Risk Factors for the Recurrent Herniation After Microendoscopic Discectomy

BACKGROUND: Microendoscopic discectomy (MED) has been widely accepted for its advantage of minimal injury in the treatment of lumbar disc herniation. Recurrence after successful MED has been reported; however, the risk factors responsible for the MED recurrence were still unclear. METHODS: From April 2005 to April 2016, 111 patients with recurrent herniation after successful MED were included in this retrospective study. Kaplan-Meier methods and Cox regression analysis were used to identify the significant risk factors responsible for MED recurrence. RESULTS: Univariate analysis demonstrated that age (>= 50 years old), obesity (body mass index [ BMI] >= 25), the treatment period (April 2005 to October 2010), modic change, nonmigrated herniation, and central herniation are identified as the potential risk factors for percutaneous endoscopic lumbar discectomy recurrence. Multivariate analysis suggested that age (>= 50 years old), obesity (BMI >= 25), and modic change are identified as the significant risk factors responsible for MED recurrence. CONCLUSIONS: Age (>= 50 years old) was the most robust risk factor for MED recurrence. Obesity (BMI >= 25) and modic change were also highly involved in the recurrent herniation after successful MED. Taking these risk factors into consideration before surgery may be instrumental in pursuing a personalized operative method, which may lead to a more satisfactory operative outcome and a relatively lower recurrence rate.