If you’ve had several disc herniations, you may be looking for surgical treatment. Both lumbar discectomy and spinal fusion are options, but which is better? At NU-Spine: The Minimally Invasive Spine Surgery Institute, board-certified surgeons provide spine surgeries, including discectomies and spine fusions, for patients in New Jersey, Pennsylvania, and Florida. Here, we compare lumbar discectomy and fusion for patients with recurrent herniations, including the risks, benefits, and recovery timelines.
Key Takeaways
- Recurrent disc herniations in the lumbar spine can be caused by surgical factors, lifestyle factors, and genetics.
- Both repeat lumbar discectomies and lumbar spinal fusion can be used to treat recurrent herniated discs.
- Repeat lumbar discectomy is better for patients with radiating leg pain, while fusion is better suited for patients with mechanical back pain and instability.
- NU-Spine: The Minimally Invasive Spine Surgery Institute provides cutting-edge spine procedures, including discectomies and fusions, for patients in New Jersey, Pennsylvania, and Florida.
What Is a Herniated Disc?
A herniated disc occurs when the disc’s jelly-like nucleus protrudes through a tear in the outer ring, pressing on surrounding nerves and leading to pain, numbness, and weakness. Herniated discs may heal on their own, or they may require surgery.
What Causes Recurrent Disc Herniation?
Although surgery is often sufficient for treating herniated discs, some patients experience recurrent disc herniation. This can be due to:
- Surgical factors, such as the surgeon only removing the protruding fragment
- Premature activity post-surgery
- Lifestyle factors such as obesity and smoking
- Genetic predisposition
If you’ve previously had herniated disc surgery and are experiencing a sudden return of original symptoms, such as sharp pain, sciatica, numbness, or weakness, you should get re-evaluated, as you may have another herniation.
How Does Lumbar Discectomy Treat Recurrent Lumbar Herniation?
A lumbar discectomy is a procedure that involves removing the damaged, herniated portion of a spinal disc. When it is used to treat a recurrent herniated disc, a discectomy removes the re-herniated disc material at the same level as the previous surgery. It is typically the preferred option for treating recurrent herniation.
The ideal candidate is a patient who is experiencing persistent, severe radiating leg pain, numbness, or weakness that hasn’t improved with six to 12 weeks of conservative care, such as physical therapy or pain management. Younger patients without significant back pain are often better candidates for repeat discectomies. A magnetic resonance imaging (MRI) scan must be given to the patient to confirm that the herniated disc is at the same level and side as the previous surgery.
Repeat lumbar discectomy has a high success rate for relieving pain, but it does have limitations. There is an increased risk of further re-herniation, an increased chance of chronic back pain, and a higher incidence of scarring. It’s also not well-suited for patients who have spinal instability in addition to recurrent disc herniation.
How Does Spine Fusion Treat Recurrent Lumbar Herniation?
Lumbar spinal fusion is a surgical procedure that uses hardware and bone grafts to permanently fuse two vertebrae into one strong bone. It helps stabilize the structure while reducing friction, nerve pinching, and other causes of pain. There are several fusion techniques that may be used, including transforaminal lumbar interbody fusion (TLIF) and extreme lateral interbody fusion (XLIF).
Spinal fusion may be recommended for recurrent herniated discs over a repeat discectomy when a patient:
- Has spinal instability or severe degeneration
- Has chronic mechanical back pain
- Has already had one or more discectomies
- Is of older age
Older patients with substantial mechanical pain are often better candidates for fusion over a second discectomy because of the stability a fusion provides. A fusion also offers reduced re-herniation rates, but it has a longer recovery time.
How Does NU-Spine Evaluate Recurrent Herniations?
To determine the best treatment option for each patient, the doctors at NU-Spine perform a thorough evaluation. It includes:
- Imaging: Scans, such as MRIs, are used to visualize the spine and determine whether the herniated disc is on the same side and level as previous herniations. They can also help identify degenerative changes and instability.
- Diagnostic injections: Injections like nerve blocks and facet joint injections are frequently used before spine surgery to pinpoint the exact source of pain and confirm the correct level of the spine is targeted during a fusion or discectomy.
The surgeons at NU-Spine take a personalized approach to surgical planning for each patient, weighing the benefits, risks, and overall health of the patient to determine the best solution. If minimally invasive procedures are a viable option, the surgeons will consider them to reduce recovery times and post-operative complications.
Find Treatment for Recurrent Herniations in New Jersey, Pennsylvania, or Florida
If you’re dealing with recurrent lumbar disc herniations, don’t wait for relief. Schedule your appointment with the spine experts at NU-Spine: The Minimally Invasive Spine Surgery Institute and transform your life with a touch of care. We offer the cutting edge in minimally invasive spine treatments, including repeat discectomies and spinal fusions. Contact us today to learn more or schedule an appointment at one of our New Jersey, Florida, and Pennsylvania locations.
Recurrent Herniation FAQ
Is a repeat lumbar discectomy safe?
Yes, a repeat lumbar discectomy is generally considered a safe treatment for recurrent disc herniation. However, it also has higher risks of complications than initial discectomies.
Does lumbar discectomy or lumbar fusion offer a reduced chance of re-herniation?
Lumbar fusion typically offers a lower risk of re-herniation at the same disc level compared to repeat discectomy, since it eliminates movement in that segment. However, fusion can also increase the risk of herniation at adjacent levels.
Which has a longer recovery time, lumbar discectomy or lumbar fusion?
Lumbar fusion has a significantly longer recovery time compared to a lumbar discectomy, as the fusion of the bone can take up to a year to fully heal.