1.Prevalence of Symptomatic Reherniation After Lumbar Discectomy Using a Bone-Anchored Annular Closure Device and Associated Contributing Factors: A MetaAnalysis
Al-Gunaid ST ; Iqhrammullah M ; Maulana G ; Qanita I ; Adista MA ; Hidayat I
Malaysian Orthopaedic Journal 2026;20(No. 1):45-
Introduction: The primary issue following lumbar
discectomy for disc herniation is the risk of reherniation in
the post-operative period. Many surgical techniques have
been proposed to treat disc reherniation, however, the
optimal one remains variable. This meta-analysis aimed to
investigate the prevalence of symptomatic reherniation after
using a Bone-anchored annular closure device following
lumbar discectomy and the contributing factors.
Materials and methods: Identification of published
literature was performed on PubMed, Google Scholar,
Scopus, and Web of Science databases. Studies published
until 14 February 2024 reported the prevalence of
symptomatic reherniation after using a Bone-anchored
annular closure device following lumbar discectomy and the
associated contributing factors. A random effects model was
used to conduct Bayesian frequentist network meta-analysis
and pair-wise meta-analysis, with the assessment based on
standardised mean difference (SMD) and 95% confidence
interval (CI).
Results: Eleven studies published in 2012 − 2022 recruiting
a total of 5195 patients were included in the meta-analysis.
The prevalence of reherniation in ACD and control groups
was 23.2% (95% CI: 18.2% − 28.1%) and 36.4% (95% CI:
28.2% − 44.5%), respectively. The moderator effect of
sample size is significant for pooled data of the ACD group
(p-mod=0.002), but not for the control group (pmod=0.278). After the adjustment with sample size, the
prevalence rates were 13.6% (95% CI: 6.2% − 21.1%) and
29.6% (95% CI: 14.9% − 33.2%) for ACD and control
groups, respectively.
Conclusion: Comparatively to lumbar discectomy alone,
using a Bone-anchored annular closure device following
lumbar discectomy decreased the symptomatic reherniation
rate and post-operative complications, as well as the
necessity for subsequent surgeries.
Result Analysis
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