Investigation on risk factors of postoperative recurrence of lumbar disc herniation based on MRI evaluation of multifidus muscle fat infiltration and clinical features
YANG Xiyuan
LI Jianan
LIANG Qingyuan
SHI Bo
LI Lijun
JING Zhizhen
Abstract：Objective To investigate the association between MRI-based multifidus muscle fat infiltration degree and other clinical features and postoperative recurrence of lumbar disc herniation(LDH).Methods The medical records of 743 patients with LDH who received lumbar minimally invasive surgery in Shanxi Provincial People's Hospital from April 2023 to April 2024 were retrospectively collected.The fat infiltration degree and lesion features were obtained from MRI.According to the recurrence status of LDH within 12 months after surgery,the above patients were classified into recurrence group(n=74)and non-recurrence group(n=669).Potential predictors were screened by univariate analysis.Multivariate logistic regression analysis was applied to determine the independent risk factors for postoperative recurrence of LDH.ROC curve was drawn and the area under the curve(AUC)was calculated to evaluate the predictive efficiency of the model.Results There were no statistical differences in gender,age,diabetes mellitus,hypertension and protrusion segment between the two groups of patients(P>0.05).The disease course,body mass index,Pfirrmann grading and multifidus muscle fat infiltration degree in recurrence group were higher than those in non-recurrence group(P<0.05).Regression analysis results showed that long course of disease,high body mass index,high degree of multifidus muscle fat infiltration and high Pfirrmann grade were independent risk factors for postoperative recurrence of LDH(P<0.05).The combined prediction model equation was manifested as y=2.030×disease course+0.216×body mass index+0.660×multifidus muscle fat infiltration degree+0.931×Pfirrmann grading assignment,and the AUC,sensitivity and specificity of the model were 0.991,96.43%and 94.63%respectively.Conclusion MRI sign of multifidus muscle fat infiltration is a key independent risk factor for predicting postoperative recurrence of LDH,and its combined application with clinical features can significantly enhance the predictive efficiency.
Keywords：lumbar disc herniationmultifidus musclefat infiltrationmagnetic resonance imagingrecurrenceinfluencing factors
Publication Date：2025-12-20
Online Publishing Date：2026-01-07(First online date of this platform, not the publication date of the document)
Pages：6( 1491-1496 )