Medical Student University of Arizona, College of Medicine- Phoenix Phoenix, AZ, US
Introduction: Recurrent lumbar disc herniation is common. The timing to re-herniation as well as the potential need for fusion are areas of great interest to spine surgeons. There are no current, comprehensive reviews on this critical topic.
Methods: A PRISMA-compliant systematic review was conducted searching PubMed, EMBASE and Scopus databases on September 24th, 2024. Studies were included if they reported average times of recurrence rates in the appropriate lumbar disc herniation subpopulation. The results were uploaded into the systematic review software Rayyan where abstract and full text analysis were conducted. After the extraction of clinical outcomes, data of included studies was meta-analyzed in R version 4.3.4.
Results: The search ultimately yielded five included studies that reported outcomes of interest across 120 different patients. The pooled mean age across all studies is 51.57 ± 4.91 years. The most common types of fusion utilized after recurrence were TLIF two times, PLF two times, and LLIF once. The meta-analysis of single means demonstrated that the pooled average of time to recurrence is 14.35 months [12.02; 16.69] and subsequent time to fusion for this population of patients was 45.93 months [38.63; 53.24].
Conclusion : This meta-analysis revealed that the average time for re-herniation, when they do occur, is just over one year. Fusion surgery for these re-herniations occurs, on average, within four years of index surgery.