How common is it to reherniate a disc?

Answered by Jeremy Urbaniak

Reherniation of a disc is indeed a common concern following a lumbar discectomy. It occurs when the disc material protrudes or bulges out again after the initial surgery to remove the herniated portion. This can lead to a recurrence of symptoms and may require further treatment or surgery.

The prevalence of reherniation varies in different studies, but it is generally estimated to occur in around 7 to 18 percent of patients who have undergone a lumbar discectomy. This means that between 7 and 18 out of every 100 patients may experience a reherniation at some point after their initial surgery.

The risk of reherniation is influenced by several factors. One important consideration is the size and location of the original herniation. Large or centrally located herniations are more likely to recur compared to smaller or more peripherally located ones. Additionally, the presence of certain anatomical variations, such as a narrow spinal canal or a short pedicle, may increase the risk of reherniation.

The technique used during the discectomy procedure can also impact the likelihood of reherniation. For example, studies have suggested that a limited or partial discectomy, where only a portion of the herniated disc is removed, may increase the risk of reherniation compared to a complete removal of the herniated material. Surgeons may also use different methods to seal the disc space after the removal, such as sutures or biological agents, which can affect the risk of reherniation.

It is important to note that the risk of reherniation is not solely determined by the surgical procedure itself. Patient factors, such as age, overall health, smoking status, and activity level, can also play a role. Engaging in activities that put excessive stress on the spine, such as heavy lifting or repetitive bending, may increase the chances of reherniation.

Furthermore, the natural degenerative process of the spine can contribute to the risk of reherniation. Over time, the discs may undergo further degeneration, making them more prone to herniation and reherniation.

To reduce the risk of reherniation, it is important for patients to follow post-operative guidelines provided by their surgeon. These may include avoiding heavy lifting, maintaining good posture, engaging in regular exercise to strengthen the core and back muscles, and practicing proper body mechanics during daily activities.

Reherniation of a disc is a common complication following a lumbar discectomy, occurring in approximately 7 to 18 percent of patients. The risk of reherniation is influenced by factors such as the size and location of the original herniation, surgical technique, anatomical variations, patient factors, and the natural degenerative process of the spine. Adhering to post-operative guidelines and adopting healthy lifestyle habits can help reduce the likelihood of reherniation.