Alessandro Siccoli1,2, Marc L Schröder1, Victor E Staartjes3,4,5. 1. Department of Neurosurgery, c/o Bergman Clinics, Rijksweg 69, 1411 GE, Naarden, Amsterdam, The Netherlands. 2. Faculty of Medicine, University of Zurich, Zurich, Switzerland. 3. Department of Neurosurgery, c/o Bergman Clinics, Rijksweg 69, 1411 GE, Naarden, Amsterdam, The Netherlands. victor.staartjes@gmail.com. 4. Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. victor.staartjes@gmail.com. 5. Neurosurgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. victor.staartjes@gmail.com.
Abstract
OBJECTIVE: Recurrent lumbar disc herniation (LDH) is the most frequent reason for reoperation after lumbar microdiscectomy. While several risk factors for recurrent LDH have been well-described, the effect of age on recurrence remains unclear, especially concerning the timing of recurrent LDH. METHODS: From a prospective registry, we identified all patients who underwent tubular microdiscectomy for LDH. Recurrent LDH was defined as reoperation for LDH at the same index level and side. The associations among age and incidence of recurrent LDH as well as on time to recurrent LDH were statistically evaluated using multivariable analysis of covariance, linear regression, and Cox proportional hazards modelling. RESULTS: Of the 3013 patients who underwent surgery for LDH, 166 (5.5%) had to undergo reoperation due to LDH recurrence. Uni- and multivariable analysis revealed no influence of age on the incidence of recurrent LDH (both p > 0.05). Linear regression indicated earlier reoperation in older patients, both with (β = -0.248) and without (β = -0.374) correction for confounders (both p < 0.05). An additional survival analysis found that patients aged over 35 years had recurrent LDH significantly earlier (hazard ratio 0.617, p = 0.013). CONCLUSION: In an analysis of a large prospective database of patients undergoing microdiscectomy for lumbar disc herniation, we found that younger patients do not have a higher reoperation probability than their older counterparts, even after correcting for multiple confounders. However, older patients tend to experience recurrent LDH significantly earlier after the index surgery compared to younger patients.
OBJECTIVE: Recurrent lumbar disc herniation (LDH) is the most frequent reason for reoperation after lumbar microdiscectomy. While several risk factors for recurrent LDH have been well-described, the effect of age on recurrence remains unclear, especially concerning the timing of recurrent LDH. METHODS: From a prospective registry, we identified all patients who underwent tubular microdiscectomy for LDH. Recurrent LDH was defined as reoperation for LDH at the same index level and side. The associations among age and incidence of recurrent LDH as well as on time to recurrent LDH were statistically evaluated using multivariable analysis of covariance, linear regression, and Cox proportional hazards modelling. RESULTS: Of the 3013 patients who underwent surgery for LDH, 166 (5.5%) had to undergo reoperation due to LDH recurrence. Uni- and multivariable analysis revealed no influence of age on the incidence of recurrent LDH (both p > 0.05). Linear regression indicated earlier reoperation in older patients, both with (β = -0.248) and without (β = -0.374) correction for confounders (both p < 0.05). An additional survival analysis found that patients aged over 35 years had recurrent LDH significantly earlier (hazard ratio 0.617, p = 0.013). CONCLUSION: In an analysis of a large prospective database of patients undergoing microdiscectomy for lumbar disc herniation, we found that younger patients do not have a higher reoperation probability than their older counterparts, even after correcting for multiple confounders. However, older patients tend to experience recurrent LDH significantly earlier after the index surgery compared to younger patients.
Authors: Jennifer A Moliterno; Jared Knopman; Karishma Parikh; Jessica N Cohan; Q Daisy Huang; Grant D Aaker; Anastasia D Grivoyannis; Ashwin R Patel; Roger Härtl; John A Boockvar Journal: J Neurosurg Spine Date: 2010-06
Authors: Garrett K Harada; Zakariah K Siyaji; G Michael Mallow; Alexander L Hornung; Fayyazul Hassan; Bryce A Basques; Haseeb A Mohammed; Arash J Sayari; Dino Samartzis; Howard S An Journal: Eur Spine J Date: 2021-06-07 Impact factor: 3.134
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