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Introduction to Post-Discectomy Syndrome


Spinal discs sometimes irritate nerves to the point where surgery is necessary to improve quality of life and ease near-debilitating discomfort. If you have a discectomy to remove a portion of disc material affecting nerve roots, you may experience what's known as post-discectomy syndrome, or PDS. This article will explain PDS and give you options if you experience it following your surgery.

Defining Post-Discectomy Syndrome

Failed back surgery syndrome, where patients still experience troublesome symptoms after surgery, is often discussed and is very similar to post-discectomy syndrome. In the case of PDS, a patient notices lingering, worsening, or returning disc-related symptoms following a microdiscectomy for a
herniated disc. It's typically a more generalized way of referring to an unsuccessful surgery.

Signs & Symptoms

Post-discectomy syndrome is similar to any type of failed back surgery, from spinal fusion surgery to a
laminectomy, in that patients typically experience some degree of returning or worsening symptoms after the procedure. Signs and symptoms associated with PDS include:

• Leg pain if the discectomy was in the lower back area
• Numbness, weakness, and tingling sensations
• Pain triggered by certain movements
• A return of the same symptoms you had before surgery

Reasons for PDS

There are several reasons post-discectomy syndrome may occur. One possibility is another disc is also irritating spinal nerves. It's also possible not enough disc material was removed during the initial surgery. Other potential contributing factors include:

• Getting back to a more active lifestyle too soon
• Not being diligent about following post-surgery recommendations
• Too much stress and strain on the affected area of the spine

Rates of Occurrence

PDS is considered a fairly common post-surgery complaint for discectomy patients, although research on this point is also fairly limited.
Spine Universe cites studies suggesting anywhere from 5 to 36 percent of patients who have discectomies for lower back discs see nerve-related pain return within a few years post-surgery.

Diagnosing & Treating Post-Discectomy Syndrome

A diagnosis of PDS is made if your returning symptoms are found to be directly related to your initial discectomy. This can be more difficult if your symptoms return several months or more after your first surgery. Making a PDS diagnosis involves a combination of diagnostic test results and the elimination of other possible sources of your discomfort. Treatment for post-discectomy syndrome is similar to the recommendations given when you first experienced disc-related problems. Care will be customized based on the nature of your symptoms and their effects on your daily life. Typically, nonsurgical treatments will include:

• Medication to manage pain and inflammation
• A customized physical therapy routine
• Lifestyle adjustments with diet, exercise, and posture
• Injections and other treatments that may make your discomfort manageable

Success rates associated with subsequent spine surgeries are statistically lower than first-time procedures. However, a second surgery may be the best option if your disc-related symptoms are severe and not manageable with other treatments.

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 won’t know the size of the hole until beginning surgery. A new treatment, Barricaid, which is a bone-anchored device proven to reduce the risk of reherniation, 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 doesn’t require any additional incisions or time in the hospital. In a large-scale study, 95 percent of Barricaid patients didn’t 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 844-288-7474.

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