Evidence map›Paper›PMID 41666860›Full record

ArticleNeurospine2026

Preoperative Clinical and Radiographic Risk Factors for Recurrent Lumbar Disc Herniation: Systematic Review and Meta-analysis.

Mohamed A R Soliman, Hendrick Francois, Alexander O Aguirre, Asham Khan, Waeel Hamouda, Stipe Ćorluka, Zorica Buser, Samuel K Cho, S Tim Yoon, AO Spine Knowledge Forum Degenerative

Abstract read
In one paragraph

Article in Neurospine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Mohamed A R SolimanDepartment of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
Hendrick FrancoisDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA.
Alexander O AguirreDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA.
Asham KhanDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA.
Waeel HamoudaDepartment of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
Stipe ĆorlukaSpinal Surgery Division, Department of Traumatology, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia.
Zorica BuserDepartment of Orthopedic Surgery, NYU Grossman School of Medicine, New York, NY, USA.
Samuel K ChoDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
S Tim YoonDepartment of Orthopedic Surgery, Emory University, Atlanta, GA, USA.
AO Spine Knowledge Forum Degenerative

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveLumbar discectomy is one of the most frequently undertaken procedures for the management of lumbar disc herniation. However, it may be complicated by recurrent disc herniation, with reported rates as high as 25%. To the authors' knowledge, this study is the largest systematic review to date, analyzing the clinical and radiographic risk factors for recurrent disc herniation.

methodsA systematic literature search of Embase and PubMed/Medline, covering the period from inception to October 1, 2025, was conducted to identify case-control or cohort studies reporting risk factors for recurrent disc herniation. Risk factors were classified into baseline, clinical, and radiographic risk factors. Meta-analysis was performed for any reported risk factor with data from 3 or more studies. The assessment included an evaluation of publication bias and heterogeneity.

resultsA total of 51 studies published during the search timeframe, comprising 52,479 patients, met the inclusion criteria. Recurrent disc herniation occurred in 6,794 patients (12.9%). Significant risk factors for disc herniation included high body mass index (BMI) (standard mean difference [SMD], 0.48; 95% confidence interval [CI], 0.26-0.70), diabetes (odds ratio [OR], 1.48; 95% CI, 1.23-1.77), increased sagittal range of motion (SMD, 2.15; 95% CI, 0.35-3.94), and Modic changes (OR, 2.97; 95% CI, 2.20-4.01). No other significant predictors for recurrent disc herniation were identified.

conclusionIn conclusion, patients with high BMI, diabetics, increased sagittal range of motion, and presence of Modic changes are at increased risk of recurrent disc herniation. Future prospective studies are needed to validate the risk factors identified in this study associated with recurrent disc herniation.

Indexed as

Body mass indexDiabetesModic changesRecurrent disc herniationRisk factorsSagittal range of motionSmoking

Identifiers

PMID41666860
PMCPMC12890318

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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.