ReviewFrontiers in surgery2026
Comprehensive identification of risk factors for recurrence after percutaneous endoscopic lumbar discectomy: a systematic review and meta-analysis.
Review in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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
3 citing papers in PubMed.
- Comparative efficacy of unilateral biportal endoscopy versus endoscopic foraminoplasty decompression for single-level lumbar spinal stenosis: a retrospective cohort study.Frontiers in surgery · 2026Article
- Comparison of clinical and radiological outcomes between microscope-assisted tubular unilateral laminectomy for bilateral decompression and bilateral laminotomy for crossover decompression in single-level lumbar spinal stenosis.Frontiers in surgery · 2026Article
- Oblique lateral interbody fusion versus transforaminal lumbar interbody fusion for single-level lumbar adjacent segment disease: a retrospective comparative study of clinical and radiographic outcomes.Frontiers in surgery · 2026Article
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
Objective: This meta-analysis aimed to identify risk factors associated with postoperative recurrence following Percutaneous Endoscopic Lumbar Discectomy (PELD) for Lumbar Disc Herniation (LDH). Methods: We systematically searched PubMed, the Cochrane Library, EMbase, CNKI, WanFang, and VIP databases for case-control and cohort studies investigating risk factors for recurrence after PELD, from their inception until August 30, 2025. Two reviewers independently extracted data and assessed the methodological quality of the included studies using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using Stata 12.0 software to calculate the pooled odds ratios (OR) and 95% confidence intervals (CI) for each potential factor. Results: A total of 39 case-control studies, involving 14,454 patients, were included. The overall postoperative recurrence rate was 11.0% (95% CI: 9.1%-13.0%). Factors significantly associated with an increased risk of recurrence included: Modic changes (OR = 1.74, 95% CI: 1.25-2.23), particularly type II Modic changes (OR = 1.87, 95% CI: 1.02-2.72); diabetes mellitus (OR = 2.34, 95% CI: 1.52-3.59); smoking (OR = 2.02, 95% CI: 1.27-3.21); intraoperative annulus fibrosus rupture (OR = 2.40, 95% CI: 1.28-4.49); greater sagittal range of motion (SROM) (OR = 2.00, 95% CI: 1.58-2.53); higher body mass index (BMI) (OR = 1.30, 95% CI: 1.18-1.42); advanced age (OR = 1.21, 95% CI: 1.12-1.30); and high-intensity postoperative activity (OR = 1.83, 95% CI: 1.23-2.44). Among the herniation types, sequestrated disc herniation was associated with the highest recurrence risk. No significant correlation was found between the Pfirrmann grading system and recurrence risk (OR = 1.28, 95% CI: 0.95-1.60). Conclusion: The results of this meta-analysis indicate that recurrence after PELD for LDH is associated with a range of factors. Significant independent patient-related risk factors include advanced age, higher BMI, smoking, diabetes, and the presence of Modic changes (especially type II). Regarding surgical factors, intraoperative annulus fibrosus rupture significantly increases the risk of recurrence. Postoperatively, engaging in high-intensity activities too early or having a greater lumbar SROM also markedly elevates the probability of recurrence.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.