Multiple factors influencing the postoperative recurrence of lumbar disc herniation treated with lumbar discectomy

CHEN Guo-yong; XIE En; ZHANG Zhen-xing; HAO Ding-jun; FAN Yong; LI Fei-hu

doi:10.3969/j.issn.2095-252X.2018.06.007

Abstract：Objective To study the multiple factors affecting the postoperative recurrence of lumbar disc herniation after lumbar discectomy. Methods From April 2013 to May 2016, 181 L5 - S1 disc herniation patients were treated with lumbar discectomy. All patients were divided into recurrent and non-recurrent groups. Clinical parameters ( age, gender and body mass index ), duration of symptoms, diabetes, smoking, disc herniation type, preoperative visual analogue scale ( VAS ) and preoperative radiological parameters [ intervertebral disc degeneration, intervertebral disc height and sagittal range of motion ( sROM ) ] were compared. The clinical and X-ray parameters were analyzed by F test. Paired t-test was used to compare the mean value of the continuous data between the 2 groups. Any variable ≤ 0.5 in single factor analysis was included in the multivariate Logistic regression model. Based on the multivariate Logistic analysis, the independent risk factors associated with postoperative recurrent lumber disc herniation ( PRLDH ) were confirmed. Results Age, gender, smoking, intervertebral disc degeneration, intervertebral disc height and sROM were significantly different between the 2 groups ( P < 0.05 ). Results of Logistic regression analysis: age ( R2 =0.641, P = 0.013 ), smoking ( R2 = 0.595, P = 0.022 ), intervertebral disc degeneration ( Group B ) ( R2 = 0.683, P =0.012 ), intervertebral disc height ( R2 = 0.536, P = 0.028 ) and sROM ( R2 = 0.792, P < 0.001 ) were all risk factors of PRLDH. Gender ( R2 = 0.263, P = 0.236 ) was a relative risk factor. Conclusions Age, smoking, intervertebral disc degeneration, intervertebral disc height index and sROM were the risk factors for the PRLDH, while the sROM was the most risky factor of all.