1，椎间盘突出位置及与椎弓根的位置关系
对于超过上位椎弓根下缘和下位椎弓根中线的脱垂髓核，后路单摘有损伤峡部风险因为比较困难
2，椎间盘突出性质
1. Osman SG. Anatomic Image-Based Classification of Lumbar Intervertebral Disc Pathologies. Cureus 2021, 13(8): e16861
3，脱出髓核是否进去硬膜囊下
1. Segi N, Ando K, Nakashima H, Machino M, Imagama S. Intradural Lumbar Disc Herniation From the Lateral Inner Surface of the Dura Without a Penetration Hole: A Case Report. Cureus 2022, 14(2): e22418.
4，是否合并退变性侧隐窝狭窄，这是中老年人单摘手术优良率低的重要因素。
1. Arnoldi CC, Brodsky AE, Cauchoix J, Crock HV, Dommisse GF, Edgar MA, Gargano FP, Jacobson RE, Kirkaldy-Willis WH, Kurihara A, Langenskiold A, Macnab I, McIvor GW, Newman PH, Paine KW, Russin LA, Sheldon J, Tile M, Urist MR, Wilson WE, Wiltse LL. Lumbar spinal stenosis and nerve root entrapment syndromes. Definition and classification. Clin Orthop Relat Res 1976(115): 4-5.
5，是否合并Modic改变
合并Modic改变的椎间盘突出不容易自我吸收，相比单纯髓核，这种包含软骨的髓核脱出不容易自发吸收消失。
1. Shan Z, Fan S, Xie Q, Suyou L, Liu J, Wang C, Zhao F. Spontaneous resorption of lumbar disc herniation is less likely when modic changes are present. Spine 2014, 39(9): 736-744.
合并Modic改变的椎间盘突出做单纯摘除术术后容易复发，软骨与骨界面愈合困难，容易髓核再次脱出。
1. Hao L, Li S, Liu J, Shan Z, Fan S, Zhao F. Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present. Journal of Orthopaedic Surgery and Research 2020, 15(1): 176.
6，其他复发危险因素
椎间隙后凸
节段活动度大
椎间隙高度
1. Zhao C, Zhang H, Wang Y, Xu D, Han S, Meng S, Han J, Liu H, Zhou C, Ma X. Nomograms for Predicting Recurrent Herniation in PETD with Preoperative Radiological Factors. J Pain Res 2021, 14: 2095-2109.
2. Kim K-T, Park S-W, Kim Y-B. Disc height and segmental motion as risk factors for recurrent lumbar disc herniation. Spine 2009, 34(24): 2674-2678.
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