True Recurrent Lumbar Disc Herniation And Arterial Hypertension: Is There Any Relation?

Abstract

Cardiovascular risk factors and atherosclerosis are associated with lumbar disc herniation. However, studies fail to identify a consistent risk factor for the recurrence. To investigate the association between cardiovascular risk factors and true recurrent of lumbar disc herniation, 186 patients who underwent unilateral microdiscectomy for intractable radiculopathy due to lumbar disc herniation were enrolled in this cross-sectional study. One surgeon performed all operations, and all patients were treated with the same procedure. The follow-up period was between 6 months to 5 years. The association between some cardiovascular risk factors e.g. hypertension, diabetes, hyperlipidemia, smoking and true recurrent lumbar disc herniation investigated using logistic regression analysis. Sixty-nine patients with true recurrence of lumbar disc herniation (RLDH group) were compared to 117 patients who were surgically treated with no recurrence of lumbar disc herniation (LDH group). The differences of age, gender, diabetes, morphine addiction, hyperlipidemia and smoking between two groups were not statistically significant. The prevalence of hypertension in RLDH and LDH was 61.5% and 38.5% respectively. The difference was significant (p<0.001). The logistic regression analysis showed the recurrence rate was significantly higher in hypertensive patients (OR: 1.74-7.55, CI: 95%, P = 0.001). Furthermore, there was no correlation between confounding factor of medications, diabetes, history of cardiovascular disease, hyperlipidemia, duration of the symptom-free interval, gender and the true recurrence. The results of this preliminary study showed that there might be a possible relation between arterial hypertension and true recurrence of lumbar disc herniation, so it would be advisable to pay more attention to hypertensive patients who have been operated.