH recurrence after PETD at the L4-5 level. Multivariate analysis suggested that high BMI, large physical load intensity, moderate disc degeneration, small M/D, more fat infiltration, large sROM, small ISA, and small LL were independent significant risk factors for recurrence of LDH after PETD.Conclusion: Consideration of disc degeneration, M/D, fat infiltration of the paravertebral muscles, sROM, ISA, LL, BMI, and physical load intensity prior to surgical intervention may contribute to the prevention of rLDH following PETD and lead to a more satisfactory operative outcome and the development of a reasonable rehabilitation program after discharge.Keywords: percutaneous endoscopic transforaminal discectomy, recurrent LDH, risk factorhttps://www.dovepress.com/risk-factors-for-recurrent-l4-5-disc-herniation-after-percutaneous-end-peer-reviewed-article-RMHPpercutaneous endoscopic transforaminal discectomyrecurrent ldhrisk factor |
| spellingShingle | Kong M Xu D Gao C Zhu K Han S Zhang H Zhou C Ma X Risk Factors for Recurrent L4-5 Disc Herniation After Percutaneous Endoscopic Transforaminal Discectomy: A Retrospective Analysis of 654 Cases Risk Management and Healthcare Policy percutaneous endoscopic transforaminal discectomy recurrent ldh risk factor |
| title | Risk Factors for Recurrent L4-5 Disc Herniation After Percutaneous Endoscopic Transforaminal Discectomy: A Retrospective Analysis of 654 Cases |
| title_full | Risk Factors for Recurrent L4-5 Disc Herniation After Percutaneous Endoscopic Transforaminal Discectomy: A Retrospective Analysis of 654 Cases |
| title_fullStr | Risk Factors for Recurrent L4-5 Disc Herniation After Percutaneous Endoscopic Transforaminal Discectomy: A Retrospective Analysis of 654 Cases |
| title_full_unstemmed | Risk Factors for Recurrent L4-5 Disc Herniation After Percutaneous Endoscopic Transforaminal Discectomy: A Retrospective Analysis of 654 Cases |
| title_short | Risk Factors for Recurrent L4-5 Disc Herniation After Percutaneous Endoscopic Transforaminal Discectomy: A Retrospective Analysis of 654 Cases |
| title_sort | risk factors for recurrent l4 5 disc herniation after percutaneous endoscopic transforaminal discectomy a retrospective analysis of 654 cases |
| topic | percutaneous endoscopic transforaminal discectomy recurrent ldh risk factor |
| url | https://www.dovepress.com/risk-factors-for-recurrent-l4-5-disc-herniation-after-percutaneous-end-peer-reviewed-article-RMHP |
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