Is the Disc Weaker after Microdiscectomy?

A microdiscectomy is a minimally invasive surgical procedure that involves removing a small portion of a herniated disc that is compressing a nerve root or the spinal cord. A microdiscectomy can relieve pain, numbness, tingling, or weakness in the lower back, buttock, and leg or in the neck, shoulder, and arm, depending on the location of the herniated disc.

Some people may wonder if the disc is weaker after a microdiscectomy. This article will explore the answer to this question and provide some tips on how to prevent disc reherniation and maintain a healthy spine.

Postoperative Structural Changes

Contrary to popular belief, research suggests microdiscectomy does not inherently weaken the spinal disc. In fact, the procedure primarily addresses the specific issue—removing the herniated portion—without compromising the overall structural integrity of the disc.

According to a 2015 study, the average disc height loss after a microdiscectomy is only 1.2 mm, which is not clinically relevant. Moreover, the disc can heal and regenerate to some extent after a microdiscectomy as the body produces scar tissue and collagen to fill the defect and restore the disc.

Stability and Disc Health Following Microdiscectomy

However, this does not mean the disc is completely normal or unaffected after a microdiscectomy, as there may be some changes, challenges, or other factors that can affect the disc’s strength and stability, such as:

• Loss of disc hydration and elasticity – The disc is composed of a soft gel-like core called the nucleus pulposus and a tough fibrous outer layer called the annulus fibrosus. The nucleus pulposus contains water and proteoglycans, which give the disc its hydration and elasticity. After a microdiscectomy, some of the nucleus pulposus may leak out through the defect, reducing the disc’s water content and ability to absorb shock.
• Formation of scar tissue and adhesions – The body’s natural response to injury is to produce scar tissue and adhesions, which are fibrous bands that connect the damaged tissues. These can seal the defect and prevent further leakage of the nucleus pulposus, but they can also cause stiffness, inflammation, or irritation of the disc and the surrounding structures, such as the nerve root or the spinal cord.
• Degeneration of disc and spine – The disc and the spine are subject to wear and tear over time due to aging, genetics, or lifestyle factors such as smoking, obesity, and poor posture. Degeneration of the disc and the spine can lead to loss of disc height, disc bulging, disc herniation, or spinal stenosis, which can cause pain, stiffness, or nerve compression. 
• Size and location of the herniation – Larger and more central herniations may require more disc removal and cause more damage to the annulus fibrosus, leading to disc weakness.
• Patient age and health – Older and less healthy patients may have more degenerative changes in their discs, such as loss of water content, reduced elasticity, and reduced blood supply, making them more prone to reherniation and further disc deterioration.
• Postoperative care and rehabilitation – Proper care and rehabilitation after microdiscectomy can restore the strength and function of the disc as well as prevent complications such as infection, bleeding, scarring, or nerve damage. Patients should follow their surgeons’ instructions on wound care, pain management, activity restrictions, physical therapy, and exercises.
• Patient lifestyle habits – Healthy lifestyle habits such as maintaining a normal weight, avoiding smoking, eating a balanced diet, staying hydrated, avoiding excessive bending or twisting of the spine, using proper posture and ergonomics, and exercising regularly can preservethe health and longevity of the disc.

How to Prevent Disc Reherniation after Microdiscectomy 

The risk of reherniation or other complications after a microdiscectomy is low but not zero. To reduce this risk and increase the strength and stability of the disc after a microdiscectomy, it is important to follow some tips and recommendations, such as:

• Follow postoperative instructions and guidelines – After a microdiscectomy, the patient should follow the instructions and guidelines provided by the surgeon and the physical therapist, such as taking the prescribed medications, avoiding strenuous activities, and performing the recommended exercises. These measures can prevent infection, bleeding, and inflammation as well as promote healing and minimize back surgery recovery time.
• Maintain a healthy weight and diet – Excess weight can put more pressure and stress on the disc and the spine, increasing the risk of reherniation or degeneration. A healthy diet can provide the nutrients and hydration the disc needs to function properly and heal faster. Therefore, the patient should maintain a healthy weight by eating a balanced and varied diet, drinking plenty of water, and avoiding alcohol, tobacco, and caffeine.
• Strengthen the core and back muscles – The core and back muscles support the spine and the disc and maintain proper posture and alignment. Weak or tight muscles can cause imbalance, instability, or misalignment of the spine and the disc, increasing the risk of reherniation or degeneration. Therefore, the patient should strengthen his or her core and back muscles by doing exercises such as bridges, planks, or pelvic tilts under the guidance of a physical therapist.
• Avoid or modify activities that can strain the disc and the spine – Activities such as bending, twisting, lifting, and sitting for a long time can strain the disc and the spine and cause reherniation, degeneration, or nerve compression. Therefore, the patient should avoid or modify these activities by using proper techniques, equipment, and support.

Microdiscectomy is an effective treatment for relieving nerve compression caused by a herniated disc. However, it may also affect the strength and function of the disc to some extent. Whether or not your disc is weaker after microdiscectomy depends on several factors that are unique to your case. To ensure optimal outcomes after microdiscectomy, you should follow your surgeon’s advice on postoperative care and rehabilitation as well as adopt healthy lifestyle habits that can protect your spine and prevent disc reherniation.

Although microdiscectomy surgery is generally a very successful procedure, patients with a larger hole in the outer ring of the disc have a significantly higher risk of reherniation following surgery. Often, the surgeon will not know the size of the hole until he or she begins surgery. A new treatment, Barricaid, which is a bone-anchored device proven to reduce reherniations, was specifically designed to close the large hole often left in the spinal disc after discectomy. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital.In a large-scale study, 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in the 2-year study timeframe. 

If you have any questions about the Barricaid treatment or how to get access to Barricaid, ask your doctor or contact us at 844-705-1081.

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