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The JBJS Quiz of the Month is a collection of 10 relevant questions from each orthopaedic subspecialty. The questions are drawn from JBJS Clinical Classroom, which houses over 4,500 questions and 3,100 learning resources. Take the Quiz to see how you score against your peers!

NOTE: This quiz does not earn users CME credits. The questions must be answered within Clinical Classroom to earn CME credits.

Which of the following is a risk factor for same-level recurrent disc herniation following microdiscectomy?
    • Low-demand occupation
      • Patients with heavy lifting occupations, not low-demand occupations, have a higher risk for same-level recurrent disc herniation following microdiscectomy. Heavy lifting is thought to place great biomechanical stress on the disc, which can lead to recurrent disc herniation

 

    • Age >45 years old at the time of primary herniation
      • Younger age at the time of primary lumbar disc herniation provides a greater risk for same-level recurrent disc herniation following microdiscectomy. Younger patients have more nucleus pulposus remaining that can later herniate, and they engage in more physically demanding activity

 

    • Discrete disc herniation without fragmentation
      • A fragmented intervertebral disc has a higher risk for same-level recurrent disc herniation following microdiscectomy compared with a discrete, contained disc herniation

 

    • Annular tear defect >6 mm
      • An annular tear defect >6 mm presents a risk factor for same-level recurrent disc herniation following microdiscectomy. Carragee, et al. (2003) showed that when the defect is large, the recurrence rate approaches 30%

     

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