title: Risk factors of recurrent lumbar disk herniation: a single center study and review of the literature.
abstract: BACKGROUND
  The recurrence of lumbar disk herniation (LDH) is a major problem in the treatment of LDH. The purpose of this study was to investigate the risk factors for recurrent LDH.
  
  
  METHODS
  Between April 2005 and March 2008, 298 patients with LDH, who underwent surgical treatment, were enrolled in this study. The patients were divided into a nonrecurrent group (N group) and a recurrent group (R group). We compared their clinical parameters including age, sex, body mass index, smoking, alcohol, sports activity, occupational lifting, and occupational driving. The relationships between the variables and recurrent LDH were evaluated by univariate analysis and multiple logistic regression analysis.
  
  
  RESULTS
  The N group had 266 patients (89.3%) and the R group had 32 patients (10.7%). Univariate analysis showed that current smoking (P<0.001) and occupational lifting (P=0.02) significantly correlated with recurrent LDH. Multivariate analysis showed that current smoking significantly related with recurrent LDH (OR, 3.47; 95% CI, 1.55-7.80; P=0.003).
  
  
  CONCLUSIONS
  Our study suggests that smoking cessation and restraining from lifting may significantly decrease the incidence of recurrent LDH.
authors.affiliation: *Department of Orthopedic Surgery, Saiseikai Kanazawa Hospital †Department of Orthopedic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Miwa
authors.forename: Akio
authors.initials: A
authors.lastname: Yokogawa
authors.forename: Tadayoshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nishimura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Igarashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Inatani
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000453:epidemiology / Q000601:surgery*; D008019:Life Style; D017770:Lifting / Q000009:adverse effects; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D055815:Young Adult