title: Risk Factors for the Recurrent Herniation After Microendoscopic Discectomy.
abstract: BACKGROUND
  Microendoscopic discectomy (MED) has been widely accepted for its advantage of minimal injury in the treatment of lumbar disc herniation. Recurrence after successful MED has been reported; however, the risk factors responsible for the MED recurrence were still unclear.
  
  
  METHODS
  From April 2005 to April 2016, 111 patients with recurrent herniation after successful MED were included in this retrospective study. Kaplan-Meier methods and Cox regression analysis were used to identify the significant risk factors responsible for MED recurrence.
  
  
  RESULTS
  Univariate analysis demonstrated that age (≥50 years old), obesity (body mass index [BMI] ≥25), the treatment period (April 2005 to October 2010), modic change, nonmigrated herniation, and central herniation are identified as the potential risk factors for percutaneous endoscopic lumbar discectomy recurrence. Multivariate analysis suggested that age (≥50 years old), obesity (BMI ≥25), and modic change are identified as the significant risk factors responsible for MED recurrence.
  
  
  CONCLUSIONS
  Age (≥50 years old) was the most robust risk factor for MED recurrence. Obesity (BMI ≥25) and modic change were also highly involved in the recurrent herniation after successful MED. Taking these risk factors into consideration before surgery may be instrumental in pursuing a personalized operative method, which may lead to a more satisfactory operative outcome and a relatively lower recurrence rate.
authors: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors: Yuan
authors: Y
authors: Yao
authors: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors: Huan
authors: H
authors: Liu
authors: Department of Stomatology, the 457th Hospital of Chinese People's Liberation Army, Wuhan, People's Republic of China.
authors: Huiyu
authors: H
authors: Zhang
authors: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors: Honggang
authors: H
authors: Wang
authors: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors: Zhengfeng
authors: Z
authors: Zhang
authors: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors: Yangyi
authors: Y
authors: Zheng
authors: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China. Electronic address: tangyu628@sina.com.
authors: Yu
authors: Y
authors: Tang
authors: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China. Electronic address: happyzhou@vip.163.com.
authors: Yue
authors: Y
authors: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D018572:Disease-Free Survival; D017586:Diskectomy / Q000379:methods; D017587:Diskectomy, Percutaneous / Q000379:methods*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000453:epidemiology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008159:Lumbar Vertebrae; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D044583:Neuroendoscopy / Q000379:methods*; D009765:Obesity / Q000453:epidemiology; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Microendoscopic discectomy; Recurrent herniation; Risk factor