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Inicio Revista Española de Cirugía Ortopédica y Traumatología (English Edition) Factors associated with lumbar disc hernia recurrence after microdiscectomy
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Vol. 61. Issue 6.
Pages 397-403 (November - December 2017)
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Vol. 61. Issue 6.
Pages 397-403 (November - December 2017)
Original Article
DOI: 10.1016/j.recote.2017.10.003
Factors associated with lumbar disc hernia recurrence after microdiscectomy
Factores asociados a recidiva de hernia de disco lumbar luego de una microdiscectomía
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G. Camino Willhuber
Corresponding author
, G. Kido, M. Mereles, J. Bassani, M. Petracchi, C. Elizondo, M. Gruenberg, C. Sola
Instituto de Ortopedia y Traumatología Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Tables (3)
Table 1. General sample characteristics.
Table 2. Comparison of factors related to a disc hernia.
Table 3. Intra and postoperative complications, and reoperation rate.
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Abstract
Introduction

Lumbar disc hernias are a common cause of spinal surgery. Hernia recurrence is a prevalent complication.

Objective

To analyse the risk factors associated with hernia recurrence in patients undergoing surgery in our institution.

Materials and methods

Lumbar microdiscectomies between 2010 and 2014 were analysed, patients with previous surgeries, extraforaminales and foraminal hernias were excluded. Patients with recurrent hernia were the case group and those who showed no recurrence were the control group.

Results

177 patients with lumbar microdiscectomy, of whom 30 experienced recurrence (16%), and of these 27 were reoperated. Among the risk factors associated with recurrence, we observed a higher rate of disc height, higher percentage of spinal canal occupied by the hernia and presence of degenerative facet joint changes; we observed no differences in sex, body mass index or age.

Discussion

Previous studies show increased disc height and young patients as possible factors associated with recurrence.

Conclusion

In our series we found that the higher rate of disc height, the percentage of spinal canal occupied by the hernia and degenerative facet joint changes were associated with hernia recurrence.

Keywords:
Microdiscectomy
Lumbar disc herniation
Hernia recurrence
Resumen
Introducción

Las hernias de disco lumbares son una causa frecuente de cirugía lumbar. La recurrencia herniaria es una complicación prevalente.

Objetivo

Analizar los factores de riesgo asociados a recurrencia herniaria en pacientes intervenidos por hernia discal lumbar en nuestra institución.

Materiales y métodos

Se analizaron en forma retrospectiva una serie de 177 microdiscectomías lumbares entre 2010 y 2014; se excluyeron pacientes con cirugías previas, hernias foraminales y extraforaminales. Los pacientes con recurrencia herniaria constituyeron el grupo de casos y los que no presentaron recurrencia fueron el grupo control; se analizó: sexo, edad, índice de masa corporal, nivel, degeneración facetaria, altura discal y protrusión discal.

Resultados

Hubo 177 pacientes con microdiscectomía lumbar, de los cuales 30 (16%) presentaron recurrencia herniaria; de ellos, 27 fueron reoperados. Entre los factores de riesgo asociados a recurrencia observamos mayor índice de altura discal, mayor porcentaje de canal ocupado por la hernia y mayor presencia de cambios degenerativos facetarios; no observamos diferencias en cuanto al sexo, índice de masa corporal y edad.

Discusión

Estudios previos muestran el aumento de altura discal y pacientes jóvenes como posibles factores asociados a recidiva.

Conclusión

En nuestra serie encontramos que el mayor índice de altura discal, el porcentaje de canal ocupado por la hernia y los cambios degenerativos facetarios se asociaron a recurrencia herniaria.

Palabras clave:
Microdiscectomía
Hernia discal lumbar
Recidiva herniaria

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