• Ratko Yurac, Juan J Zamorano, Fernando Lira, Diego Valiente, Vicente Ballesteros, and Alejandro Urzúa.
• Spine Surgery Unit, Traumatology and Orthopedics Department, Clínica Alemana de Santiago-Universidad del Desarrollo, Vitacura 5951, 7650568, Vitacura, Santiago, Chile. ryurac@gmail.com.
• Eur Spine J. 2015 Oct 15.

PurposeA recurrent lumbar disc herniation (RLDH) is the most prevalent cause for new radicular pain after surgery for disc herniation-induced sciatica. Reported risk factors include age, gender and smoking, while its surgical treatment is associated to a higher rate of complications and costs. The purpose of this study is to identify factors that increase the risk of requiring surgical treatment for a first RLDH in workers' compensation patients.MethodsNested case-control: 109 patients operated for an RLDH (cases) between June 1st 1994 and May 31st 2011 (minimum follow-up 1 year) and 109 randomly selected patients operated for a first disc herniation with no recurrence during the study period (controls). Age, gender, smoking status, type of work and MRI characteristics of the index herniation were statistically evaluated as potential risk factors.ResultsPatient's age of less than 35 years (p = 0.001) and a subligamentous herniation (p < 0.05) at the time of the index surgery were identified as risk factors for requiring surgical treatment of a first RLDH. No statistical differences were observed between both groups regarding the other evaluated variables.ConclusionA subligamentous disc herniation and patient's age inferior to 35 years at the time of the first surgery are risk factors for requiring surgical treatment of a first RLDH among workers' compensation patients.

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