ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Risk factors for recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy: the role of spinopelvic parameters and facet joint degeneration.
Article in 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Letter to the Editor concerning "Risk factors for recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy: roles of spinopelvic parameters and facet joint degeneration" by Xiangdong Gong, et al. (Eur Spine J [2026]; doi: 10.1007/s00586-026-10111-2).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 · 2026Review
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12 authors.
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Abstract
backgroundRecurrent lumbar disc herniation (rLDH) remains a major cause of treatment failure after percutaneous endoscopic lumbar discectomy (PELD). The roles of spinopelvic parameters and facet joint degeneration in postoperative recurrence have not been fully clarified.
objectiveTo investigate the associations between spinopelvic parameters, facet joint degeneration, and recurrent lumbar disc herniation after PELD.
methodsA total of 106 patients who underwent single-level PELD were retrospectively analyzed, including 53 patients with recurrence (rLDH group) and 53 without recurrence (non-rLDH group). Propensity score matching was performed to balance baseline characteristics. Clinical and radiological parameters, including pelvic incidence (PI), lumbar lordosis (LL), PI-LL mismatch, disc height (DH), range of motion (ROM), facet joint degeneration, Pfirrmann grade, and Modic changes, were evaluated. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted.
resultsAfter matching, no significant differences were observed in age, sex, BMI, or surgical level between the two groups (all P > 0.05). The rLDH group exhibited significantly greater PI-LL mismatch, DH, ROM, facet degeneration, Pfirrmann grade, and a higher prevalence of Modic changes (all P < 0.05). Multivariate analysis identified DH (OR = 1.50, 95% CI: 1.14-1.97), facet degeneration (OR = 6.00, 95% CI: 1.74-20.70), Modic changes (OR = 7.35, 95% CI: 1.55-34.86), PI-LL mismatch (OR = 1.08, 95% CI: 1.01-1.14) as independent predictors of recurrence. ROC analysis showed that DH (AUC = 0.785) and ROM (AUC = 0.749) had the highest predictive value.
conclusionsPI-LL mismatch, facet joint degeneration, disc height, and Modic changes are independent risk factors for recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy. PI-LL mismatch greater than 10° and facet joint degeneration (Weishaupt grade ≥ 2) are significantly associated with an increased risk of recurrence.
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