LI Zhiqi, CAO Peng, XIANG Ganggang, TONG Meng, LI Taiyou, WU Ruirui, TANG Guangping, CHEN Jiankun, GAO Qilong
Objective: To analyze the risk factors for recurrence of lumbar disc herniation after percutaneous transforaminal endoscopic discectomy. Methods: From January 2018 to October 2022, a total of 2 123 patients with lumbar disc herniation(LDH) who underwent percutaneous transforaminal endoscopic discectomy in the Third Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, the First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Qujing Hospital Affiliated to Yunnan University of Traditional Chinese Medicine, Tongxiang Hospital of Traditional Chinese Medicine and Xuanhan County People's Hospital were analyzed. The preoperative general conditions (gender, age, body mass index, herniated segment, herniated type, degree of disc degeneration), surgical conditions (endoscopic type, annulus fibrosus treatment, nucleus pulposus removal volume, lateral recess decompression, preoperative endplate inflammation) were collected, and the recurrence was followed up after operation. The clinical data of the two groups were compared, and the risk factors of postoperative recurrence were evaluated by univariate and multivariate logistic analysis. Results: There were significant differences in the type of disc herniation, annulus fibrosus treatment, degree of disc degeneration, volume of nucleus pulposus removal, decompression of lateral recess and endplate inflammation between the recurrent group and the non-recurrent group (P<0.05). Univariate logistic regression analysis showed that the influencing factors of recurrence of lumbar disc herniation after percutaneous transforaminal endoscopic discectomy may include the type of herniation, the suture of annulus fibrosus, the degree of disc degeneration, the volume of nucleus pulposus removal, the adequacy of lateral recess decompression, and the presence of endplate inflammation (P<0.05). Multivariate logistic regression analysis showed that annulus fibrosus treatment, degree of intervertebral disc degeneration, volume of nucleus pulposus removal, lateral recess decompression, and endplate inflammation (P<0.05) were the influencing factors of recurrence of lumbar disc herniation after percutaneous transforaminal endoscopic discectomy. Conclusion: Improper treatment of annulus fibrosus, high degree of intervertebral disc degeneration, incomplete removal of nucleus pulposus, inadequate decompression of lateral recess and endplate inflammation are the influencing factors of recurrence of lumbar disc herniation after percutaneous transforaminal endoscopic discectomy.