Column Recurrence and Reoperation of Lumbar Disc Herniation: Proper Understanding For Appropriate Treatment
March 14, 2023
What is disc herniation? What the latest research reveals
Everyone is familiar to some extent with lumbar disc herniation.
The intervertebral disc is made up of two types of tissue: the nucleus pulposus and the annulus fibrosus. A crack in the annulus fibrosus will cause the nucleus pulposus inside to protrude outward, resulting in a herniated disc.
Recent studies have shown that the protruding nucleus pulposus becomes inflamed and inflammation spills over into the surrounding nerves, causing pain.
If the pain persists for more than a few months, it means that new myelinated nuclei are constantly leaking. Conversely, if the pain disappears, it means that the nucleus pulposus has stopped leaking.
This is very important to properly understand the condition of disc herniation.
Now, what happens once a herniated disc is surgically removed?
Surgery removes the leaking nucleus pulposus (the herniation itself) to physically decompress the nerve. However, the crack in the annulus fibrosus will remain open and the nucleus pulposus will continue to leak, resulting in another herniated disc.
Illustration of a preoperative and postoperative disc
After surgery, the risk of disc herniation recurrence is approximately 64%. *1
The high recurrence rate is due to the inability of surgical procedures to close the crack in the annulus fibrosus.
*1: Lu Hao, Shengwen Li, Junhui Liu, Zhi Shan, Shunwu Fan and Fengdong Zhao. Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present. Journal of Orthopaedic Surgery and Research, volume 15, 176 (2020)
The continued leakage of the nucleus pulposus and the continued degeneration of the disc will likely lead to lumbar instability and other problems, and this time reoperation may not be limited to herniectomy, but may require fusion surgery.
If pain persists or new symptoms develop after a surgery for disc herniation, it is suspected that the disc herniation has recurred.
Our clinic offers the Cellgel Method, a treatment that seals the leakage of the nucleus pulposus by filling in the cracks in the annulus fibrosus. This provides a fundamental treatment that not only relieves symptoms, but also prevents the recurrence of herniated discs.
If you already had surgery once, but now feels that the pain is coming back…
Please consider a medical examination at our clinic.
