{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:17:17Z","timestamp":1787019437155,"version":"build-2736575974"},"reference-count":33,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Identify demographic and clinical predictors for revision discectomy and compare postoperative complications between primary microdiscectomy (MD) and revision discectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent one-level primary lumbar MD and subsequent one-level revision discectomy for lumbar disc herniation were identified using the PearlDiver national database. Multivariate regression analysis was performed to identify predictors of revision discectomy, assess 30-day postoperative complications and opioid use, and assess the likelihood of future lumbar fusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 52,310 patients undergoing primary lumbar MD, 4536 (7.98%) required revision. Independent predictors included smoking (aOR: 1.72), obesity (aOR: 1.44), lateral disc herniation (aOR: 1.69), coagulopathies (aOR: 1.34), CAD (aOR: 1.62), anemia (aOR: 1.38), diabetes (aOR: 1.47), hypertension (aOR: 1.63), peripheral vascular disease (aOR:1.33), preoperative opioid use (aOR: 2.06), postoperative opioid use (aOR: 1.80), and depression (aOR: 1.73) (all,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.01). Revision discectomy was associated with higher risks of infection (aOR: 1.78), AKI (aOR: 1.41), VTE (aOR: 1.46), dehiscence (aOR: 2.32), neurological injury (aOR: 1.48), durotomy (aOR: 2.19), epidural hematoma (aOR: 2.61), I&amp;D (aOR: 2.32), opioid use (aOR: 1.73), and increased fusion rates (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Several patient-related factors increase the risk of revision MD, which is associated with additional short- and long-term complication risks relative to the index procedure. These findings inform expectations for disease progression and postoperative outcomes in revision MD. Revision discectomy should be avoided when possible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682251323274","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T18:43:06Z","timestamp":1740422586000},"page":"3273-3279","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Predictors and Postoperative Complication Risks for Revision Discectomies Following Primary Lumbar Microdiscectomy"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8891-0353","authenticated-orcid":false,"given":"Andy","family":"Ton","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine at The University of Southern California, Los Angeles, CA, USA"},{"name":"Department of Orthopaedic Surgery, University of California \u2013 Irvine, Irvine, CA, 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