The Impact of Demographic Characteristics, Obesity, Surgical Level, and Intervertebral Disc Properties on Recurrence of Lumbar Disc Herniation

BACKGROUND: This study focused on identifying factors influencing recurrent lumbar disc herniation (RLDH) by analyzing demographic data, body mass index (BMI), and radiologic disc properties in patients undergoing single- level unilateral lumbar disc herniation surgery. METHODS: Our retrospective analysis included 2 groups from our clinic: Group 1 (n = 41) with patients experiencing RLDH requiring a second surgery, and Group 2 (n = 73) with patients having a single surgery and no recurrence over at least a 5-year follow-up. We assessed age, sex, diabetes mellitus (DM), hypertension (HT), BMI, Pfirrmann disc degeneration type, herniation types (protrusion, extrusion, and sequestration), and surgical level. RESULTS: The mean ages of Groups 1 and 2 were 48.93 +/- 13.47 and 44.4 +/- 11.79 years, respectively, with no significant age difference (P P = 0.064). Gender distribution was also not significantly different, with 63.41% males in Group 1 and 56.16% in Group 2 (P P = 0.450). DM prevalence was similar in both groups (P P = 0.727). Notably, HT was significantly lower in Group 2 (P P = 0.018). The average BMI was comparable between groups (P P = 0.607), and no significant difference in Pfirrmann disc degeneration scores was observed (P P = 0.547). Radio- logic disc type distributions did not significantly differ (P P = 0.448). Most surgeries in both groups were at the L45 level, with no significant differences in surgical levels (P P = 0.456). CONCLUSIONS: We found that factors like gender, age, DM, obesity, surgical level, disc degeneration, and disc types do not significantly impact RLDH. However, the higher occurrence of HT in recurrent cases indicates a potential area for further research.