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.
Haibier et al. (2026) studied this question.