Associations of recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy with age, body mass index, modic change, disc degeneration and sacral slope: A quantitative review

Jinlong Zhao; Lingfeng Zeng; Shuai Zhao; Guihong Liang; Bangxin Sha; Haoyang Fu; Weiyi Yang; Jun Liu; Yuping Zeng

doi:10.3892/etm.2024.12483

Associations of recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy with age, body mass index, modic change, disc degeneration and sacral slope: A quantitative review

Exp Ther Med. 2024 Mar 11;27(5):195. doi: 10.3892/etm.2024.12483. eCollection 2024 May.

Authors

Jinlong Zhao^{1

2

3}, Lingfeng Zeng^{1

2

3}, Shuai Zhao², Guihong Liang^{1

2

3}, Bangxin Sha⁴, Haoyang Fu², Weiyi Yang², Jun Liu^{1

2

3

4}, Yuping Zeng^{1

2}

Affiliations

¹ Department of Orthopedics, The Second Clinical College of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China.
² Department of Orthopedics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China.
³ The Research Team on Bone and Joint Degeneration and Injury, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong 510120, P.R. China.
⁴ Department of Orthopedics, Guangdong Second Chinese Medicine Hospital (Guangdong Province Engineering Technology Research Institute of Traditional Chinese Medicine), Guangzhou, Guangdong 510095, P.R. China.

Abstract

Recurrent lumbar disc herniation (rLDH) seriously affects the quality of life of patients and increases the medical burden. The purpose of the present study was to determine the risk factors for rLDH after percutaneous endoscopic lumbar discectomy (PELD). The PubMed, Cochrane Library and Embase databases were searched for studies on the factors associated with rLDH after PELD. The databases were searched from inception to March 30, 2023. The combined effects of categorical variables and continuous variables were measured using odds ratios (ORs) and weighted mean differences (WMDs), respectively, and their corresponding 95% confidence intervals (CIs) were calculated. RevMan 5.3 software was used for data analysis. A total of 9 case-control studies were included in this meta-analysis, comprising 5,446 patients. This study explored a total of 18 potential risk factors for rLDH after PELD; ultimately, 5 factors were associated with the risk of rLDH. Meta-analysis showed that older age (WMD=6.49, 95% CI: 2.52 to 10.46), greater body mass index (WMD=1.16, 95% CI: 0.69 to 1.62), modic change (OR=2.48, 95% CI: 1.54 to 3.99), Pfirrmann grade ≥4 (OR=2.84, 95% CI: 1.3 to 6.16) and greater sacral slope angle (WMD=3.48, 95% CI: 0.53 to 6.42) were risk factors for rLDH after PELD. The risk factors identified in the present study may enable clinicians to identify high-risk populations early and to select appropriate surgical procedures to reduce the risk of rLDH. Perioperative interventions targeting the modifiable factors identified in this study may be beneficial for reducing the risk of rLDH.

Keywords: meta-analysis; percutaneous endoscopic lumbar discectomy; recurrent lumbar disc herniation; risk factors.

Grants and funding

Funding: This work was supported by the National Key Research and Development Program (grant no. 2021YFC1712804), Guangdong Basic and Applied Basic Research Foundation (grant no. 2022A1515220131) and Research Fund for Bajian Talents of Guangdong Provincial Hospital of Chinese Medicine (grant no. BJ2022KY01).