What Are the Chances of Reherniation After a Microdiscectomy?
Microdiscectomy is a widely performed spinal procedure designed to relieve nerve compression caused by herniated discs. While this procedure is generally successful, patients often wonder about the possibility of reherniation—the recurrence of disc herniation at the same or adjacent levels. In this article, you will learn about the statistics and factors involved, which can help patients make informed decisions about their treatment and recovery.
Reherniation Statistics: What the Research Shows
The percentage of microdiscectomy patients who experience reherniation varies significantly across studies, but several key statistics emerge from the medical literature. Research suggests reherniation occurs in approximately 5 to 15 percent of cases following microdiscectomy. One study published in the Asian Spine Journal found a recurrence rate of around 9 percent.
However, the range can be broader depending on the study parameters and patient populations examined. Based on follow-up studies, recurrent lumbar disc herniation only occurs in roughly 10 percent of all microdiscectomy patients, while other research indicates reherniation can occur in about 10 to 25 percent of cases. One multicenter randomized controlled trial found that the incidence of symptomatic recurrent lumbar disc herniation was 25.3 percent (64 of 253) at two years post-surgery.
The variation in these statistics reflects differences in study methodology, patient selection criteria, follow-up duration, and definitions of reherniation. Generally, most studies converge on a reherniation rate of approximately 10–15 percent within the first few years following microdiscectomy.
Timeline of Reherniation Occurrence
Understanding when reherniation typically occurs helps patients and healthcare providers monitor for potential complications. Herniation occurring at a mean of 264 days after the procedure suggests reherniation can happen anywhere from immediately post-surgery to more than two years later, with the average occurring around 8–9 months post-procedure.
This timeline emphasizes the importance of long-term follow-up and adherence to postoperative guidelines throughout the recovery period, not just in the immediate weeks following surgery.
Risk Factors for Reherniation
Several factors influence the likelihood of reherniation after microdiscectomy. Patient demographics play a significant role, with research showing mixed results regarding gender. Some studies indicate females have an increased risk for recurrent lumbar disc herniation in comparison with males, while others suggest males represent 59.6 percent of the recurrent group.
Medical comorbidities also impact reherniation risk. Diabetes mellitus has been identified as a significant risk factor. The risk can also be influenced by various factors such as surgical technique, the type of herniation, and patient-specific factors like smoking and obesity.
Surgical factors are equally important. Patients with larger annular defects (6 to 10 mm wide by 4 to 6 mm long) are at higher risk for reherniation. The size and characteristics of the defect left in the annulus fibrosus after disc material is removed significantly influence the likelihood of future herniation.
Prevention Strategies and Modern Approaches
Preventing reherniation involves both surgical techniques and postoperative care strategies. Traditional approaches focus on patient education and activity modification. When lifting heavy objects, keep your back straight and use your knees to lift rather than your back, and proper sleep positioning can reduce mechanical stress on the healing disc.
Advanced surgical techniques are being developed to address the root cause of reherniation. These newer approaches, such as annular closure devices, represent a significant advancement in preventing reherniation by mechanically reinforcing the annular defect created during disc removal.
Treatment Options for Reherniation
When reherniation occurs, treatment approaches mirror those used for initial disc herniation. Your surgeon will start with conservative treatment options in the form of pain medications, followed by physical therapy and other nonsurgical interventions.
The management of reherniation may be nonsurgical or surgical depending upon the underlying condition. Conservative management often proves effective, particularly for minor reherniations without significant nerve compression. However, cases with severe symptoms or neurological deficits may require revision surgery.
Long-Term Outlook and Patient Expectations
The prognosis for patients experiencing reherniation varies considerably based on multiple factors. The severity of the recurrent herniation, the success of chosen herniated disc treatment approaches, and patient compliance with postoperative guidelines all influence outcomes. Many patients achieve significant pain relief and improved function with appropriate treatment, whether conservative or surgical.
While the chance of reherniation exists, understanding the risk factors and prevention strategies can optimize outcomes. Modern surgical techniques show promise in reducing reherniation rates for high-risk patients. The key to successful long-term outcomes lies in proper patient selection, surgical technique, and comprehensive postoperative care. Patients should work closely with their healthcare providers to understand their individual risk factors and develop appropriate prevention and monitoring strategies for optimal recovery.
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 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.
Comments