RISK FACTORS OF RECURRENCE LUMBAR DISC HERNIATION AFTER PRIMARY ENDOSCOPIC TRANSFORAMINAL DISCECTOMY. PART 2
DOI:
https://doi.org/10.15674/0030-598720261101-108Keywords:
Рrimary endoscopic transforaminal discectomy, recurrent lumbar disc herniation, risk factors, lumbar segment morphometry, degenerative changes in lumbar intervertebral discAbstract
Recurrence of lumbar disc herniation (LDH) after primary endoscopic transforaminal discectomy (PETD) is diagnosed in 3.8–15 % of cases. Objective. To study preoperative radiographic and MRI signs that potentiate LDH recurrence after PETD. Methods The study material consisted of articles identifying radiographic and MRI risk factors for recurrent LDH after PETD between 2015 and 2025 in the PubMed, Google Scholar, and Medline databases. The study method was a systematic review of relevant literature sources. Results. The level of LDH does not influence the incidence of rLDH, although some authors consider the presence of a disc herniation in the upper lumbar spine as a risk factor for recurrence. rLDH is significantly more frequently recorded with primary disc protrusion; in cases of migrated disc herniation, the risk of rLDH significantly increases with large intracanal displacement of disc material extending beyond the inferior margin of the superior or inferior vertebral pedicle. The use of PETD for resection of central disc herniations most often results in recurrent LDH (compared to foraminal, extraforaminal, and migratory) due to technical errors. A study of disc height index dynamics in the pre- and postoperative periods and the degree of Modic type endplate degeneration showed that the less severe the degenerative processes in the prolapsed intervertebral disc, the higher the risk of herniation recurrence after PETD. Conclusions. Recurrence disc herniation after PETD is significantly more common in cases of primary protrusion and significantly increases with large annular defects (≥ 6 mm). rLDH is significantly more common in discs with moderate degenerative changes, with a disc height index of approximately 0.37 ± 0.09 and Modic type 1
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Copyright (c) 2026 Valentin Piontkovskyi, Vira Kolesnichenko, Maksym Holbaum
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