title: Risk Factors for Recurrent Lumbar Disc Herniation: A Systematic Review and Meta-Analysis.
abstract: Recurrent lumbar disc herniation (rLDH) is a common complication following primary discectomy. This systematic review aimed to investigate the current evidence on risk factors for rLDH.Cohort or case-control studies addressing risk factors for rLDH were identified by search in Pubmed (Medline), Embase, Web of Science, and Cochrane library from inception to June 2015. Relevant results were pooled to give overall estimates if possible. Heterogeneity among studies was examined and publication bias was also assessed.A total of 17 studies were included in this systematic review. Risk factors that had significant relation with rLDH were smoking (OR 1.99, 95% CI 1.53-2.58), disc protrusion (OR 1.79, 95% CI 1.15-2.79), and diabetes (OR 1.19, 95% CI 1.06-1.32). Gender, BMI, occupational work, level, and side of herniation did not correlate with rLDH significantly.Based on current evidence, smoking, disc protrusion, and diabetes were predictors for rLDH. Patients with these risk factors should be paid more attention for prevention of recurrence after primary surgery. More evidence provided by high-quality observational studies is still needed to further investigate risk factors for rLDH.
authors.affiliation: From the Department of Orthopedics, General Hospital of Jinan Military Commanding Region Jinan, Shandong, China (WH, ZH, JL, XY); Department of Health Statistics, General Hospital of Jinan Military Commanding Region, Jinan, Shandong, China (LY).
authors.forename: Weimin
authors.initials: W
authors.lastname: Huang
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Han
authors.forename: Jiang
authors.initials: J
authors.lastname: Liu
authors.forename: Lili
authors.initials: L
authors.lastname: Yu
authors.forename: Xiuchun
authors.initials: X
authors.lastname: Yu
mesh_terms: D000367:Age Factors; D015992:Body Mass Index; D048909:Diabetes Complications; D006801:Humans; D007405:Intervertebral Disc Displacement; D008159:Lumbar Vertebrae; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking