What Is the Success Rate of a Revision Discectomy?

Dealing with persistent back pain can be a daunting journey, and for many, a revision discectomy emerges as a potential solution. This surgical procedure is often considered when a primary discectomy fails to provide lasting relief. A revision discectomy is a surgery that removes part or all of a herniated disc that has recurred after a previous discectomy. This procedure aims to relieve pain, numbness, weakness, and other symptoms caused by nerve compression in the spine. This article will explore the success rates of revision discectomy and the crucial factors that influence its outcomes.

Herniated Discs and Discectomy

A herniated disc, also known as a bulging, slipped, or ruptured disc, is a condition where the soft gel-like center of an intervertebral disc pushes through a tear in the tough outer layer. This can happen due to aging, injury, or overuse of the spine. A herniated disc can compress nearby nerves and cause pain, inflammation, and nerve damage.

A discectomy is a form of back surgery that removes part or all of the herniated disc material to decompress the affected nerve and reduce symptoms. There are different types of discectomies, such as open, minimally invasive, microdiscectomy, and anterior cervical discectomy and fusion (ACDF). The type of discectomy depends on the location, size, and severity of the herniation as well as the patient’s preference and overall health.

Why a Revision Discectomy May Be Needed

A revision discectomy is surgery that is performed when a herniated disc recurs after a previous discectomy. This can happen for various reasons, such as:

• Incomplete removal of the disc material during the first surgery
• Reherniation of the same disc due to trauma, degeneration, or excessive stress on the spine
• Herniation of a different disc adjacent to the previous surgery site
• Scar tissue formation around the nerve root after the first surgery

A revision discectomy may be needed when the patient experiences recurrent or new symptoms of nerve compression, such as pain, numbness, tingling, weakness, or difficulty moving. These symptoms may interfere with the patient’s daily activities and quality of life.

Success Rates of Revision Discectomy

The success rate of a revision discectomy depends on several factors, such as the patient’s age, health, lifestyle, occupation, and expectations, as well as the surgeon’s skill, experience, and technique. According to some studies, the success rates of revision discectomies range from 50-90 percent, meaning most patients report good to excellent outcomes after the surgery.

The chances of success with a revision discectomy may be lower than that for a primary discectomy, as the surgery is more complex and challenging. The surgeon may face difficulties such as:

• Identifying the correct level and location of the recurrent herniation
• Preserving the spinal stability and alignment
• Avoiding damage to the surrounding structures, such as nerves, blood vessels, bones, and muscles
• Preventing infection, bleeding, and other complications

Therefore, a revision discectomy is often considered as a last resort after exhausting all conservative treatments, such as medication, physical therapy, injections, and lifestyle modifications. A revision discectomy should be performed by a qualified and experienced spine surgeon who can minimize the risks and maximize the benefits of the surgery.

Risks and Benefits 

As with any surgery, a revision discectomy has potential risks and benefits that should be weighed carefully before deciding to undergo the procedure. Some of the possible risks include:

• Infection, bleeding, and allergic reaction to anesthesia
• Nerve injury, spinal cord damage, or paralysis
• Dural tear, cerebrospinal fluid leak, or headache
• Recurrence of the herniated disc or herniation of another disc
• Failed back surgery syndrome, chronic pain, or disability

Some of the possible benefits include:

• Relief of pain, numbness, weakness, and other symptoms
• Improvement in function, mobility, and quality of life
• Prevention of further nerve damage or spinal instability
• Return to work, sports, and hobbies

Factors Influencing Success

The success rate of a revision discectomy depends on several factors, such as:

• Patient selection – The success of revision discectomy is often influenced by careful patient selection. Candidates with appropriate indications, such as recurrent disc herniation, are more likely to benefit from the procedure.
• Timing of surgery – The timing of the revision surgery is crucial. Engaging in the procedure too early may not allow sufficient time for healing from the primary surgery, while delaying the revision may lead to the progression of symptoms.
• Surgeon expertise – The experience and skill of the surgical team play a pivotal role in the success of revision discectomy. Surgeons with expertise in spinal procedures are better equipped to navigate complexities and minimize risks.

Rehabilitation and Recovery

Post-operative rehabilitation is crucial for a successful outcome. Some tips to improve the outcome and recovery of a revision discectomy are:

• Follow the post-operative instructions given by your surgeon
• Avoid smoking, alcohol, and anti-inflammatory drugs that may impair healing
• Participate in physical therapy and exercises to strengthen your core muscles and improve your posture
• Maintain a healthy weight and diet to reduce stress on your spine
• Avoid activities that may cause reinjury or strain on your spine

In the realm of spinal surgeries, revision discectomy stands as a viable option for individuals facing persistent back pain following primary discectomies. While success rates are encouraging, a comprehensive evaluation of individual factors and careful consideration of potential challenges are essential. Consulting with knowledgeable healthcare professionals and engaging in open communication about expectations can guide patients toward informed decisions on whether revision discectomy is the right path for them.

Although herniated disc treatment with discectomy or less invasive microdiscectomy surgery is generally very successful, a hole is left in the outer wall of the disc. Patients with a large hole in the outer ring of the disc experience 70 percent of all reherniations after 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. In a large-scale study, Barricaid was proven 95 percent effective in a study of over 500 patients. This means 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.

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