Microdiscectomy is a common minimally invasive surgery to relieve nerve pain caused by herniated discs. However, in some cases, patients experience a recurrence of disc herniation, known as reherniation, which can cause pain, mobility issues, and even the potential need for further surgery. In this article, you will learn about the causes of reherniation after microdiscectomy, potential treatment options, and lifestyle tips to prevent future disc issues.
Understanding Disc Reherniation after Microdiscectomy
Reherniation refers to the recurrence of a disc herniation at the same location following an initial microdiscectomy. After surgery, patients may experience relief, but sometimes, the disc can reherniate due to factors such as excessive stress on the spine, improper healing, or other underlying spinal conditions. Reherniation typically leads to symptoms similar to those caused by the original herniated disc, including back pain, leg pain, and numbness.
Causes of Reherniation
Several factors can contribute to the risk of reherniation after a microdiscectomy. Some of the most common include:
- Insufficient disc removal - If the damaged disc material is not adequately removed, there may still be excess tissue that could cause reherniation.
- Excessive physical activity - Engaging in strenuous activities or heavy lifting too soon after surgery can strain the healing disc, leading to reherniation.
- Genetic factors - Some individuals may have a genetic predisposition to weaker discs or spinal conditions, increasing the likelihood of reherniation.
- Poor posture - Improper posture can put excess pressure on the spine, weakening the disc and leading to reherniation.
- Improper healing - In some cases, the disc may not heal completely, making it susceptible to reherniation even with moderate physical activities.
Symptoms of Reherniation
Symptoms of reherniation can mirror those of the initial herniated disc. Common symptoms include:
- Intense lower back pain
- Pain radiating down the leg (sciatica)
- Tingling or numbness in the leg or foot
- Muscle weakness in the legs
If you experience these symptoms after a microdiscectomy, it is important to consult your healthcare provider to determine if reherniation has occurred and what treatment options are appropriate.
Treatment Options
When reherniation occurs, several treatment options can be considered depending on the severity of symptoms and individual health conditions. Treatments may range from conservative approaches to additional surgery.
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Physical therapy and rehabilitation
Physical therapy can strengthen the muscles around the spine, reduce strain on the affected disc, and increase flexibility. Physical therapists can guide you through exercises that focus on core strength, stability, and proper posture, which may alleviate pressure on the disc and reduce pain. Physical therapy is usually recommended as an initial treatment approach if symptoms are not severe.
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Medications
Over-the-counter pain relievers and anti-inflammatory drugs can help you manage pain and reduce inflammation in cases of mild reherniation. Prescription medications, such as muscle relaxants or stronger pain medications, may be prescribed if the pain is more intense. However, medications should be used carefully, especially long-term, due to the risk of side effects.
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Epidural steroid injections
Epidural steroid injections deliver powerful anti-inflammatory medication directly to the affected area around the disc. These injections can reduce inflammation and pain, providing temporary relief. Though this treatment will not fix reherniation, it can alleviate symptoms long enough to allow other therapies, such as physical therapy, to be effective.
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Lifestyle modifications
Making changes in daily habits can significantly reduce the stress placed on the spine. These modifications can include:
- Weight management - Maintaining a healthy weight can reduce pressure on the spine and decrease the risk of reherniation.
- Regular exercise - Engaging in low-impact exercises like swimming or walking can strengthen core muscles and improve spinal stability.
- Avoiding heavy lifting - Limiting heavy lifting and learning proper lifting techniques can reduce the risk of spinal injury.
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Repeat microdiscectomy
If conservative treatments are ineffective, a repeat microdiscectomy may be necessary. This procedure involves removing the reherniated disc material to alleviate nerve pressure. Although a second microdiscectomy can be effective, the decision to undergo repeat surgery should be made cautiously, as repeated surgeries carry additional risks, such as scarring and reduced success rates.
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Spinal fusion surgery
In cases where reherniation is recurrent or severe, spinal fusion surgery may be discussed and potentially recommended. This procedure involves fusing two or more vertebrae together, which stabilizes the spine and eliminates movement at the disc level, reducing the risk of further herniation. However, spinal fusion limits flexibility in the affected area and can lead to increased pressure on adjacent discs, making it a more involved option typically reserved for severe cases.
Recovery Process after Reherniation Treatment
Recovery following reherniation treatment depends on the approach taken. Conservative treatments, such as physical therapy and lifestyle modifications, may require several weeks to months to see improvement. In contrast, surgical interventions such as repeat microdiscectomy or spinal fusion often involve longer recovery periods.
To support recovery and prevent further complications:
- Follow physical therapy guidelines - Attend physical therapy sessions consistently and perform exercises as recommended by your therapist.
- Practice good posture - Proper posture minimizes strain on the spine, promoting healing and reducing the risk of future disc issues.
- Limit physical activities - Avoid activities that could strain your back, such as heavy lifting or twisting motions, until you are cleared by your healthcare provider.
- Consider regular checkups - Regular follow-ups can help your spine specialist monitor your recovery and address any concerns promptly.
How to Prevent Future Reherniation
Preventing future reherniation after microdiscectomy involves ongoing lifestyle modifications as well as adopting practices that support spine health:
- Strengthen core muscles - Core exercises stabilize the spine, reducing strain on the discs and minimizing the risk of reherniation.
- Stretch regularly - Gentle stretching increases flexibility and relieves tension in the muscles surrounding the spine.
- Limit sedentary time - Sitting for long periods can increase pressure on the lower spine, so take breaks to stand, stretch, and move throughout the day.
- Maintain a healthy weight - Excess weight increases the load on the spine, so a balanced diet and regular exercise can reduce spinal stress.
When to Seek Medical Attention
If you experience persistent pain, numbness, or difficulty walking after microdiscectomy, seek medical attention promptly. Delayed treatment for reherniation can worsen symptoms and increase the likelihood of needing more extensive surgery. Your healthcare provider can assess your condition and discuss potential treatment options to relieve your symptoms and restore your quality of life.
Reherniation after microdiscectomy is a challenging but manageable condition. Treatment options range from physical therapy and lifestyle adjustments to repeat surgeries, depending on the severity of symptoms and individual needs. Taking steps to strengthen core muscles, practicing good posture, and avoiding heavy lifting can all contribute to spine health and reduce the likelihood of reherniation. Consulting with your healthcare provider will help you determine the best approach to managing symptoms, achieving recovery, and preventing future disc issues. Reherniation does not have to mean an end to comfort or mobility—effective treatments and preventative practices are available to support long-term spine health.
Although microdiscectomy 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 experience reherniations 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.
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