One of the most common questions I come across as a neurosurgeon: Is there a chance of recurrence if I have a herniated disc surgery?. At the same time, this question is one of the concerns that causes delays in the decision of many of our patients to have surgery. The answer is: Yes, there may be a recurrence. But be careful, I’m not saying it will happen, I’m saying it MAY be. There are many factors that affect this process. Herniated tissue protruding from a large tear area, obesity, smoking habits, heavy workload, lifestyle that does not care to protect waist health, and some genetic tissue diseases. Although a value of 8-12% is used for the recurrence probability of lumbar hernia in general, there is a group in which the recurrence probability is up to 25% in some classifications made according to MR images of lumbar hernia.
However, the most important factor that we need to evaluate here is the following: To what extent is it correct to postpone or not perform the surgery due to the risk of recurrence when the patient definitely needs surgery? If there is a loss of strength in the legs and feet, or even incontinence of urine and stool, which we call sphincter defect, waiting can cause permanent damage. Another problem is none of these; The presence of pain that affects the patient’s work and social life despite drug therapy and bed rest, which we call conservative treatment. Sometimes the pain is so unbearable that it affects the patient’s life so much that increasing the patient’s quality of life with surgery may remain the only solution.
Another issue that needs to be decided in patients who have relapsed: Is there a necessity to perform an operation called fusion for every relapsed patient? the question is. The scientific answer to this is whether the patient has a tendency to slip in the vertebrae in the operated area. To determine this, we may need to use x-ray examinations taken with a special technique and sometimes tomography of the lumbar spine. If we do not see a tendency to slip as a result of these tests, we recommend our patient to have herniated disc surgery performed with the standard microsurgical technique, as we did in the first surgery.
In conclusion, what I would like to say to our patients is, if you encounter a recurrence at any time after hernia surgery: Don’t panic!! It is always possible to find a solution.
Stay healthy…
