Defining Recurrent Lumbar Disc Herniation (RLDH): An International Survey Study
Abstract
Study DesignInternational Expert Cross-Sectional Survey.ObjectivesTo establish international expert consensus on the definition, diagnostic criteria, imaging requirements, and surgical management of recurrent lumbar disc herniation (RLDH).MethodsA comprehensive survey was developed based on current literature and disseminated globally via professional, academic, and personal networks among clinicians with expertise in spinal disorders. The survey covered core definitions, clinical symptoms, imaging criteria, and surgical preferences. Consensus was predefined as ≥70% agreement. Statistical analysis included descriptive statistics, Chi-square tests, Rasch analysis, and post-hoc analysis using adjusted standardized residuals with Bonferroni correction.ResultsA global cohort of 510 experts participated (62% neurosurgeons, 30% orthopedic surgeons), primarily from Europe (42%), North America (25%), and Asia (19%). Strong consensus was reached for defining RLDH as a new herniation at the same level (83.5%) and same side (72.4%) as the index surgery, following a pain-free interval (77.0%). No consensus was reached on interval duration. MRI confirmation was considered necessary (96.7%), with differentiation from postoperative scar tissue (87.0%). Open microdiscectomy remains the global gold standard (43%), with significant geographic (P P < 0.0001) variations. North Americans more often preferred tubular microdiscectomy (25%), Asians full endoscopic techniques (25%), and Europeans…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
Read the paper
Related studies
- Understanding the factors influencing fall armyworm (Spodoptera frugiperda J.E. Smith) damage in African smallholder maize fields and quantifying its impact on yield. A case study in Eastern Zimbabwe
- Alarming situation of emerging H5 and H7 avian influenza and effective control strategies
- Livestock and food security: vulnerability to population growth and climate change
- Atmosphere–ocean oxygen and productivity dynamics during early animal radiations
- Characterization of the global distribution and diversified plasmid reservoirs of the colistin resistance gene mcr-9
- The global seroprevalence of Toxoplasma gondii in pigs: A systematic review and meta-analysis
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.