Recurrent Disc Herniation after Lumbar Discectomy: "I Still Haven't Found What I am Looking For"

A discectomy is a procedure where material from a herniated disc is cut out or removed by a surgeon.  Before the disc material is removed usually some of the bone of the affected vertebra may be also cut out.

Lumbar discectomy is the most common surgical procedure performed for people with low back and leg pain related to herniated discs in the United States.  Generally patients do very well after a discectomy procedure.  In terms of outcomes, patients usually report significant improvement in radicular leg pain after a discectomy.  Improvement in axial low back pain often occurs but is less reliably predictable than leg pain symptoms.

A recent study published in Spine looked at the incidence of recurrent disc herniation during the first two years after a lumbar discectomy surgery.

The study found that after a lumbar discectomy nearly 25% of patients demonstrated radiographic evidence of recurrent disc herniation at the level of prior surgery within the first two years after surgery.[i]  About 10% of these recurrent disc herniations were symptomatic and a source of pain/disability. [ii] 

I see people in the office with disc issues and they tell me they want a “fix” for their symptoms.  We live in a quick fix culture.  Surgery is a good fix for certain issues.  However, this recent study highlights the issue  that surgery is not a permanent cure-all.  Unless we address the underlying issues that create degenerative disc conditions we are at risk for recurrent disc herniation. 

And how do we address these “underlying issues”?  Exercise, correct postural deficits, improve cardiovascular health[iii] and stop sitting too much.  And maybe listen to our moms a little more...

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[i] Spine.  2011.  36(25): 2147-2151.

[ii] Spine.  2011.  36(25): 2147-2151.

[iii] http://www.backexercisedoctor.com/journal/2010/3/15/nutrition-and-low-back-pain.html