Analysis of risk factors for recurrence after percutaneous lumbar discectomy for lumbar disc herniation
ZHU Lei
WU Rui
LIU Jie
ZHENG Tian-you
LENG Zhen
Abstract：Objective To analyze the risk factors for the recurrence after percutaneous lumbar laminectomy(PELD)in patients with lumbar disc herniation(LDH).Methods One hundred and forty-five LDH patients treated with PELD in our hospital from April 2020 to June 2024 were selected,including 74 males and 71 females.All completed the follow-up.The mean age was(54.72±14.52)years.Body mass index(BMI),occupation,education,residence,smoking,alcohol consumption,diabetes mellitus,hypertension,American Society of Anesthesiologists(ASA)score,return-to-work time,iliac pterygoid height,transverse process length,intervertebral space height,disc height index,sagittal range of motion(SROM),Pfirrmann grade,Modic changes,location of disc herniation,operation time,Self-Rating Anxiety Scale(SAS)and rehabilitation time were collected.Factors for recurrence after PELD in LDH patients were analyzed by multifactorial logistic analysis.The accuracy of factors to diagnose relapse after PELD in LDH patients was analyzed by subject work characteristics(ROC).Results There were 26 recurrences after PELD in 145 LDH patients(17.93%).Age,BMI,percentage of smoking,percentage of diabetes mellitus,ASA score,SROM,Pfirrmann grade,operation time and SAS score were higher in patients with recurrence than in patients without recurrence(P<0.05).Education,return-to-work time and rehabilitation time were lower than in patients without recurrence(P<0.05).Multifactorial logistic analysis showed that age,education,return-to-work time,SROM,Pfirrmann grade,SAS score,and rehabilitation time were independent influencing factors for recurrence after PELD in patients with LDH(P<0.05).The area under the curve(AUC)of ROC curve analysis was 0.762(0.684-0.828),0.726(0.646-0.796),0.716(0.635-0.787),0.873(0.808-0.923),0.665(0.582-0.742),0.815(0.742-0.875),0.886(0.822-0.932)and 0.969(0.926-0.991).Conclusions Age,education,return-to-work time,SROM,Pfirrmann grade,SAS score,and rehabilitation time are influencing factors for the relapse after PELD in LDH patients.The combined detection model has the advantage of higher sensitivity,specificity and accuracy.
Keywords：Intervertebral disc displacementLumbar vertebraeDiskectomypercutaneousRecurrenceRoot cause analysis
Publication Date：2025-03-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 222-227 )