Backache, Medical Exam, Mature Adult, Rear View, Showing
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%
