Location Matters; The Impact of MRI Findings on Recurrence and Reoperation Rates in Minimally Invasive Discectomy

Introduction: Despite advancements in minimally invasive techniques like tubular and endoscopic discectomies, concerns over recurrence and reoperation rates persist. This study investigates whether preoperative lumbar MRI characteristics—such as herniated disc level and annular disc lateralization—can predict outcomes in minimally invasive discectomies.

Methods: We analyzed data from 126 patients who underwent minimally invasive discectomy between 2021 and 2024. MRI findings included disc level, annular disc location (central, paracentral, foraminal, far lateral), and disc herniation type (protrusion, extrusion, sequestration). Statistical analysis employed SPSS, utilizing Pearson Correlation tests.

Results: Among single-level discectomy cases, procedures at L1-L2 and L3-L4 correlated significantly with higher reoperation rates (r=0.187, p=0.043; r=0.192, p=0.038). Foraminal herniations exhibited a stronger correlation with increased reoperation rates (r=0.289, p=0.002), whereas paracentral herniations correlated with lower reoperation rates (r=-0.242, p=0.009). Discectomy at L2-L3 and paracentral herniation were associated with longer intervals before reoperation (268 days vs. 36.44 days; r=0.977, p=0.0002) and recurrence (r=0.848, p=0.004), respectively.

Conclusion : This study identifies specific MRI characteristics predictive of recurrence and reoperation rates in minimally invasive discectomy. Discectomies at L1-L2, L3-L4, and foraminal locations correlate with higher reoperation rates, whereas L2-L3 discectomies and paracentral herniations correlate with more favorable outcomes. These findings underscore the potential for enhancing preoperative planning and improving patient outcomes through targeted MRI-based predictions.