title: Risk Factors for Recurrent Herniation After Percutaneous Endoscopic Lumbar Discectomy.
abstract: BACKGROUND
  Percutaneous endoscopic lumbar discectomy (PELD) has been widely used for treating lumbar disc herniation. Recurrence after PELD has been reported, but few studies have focused on the risk factors responsible for recurrence after PELD.
  
  
  METHODS
  This retrospective study enrolled 116 patients with recurrent herniation after successful PELD from March 2005 to March 2016. Kaplan-Meier method and Cox regression analysis were employed to identify significant risk factors predicting recurrence after PELD.
  
  
  RESULTS
  Univariate analysis showed that older age (≥50 years old), obesity (body mass index ≥25), no smoking history, decreased reflexes, learning curve of the surgeon (<200 cases), treatment period (March 2005 to September 2010), Modic change, migrated herniation, and central herniation are potential risk factors for recurrence after PELD. Multivariate analysis suggested that older age (≥50 years old), obesity (body mass index ≥25), learning curve of the surgeon (<200 cases), treatment period (March 2005 to September 2010), and central location of herniation are independent significant risk factors for recurrence after PELD.
  
  
  CONCLUSIONS
  Obesity (body mass index ≥25) was the most robust risk factor responsible for recurrence after PELD. Older age (≥50 years old), learning curve of the surgeon (<200 cases), treatment period (March 2005 to September 2010), and central location of herniation were also closely associated with recurrent herniation after successful PELD.
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Stomatology, 457th Hospital of PLA, Wuhan, China.
authors.forename: Huiyu
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Honggang
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Zhengfeng
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Junlong
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China. Electronic address: tangyu628@sina.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China. Electronic address: happyzhou@vip.163.com.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D017587:Diskectomy, Percutaneous; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000453:epidemiology*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: Percutaneous endoscopic lumbar discectomy; Recurrent herniation; Risk factor