The Impact of Demographic Characteristics, Obesity, Surgical Level, and Intervertebral Disc Properties on Recurrence of Lumbar Disc Herniation

Abstract

This study focused on identifying factors influencing recurrent lumbar disc herniation (RLDH) by analyzing demographic data, body mass index (BMI), and radiologic disc properties in patients undergoing single-level unilateral lumbar disc herniation surgery. Our retrospective analysis included 2 groups from our clinic: Group 1 (n= 41) with patients experiencing RLDH requiring a second surgery, and Group 2 (n= 73) with patients having a single surgery and no recurrence over at least a 5-year follow-up. We assessed age, sex, diabetes mellitus (DM), hypertension (HT), BMI, Pfirrmann disc degeneration type, herniation types (protrusion, extrusion, and sequestration), and surgical level. The mean ages of Groups 1 and 2 were 48.93 ± 13.47 and 44.4 ± 11.79 years, respectively, with no significant age difference (P= 0.064). Gender distribution was also not significantly different, with 63.41% males in Group 1 and 56.16% in Group 2 (P= 0.450). DM prevalence was similar in both groups (P= 0.727). Notably, HT was significantly lower in Group 2 (P= 0.018). The average BMI was comparable between groups (P= 0.607), and no significant difference in Pfirrmann disc degeneration scores was observed (P= 0.547). Radiologic disc type distributions did not significantly differ (P= 0.448). Most surgeries in both groups were at the L4-5 level, with no significant differences in surgical levels (P= 0.456). We found that factors like gender, age, DM, obesity, surgical level, disc degeneration, and disc types do not significantly impact RLDH. However, the higher occurrence of HT in recurrent cases indicates a potential area for further research.