Recurrence Rate of Lumbar Disc Herniation After Open Discectomy in Active Young Men
Recurrence Rate of Lumbar Disc Herniation After Open Discectomy in Active Young Men
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DOI：
10.1097/brs.0b013e31818f9116
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发表时间：
2009-01-01
期刊：
影响因子：
3
通讯作者：
Lee, Dong-Ho
中科院分区：
文献类型：
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作者：
Kim, Min Seok;Park, Kun-Woo;Lee, Dong-Ho
研究设计.回顾性临床研究。Objective.采用生存分析法评估活跃青年男性腰椎间盘突出症开放性椎间盘切除术后的复发率。关于年轻人腰椎间盘突出症复发率的报道很少，尽管这个年龄组的椎间盘突出症发病率高于其他年龄组。此外，大多数关于椎间盘突出症复发率的研究报告的百分比没有考虑时间进程的影响。对241例年龄在20 ~ 39岁之间，在14年内接受开放性椎间盘切除术的患者的病历进行回顾性分析和电话调查。复发的诊断是基于新症状的发展和磁共振成像显示与初始诊断相同的节段中的兼容病变。采用Kaplan-Meier乘积限法生存分析计算复发率，并采用对数秩检验评估患者年龄、发生程度和椎间盘突出类型对复发率的影响。平均随访8.55年，总复发率为7.1%（17例患者），随访14年时累积生存率为91.5%。生存分析估计在较长的随访期内复发率较高，尽管初次手术后第9年没有复发。突出型腰椎间盘突出症的复发率明显高于其他类型。生存分析提供了一个更准确的估计真实复发率。突出的椎间盘比其他类型更容易复发。
Study Design. A retrospective clinical study. Objective. To estimate the recurrence rate of lumbar disc herniation after open discectomy in active young men using survival analysis.Summary of Background Data. There are few reports on the recurrence rate of lumbar disc herniation in young adults, even though this age group shows a higher incidence of disc herniation than the other age groups. In addition, most of the studies on the recurrence rate of disc herniation have reported percentages without regard to the effect of the time course.Methods. Medical records were retrospectively reviewed and phone call surveys were undertaken for 241 patients aged from 20 to 39 who had undergone open discectomies over a period of 14 years. A diagnosis of recurrence was based on the development of new symptoms and magnetic resonance imaging showing compatible lesions in the same segment as the initial diagnosis. The recurrence rate was calculated using a survival analysis based on the Kaplan-Meier product-limit method and the log-rank test was used to evaluate the effect of patient age, level of occurrence, and type of herniated disc on the recurrence rate.Results. The overall recurrence rate was 7.1% (17 patients) at a mean follow-up of 8.55 years, and the cumulative survival rate was 91.5% at a follow-up of 14 years. Survival analysis estimated a higher rate of recurrence at longer follow-up, although there was no recurrence after ninth year from the primary surgery. The recurrence rate was significantly higher for protruded discs compared with other types.Conclusion. Survival analysis provides a more accurate estimation of true recurrence rate. Protruded discs are more likely to show recurrence than other types.