Yaoshen Zhang, Zihao Ding, Jie Wang, Li Guan, Yuzeng Liu, Yong Hai
{"title":"Risk factors for recurrent lumbar disc herniation after unilateral biportal endoscopy: a retrospective study.","authors":"Yaoshen Zhang, Zihao Ding, Jie Wang, Li Guan, Yuzeng Liu, Yong Hai","doi":"10.1007/s00264-025-06577-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Unilateral biportal endoscopy (UBE) is a predominantly minimally invasive surgical technique for addressing LDH. Nonetheless, recurrent lumbar disc herniation (rLDH) remains the predominant reason for reoperation following UBE. This retrospective study examined the risk factors and reoperation rates for rLDH following UBE. This study aimed to examine the risk factors associated with rLDH and the reoperation rate after single-level UBE.</p><p><strong>Methods: </strong>We retrospectively analyzed 205 patients who underwent UBE for single-level LDH from 2019 to 2023 to determine reoperation causes and related risk variables. Reoperation was characterized as the postoperative radiological evidence of persistent symptomatic disc herniation at the same level, necessitating further surgical intervention. We gathered radiographic and demographic parameters preoperatively and postoperatively. Patients with recurrent LDH had additional evaluation during recurrence and revision operations.</p><p><strong>Results: </strong>Of the 205 patients, 21 (10.2%) required further rLDH revision surgery. The multivariate analysis indicated that obesity and elevated fasting blood glucose (FBG) levels were independent risk variables with strong predictive value for reoperation after controlling for other potential risk factors. Based on the receiver operating characteristic curve analysis, the cutoff points for UBE were body mass index (BMI) = 25.775 kg/m<sup>2</sup> and FBG = 5.155 mmol/L.</p><p><strong>Conclusion: </strong>This study identified obesity (BMI > 25.775 kg/m²) and elevated FBG levels (> 5.155 mmol/L) as independent risk factors for UBE reoperation. Hence, we recommend longer rehabilitation interventions, such as wearing a suitable brace and strengthening the paraspinal muscles, for patients with obesity and high FBG who undergo UBE.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1963-1971"},"PeriodicalIF":2.6000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00264-025-06577-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/14 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Unilateral biportal endoscopy (UBE) is a predominantly minimally invasive surgical technique for addressing LDH. Nonetheless, recurrent lumbar disc herniation (rLDH) remains the predominant reason for reoperation following UBE. This retrospective study examined the risk factors and reoperation rates for rLDH following UBE. This study aimed to examine the risk factors associated with rLDH and the reoperation rate after single-level UBE.
Methods: We retrospectively analyzed 205 patients who underwent UBE for single-level LDH from 2019 to 2023 to determine reoperation causes and related risk variables. Reoperation was characterized as the postoperative radiological evidence of persistent symptomatic disc herniation at the same level, necessitating further surgical intervention. We gathered radiographic and demographic parameters preoperatively and postoperatively. Patients with recurrent LDH had additional evaluation during recurrence and revision operations.
Results: Of the 205 patients, 21 (10.2%) required further rLDH revision surgery. The multivariate analysis indicated that obesity and elevated fasting blood glucose (FBG) levels were independent risk variables with strong predictive value for reoperation after controlling for other potential risk factors. Based on the receiver operating characteristic curve analysis, the cutoff points for UBE were body mass index (BMI) = 25.775 kg/m2 and FBG = 5.155 mmol/L.
Conclusion: This study identified obesity (BMI > 25.775 kg/m²) and elevated FBG levels (> 5.155 mmol/L) as independent risk factors for UBE reoperation. Hence, we recommend longer rehabilitation interventions, such as wearing a suitable brace and strengthening the paraspinal muscles, for patients with obesity and high FBG who undergo UBE.
期刊介绍:
International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters.
Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable.
The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.