What Are the Odds of Reherniation after a Discectomy?

Discectomy is a common surgical procedure aimed at relieving pain and other symptoms associated with herniated discs. While it is often successful, one concern many patients have is the possibility of reherniation. As you read this article, you will gain a better understanding of the odds, risk factors, and prevention strategies that are crucial for those considering or recovering from this surgery.

Discectomy and Reherniation

A discectomy involves the surgical removal of a portion of a herniated disc that is pressing on a nerve root or the spinal cord. This procedure is often recommended when nonsurgical treatments, such as physical therapy or medication, fail to alleviate symptoms like pain, numbness, or weakness.

Reherniation refers to the recurrence of disc herniation at the same site where the initial surgery was performed. It can occur weeks, months, or even years after the procedure, leading to the return of symptoms and sometimes requiring additional surgery.

The Odds of Reherniation

The odds of reherniation after a discectomy vary based on several factors, including the technique used and the patient’s age and overall health. On average, studies suggest the reherniation rate after a discectomy ranges from 5 percent to 15 percent. This means that out of every 100 patients, 5 to 15 may experience a recurrence of their disc herniations.

A study published in The Journal of Bone and Joint Surgery found reherniation occurred in approximately 11 percent of patients within the first year following surgery. Other research has shown the majority of reherniations happen within the first three months post-surgery, but the risk persists for several years.

Factors Influencing Reherniation Rates

Surgical Technique

The method used during surgery can impact the likelihood of reherniation. Traditional open discectomy may have a higher reherniation rate compared to minimally invasive techniques due to the extent of tissue disruption. However, both methods carry risks, and the skill of the surgeon plays a crucial role.

Patient’s Age

Younger patients tend to have higher reherniation rates. This may be due to more active lifestyles and the higher likelihood of engaging in activities that can strain the spine.

Disc Degeneration

Patients with severe disc degeneration are more prone to reherniation. When the disc is already weakened, the chances of it herniating again increase.

Postsurgical Activity Level

Patients who return to high levels of physical activity too soon after surgery are at greater risk for reherniation. Following the surgeon’s guidelines on activity levels during recovery is critical.

Recognizing the Signs of Reherniation

Symptoms to Watch For

Reherniation often presents with symptoms similar to the original herniation. These can include:

• Back pain – Persistent or returning pain in the lower back is a common sign of reherniation.
• Leg pain – Pain radiating down one or both legs, often described as sciatica, may indicate a recurrence.
• Numbness or weakness – Reherniation can cause numbness or weakness in the legs or feet, depending on the affected nerve roots.
• Loss of mobility – Difficulty in moving or bending due to pain or stiffness can be a symptom of reherniation.

If you experience any of the above symptoms after a discectomy, it is important to contact your healthcare provider. Early diagnosis and treatment can prevent further complications and may reduce the need for additional surgery.

How to Minimize the Risk of Reherniation

Adhering to Post-Surgical Guidelines

Following your surgeon’s postoperative instructions is crucial in reducing the risk of reherniation. These guidelines may include:

• Rest and recovery – Adequate rest is essential in the initial weeks after surgery. Avoid heavy lifting, bending, or twisting, as these activities can put stress on the healing spine.
• Physical therapy – Engaging in a structured physical therapy program can strengthen the muscles around the spine, providing better support and reducing the risk of reherniation.
• Gradual return to activity – Returning to normal activities should be done gradually and under the guidance of your healthcare provider. Avoid high-impact activities until you are fully healed.

Maintaining a Healthy Lifestyle

• Weight management – Excess weight can put additional strain on the spine, increasing the risk of reherniation. Maintaining a healthy weight through diet and exercise can prevent this.
• Core strengthening – Strengthening the core muscles, including the abdominals and lower back, provides better support to the spine and reduces the likelihood of reherniation.
• Smoking cessation – Smoking has been linked to poor spinal health and can impair the healing process. Quitting smoking before and after surgery can improve outcomes and reduce reherniation risk.

Regular Follow-Up with Your Surgeon

Regular checkups with your surgeon after a discectomy are important to monitor your recovery and address any concerns early. Imaging studies, such as MRI scans, may be recommended to assess the surgical site and ensure the disc is healing properly.

Treatment Options for Reherniation

Nonsurgical Approaches

For patients who experience reherniation, nonsurgical treatments are often the first line of defense. These may include:

• Physical therapy – Customized exercises and stretches can alleviate symptoms and strengthen the spine.
• Medications – Pain relievers, anti-inflammatory drugs, and muscle relaxants may be prescribed to manage symptoms.
• Epidural steroid injections – These injections can reduce inflammation around the affected nerve root, providing temporary relief.

Surgical Options

In cases where nonsurgical treatments are ineffective, additional surgery may be necessary. Surgical options for reherniation include:

• Revision discectomy – A second discectomy may be performed to remove the reherniated disc material.
• Spinal fusion – In some cases, spinal fusion may be recommended to stabilize the spine and prevent further herniation.
• Artificial disc replacement – For some patients, replacing the damaged disc with an artificial one may be an option.

Understanding the odds of reherniation after a discectomy can help patients make informed decisions about their treatment options and recovery process. While reherniation is a possibility, it is important to remember the majority of patients experience successful outcomes without recurrence.

By being aware of the risk factors and implementing strategies to minimize reherniation risk, patients can approach their recovery with confidence. Always consult with your spine specialist for personalized advice and guidance throughout your treatment journey.

Although discectomy surgery is generally a very successful procedure, a hole is left in the outer wall of the disc. Patients with a large hole in the outer ring of the disc are more than twice as likely to reherniate after surgery. A new treatment, Barricaid, which is a bone-anchored device proven to reduce the likelihood of a reherniation, was specifically designed to close the large hole often left in the spinal disc after microdiscectomy. In a large-scale study, 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in the 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital. 

If you have any questions about the Barricaid treatment or how to get access to Barricaid, ask your doctor or contact us today.

For full benefit/risk information, please visit: https://www.barricaid.com/instructions.