EPIDEMIOLOGICALRISK FACTORS OF RECURRENCE OF LUMBAR INTERVERTEBRAL DISC HERNIATION AFTER PRIMARY DISCECTOMY (LITERATURE REVIEW)

Abstract

Primary discectomy for a lumbar intervertebral disc herniated (LDH) is usually accompanied by a rapid regression of clinical symptoms, however, in 5–15 % of cases, an X-ray positive recurrence of the hernia with corresponding orthopedic disorders is registered, which leads to repeated surgical intervention. Objective. Determination of risk factors for recurrence of LDH and their frequency under the conditions of various methods of primary discectomy based on a scientific analysis of the relevant literature. Methods. The material of the research is articles containing the definition of risk factors for the recurrence of a LDH after primary discectomy, for the period 2013–2023 in PubMed, Google Scholar, Medline databases using medical subject headings and keywords «recurrent lumbar disc herniation, surgical interventions, percutaneous endoscopic lumbar discectomy, microdiscectomy, laminectomy, discectomy, spondylodesis». The research method is a systematic review of relevant literature sources. Results. Early and long-term results of primary discectomy for intervertebral disc herniation using decompression (open discectomy, microendoscopic discectomy, percutaneous discectomy, laminectomy, minidiscectomy, endoscopic discectomy) and decompression-stabilization (discectomy combined with spondylodesis) techniques are traced in the literature. The most successful were: 1 year after the operation — endoscopic discectomy (12.4 % of reoperations) and spondylodesis (11.8 %); 10 years after the operation — laminectomy (14 %) and spondylodesis (10 %). The highest rates of revision discectomy: 1 year after the operation — laminectomy (18.6 %); 10 years after surgery — open discectomy and endoscopic discectomy — 16 % each. Conclusions. Recurrent intervertebral disc herniation is an early complication of primary discectomy, the frequency of which varies depending on the surgical technique and the timing of the postoperative period. The most reliable risk factors are male gender, age younger than 50 years, diabetes mellitus, and smoking.