Background/aim: To present the incidence of recurrent lumbar disc herniation (RLDH) and to identify radiological and patient-related risk factors that lead to recurrence after lumbar disc herniation (LDH) treatment with microdiscectomy. Materials and methods: Between January 2013 and December 2021, 1214 patients who had undergone microdiscectomy for LDH were included in this retrospective study. Patients were divided into two groups, the recurrent group and the non-recurrent group, and their demographic, clinical and radiologic characteristics were recorded. The association between the variables and RLDH was assessed by univariate and multivariable logistic regression analyses. Results: Mean ages were similar in the recurrent (51.48 ± 13.63) and non-recurrent(50.38 ± 14.53) groups (p=0.232). Males represented 59.6% of the recurrent group and49.8% of the non-recurrent group (p=0.002). Multivariable logistic regression revealedthat being a male (p=0.009), diabetes mellitus (p=0.038), smoking (p<0.001), grade 4&5disc degeneration (p<0.001), and having protruded (p=0.002), extruded LDH (p<0.001),paracentral (p=0.008) and foraminal LDH (p=0.008) were independently associated withrecurrence. Conclusion: To reduce RLDH frequency and need for revision surgery, modifiable riskfactors should be minimized before and after the initial surgery. Also, in patients withunmodifiable risk factors, patients should be clearly informed about the risk forrecurrence and possible alternative treatment methods should be considered.

Introduction: Subthalamic nucleus deep brain stimulation (STN-DBS), continuous subcutaneous apomorphine infusion (APO), and levodopa-carbidopa intestinal gel infusion (LCIG) are treatments used to treat severe motor fluctuations and dyskinesia in patients with advanced levodopa responsive Parkinson’s disease (PD), who can no longer be managed with available combinations of oral medications. This study aims to evaluate patient choice of one of three device-based treatment methods. Methods: A total of 58 patients clinically diagnosed with PD were included in the study. Eligibility for device-based treatment of PD patients with motor symptoms despite optimal medical treatment was assessed based on Hoehn & Yahr Stages, and Unified Parkinson’s Disease Rating Scale-Part III. All three device-based treatment methods were thoroughly explained with on-hand demonstrations. Preferences and reasons for choice were recorded. Results: Nineteen patients were ineligible for STN-DBS due to neurological causes. A total of 23 patients preferred STN-DBS, 23 preferred APO, and only one patient preferred LCIG. Thirteen patients preferred to continue oral medical treatment, while two patients positively approached both STN-DBS and APO. Conclusion: The most common reason patients declined STN-DBS and LCIG was concerns about the surgical operation, while the most common reason APO was declined was its frequent administration of injection. While STN-DBS was preferred by younger, less severe patients, APO was preferred by older patients who had longer duration of disease.

Yasemin Hoşgören Alıcı, Müge Kuzu Kumcu. Clin Psychopharmacol Neurosci 2023;21:599-603. https://doi.org/10.9758/cpn.22.1021