SynthesisSpine2018
Association of Annular Defect Width After Lumbar Discectomy With Risk of Symptom Recurrence and Reoperation: Systematic Review and Meta-analysis of Comparative Studies.
Synthesis in Spine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- The efficacy and safety of annulus fibrosus suture as adjuvant therapy for lumbar disc herniation: a systematic review and meta-analysis.Frontiers in bioengineering and biotechnology · 2025Pooled it
- The effectiveness and safety of annulus closure device implantation in lumbar discectomy for patients with lumbar disc herniation: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Pooled it
- The Functional Role of Interface Tissue Engineering in Annulus Fibrosus Repair: Bridging Mechanisms of Hydrogel Integration with Regenerative Outcomes.ACS biomaterials science & engineering · 2020Pooled it
- Comparison of treatments for lumbar disc herniation: Systematic review with network meta-analysis.Medicine · 2019Pooled it
- Lumbar Microdiscectomy and Postoperative Activity Restrictions: A Randomized Controlled Trial.Spine · 2026Trial
- Lumbar disc reherniation prevention with a bone-anchored annular closure device: 1-year results of a randomized trial.Medicine · 2019Trial
- Three-year results from a randomized trial of lumbar discectomy with annulus fibrosus occlusion in patients at high risk for reherniation.Acta neurochirurgica · 2019Trial
- Clinical performance of a bone-anchored annular closure device in older adults.Clinical interventions in aging · 2019Trial
- Return to sports after lumbar disc herniation surgery: a survey of German surgeons and postoperative patient experiences.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- A single-source preoperative prediction model for recurrent lumbar disc herniation after primary discectomy: Development and internal validation in the SPORT registry.North American Spine Society journal · 2026Article
- Clinical value of a novel V-shaped annular suture under unilateral biportal endoscopy: a retrospective comparative study with the traditional I-shaped suture.Journal of orthopaedic surgery and research · 2026Article
- Bracing and Activity Restriction After Lumbar Discectomy Surgery: An International Survey of AO Spine Members.Neurospine · 2026Article
- Complication assessment in full-endoscopic uniportal lumbar spine surgery: A prospective analysis from 304 patients.Brain & spine · 2026Article
- Mechanical and Biological Treatments for Annulus Fibrosus Repair and Closure: A Review of Clinical Studies.Neurospine · 2026Review
- Beyond Pain Relief: Preventing Recurrence and Preserving Function After Lumbar Discectomy.International journal of spine surgery · 2025Article
- ISASS Recommendations and Coverage Criteria for Bone-Anchored Annular Defect Closure Following Lumbar Discectomy: Coverage Indications, Limitations, and/or Medical Necessity-An ISASS 2025 Policy Update on the Use of Bone-Anchored Annular Closure to Prevent Reherniation in High-Risk Lumbar Discectomy Patients.International journal of spine surgery · 2025Article
- Therapeutic exercise following lumbar spine surgery: a narrative review.North American Spine Society journal · 2025Article
- Full-endoscopic posterior longitudinal ligament coverage suturing for lumbar disc herniation with annular defects.Journal of orthopaedics · 2025Article
- Bone anchoring annular suture technique for repairing annular defects at vertebral body edge following lumbar discectomy.Scientific reports · 2025Article
- Annular Closure Device Reduces Symptomatic Reherniation Rates: Results of a Meta-analysis.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designSystematic review and meta-analysis of comparative studies.
objectiveTo characterize the association of annular defect width after lumbar discectomy with the risk of symptom recurrence and reoperation. SUMMARY OF BACKGROUND DATA: Large annular defect width after lumbar discectomy has been reported to increase risk of symptom recurrence. However, this association has not been evaluated in a systematic manner.
methodsA systematic literature search of MEDLINE and EMBASE was performed to identify comparative studies of large versus small annular defects following lumbar discectomy that reported symptom recurrence or reoperation rates. Main outcomes were reported with pooled odds ratios (OR) and 95% confidence intervals (CIs). Sensitivity analyses were performed to assess the robustness of the meta-analysis findings.
resultsAfter screening 696 records, we included data from 7 comparative studies involving 1653 lumbar discectomy patients, of whom 499 (30%) had large annular defects and 1154 (70%) had small annular defects. Methodological quality of studies was good overall. The median follow-up period was 2.9 years. The risk of symptom recurrence (OR = 2.5, 95% CI = 1.3-4.5, P = 0.004) and reoperation (OR = 2.3, 95% CI = 1.5-3.7, P < 0.001) was higher in patients with large versus small annular defects. Publication bias was not evident. The associations between annular defect width and risk of symptom recurrence and reoperation remained statistically significant in all sensitivity analyses.
conclusionAnnular defect width after lumbar discectomy is an under-reported modifier of patient outcome. Risk for symptom recurrence and reoperation is higher in patients with large versus small annular defects following lumbar discectomy. LEVEL OF EVIDENCE: 2.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.