Moderate to Severe Multifidus Fatty Atrophy is the Risk Factor for Recurrence After Microdiscectomy of Lumbar Disc Herniation

作者全名："Zhu, Fengzhao; Jia, Dongqing; Zhang, Yaqing; Ning, Ya; Leng, Xue; Feng, Chencheng; Li, Changqing; Zhou, Yue; Huang, Bo"

作者地址："[Zhu, Fengzhao; Zhang, Yaqing; Ning, Ya; Leng, Xue; Feng, Chencheng; Li, Changqing; Zhou, Yue; Huang, Bo] Army Med Univ, Xinqiao Hosp, Dept Orthoped, Chongqing, Peoples R China; [Jia, Dongqing] Chongqing Med Univ, Univ Town Hosp, Dept Blood Transfus, Chongqing, Peoples R China; [Huang, Bo] Army Med Univ, Xinqiao Hosp, Dept Orthoped, 183, Xinqiao Main St, Chongqing, Peoples R China"

通信作者："Huang, B (通讯作者)，Army Med Univ, Xinqiao Hosp, Dept Orthoped, 183, Xinqiao Main St, Chongqing, Peoples R China."

来源：NEUROSPINE

ESI学科分类：　

WOS号：WOS:001025932600025

JCR分区：Q1

影响因子：3.8

年份：2023

卷号：20

期号：2

开始页：637

结束页：650

文献类型：Article

关键词：Lumbar disc herniation; Recurrence; Risk factor; Microdiscectomy; Multifidus fatty atrophy; Logistic regression

摘要："Objective: We attempted to investigate the potential risk factors of recurrent lumbar disc herniation (rLDH) after tubular microdiscectomy. Methods: We retrospectively analyzed the data of patients who underwent tubular microd-iscectomy. The clinical and radiological factors were compared between the patients with and without rLDH. Results: This study included 350 patients with lumbar disc herniation (LDH) who under-went tubular microdiscectomy. The overall recurrence rate was 5.7% (20 of 350). The visual analogue scale (VAS) score and Oswestry Disability Index (ODI) at the final follow-up sig-nificantly improved compared with those preoperatively. There was no significant difference in the preoperative VAS score and ODI between the rLDH and non-rLDH groups, while the leg pain VAS score and ODI of the rLDH group were significantly higher than those of the non-rLDH group at final follow-up. This suggested that rLDH patients had a worse prognosis than non-rLDH patients even after reoperation. There were no significant differ-ences in sex, age, body mass index, diabetes, current smoking and drinking, disc height index, sagittal range of motion, facet orientation, facet tropism, Pfirrmann grade, Modic changes, interdisc kyphosis, and large LDH between the 2 groups. Univariate logistic re-gression analysis revealed that rLDH was associated with hypertension, multilevel microd-iscectomy, and moderate-severe multifidus fatty atrophy (MFA). A multivariate logistic re-gression analysis indicated that MFA was the sole and strongest risk factor for rLDH after tubular microdiscectomy. Conclusion: Moderate-severe MFA was a risk factor for rLDH after tubular microdiscecto-my, which can serve as an important reference for surgeons in formulating surgical strate-gies and the assessment of prognosis."

基金机构：National Nat- ural Science Foundation of China [81972114]

基金资助正文：Conflict of Interest: The authors have nothing to disclose. Funding/Support: This study was supported by National Nat- ural Science Foundation of China (81972114) .