| 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%