From the Research
The chance of re-herniating a disc after microdiscectomy is approximately 10.8% within the first few years following surgery, as reported in a study published in 2013 1. This recurrence rate varies based on several factors including the patient's age, the specific disc that was operated on, surgical technique used, and post-operative activity levels. Some of the key factors associated with an increased risk of recurrence include:
- Higher disc height
- Higher percentage of spinal canal occupied by the hernia
- Presence of degenerative facet joint changes
- Smoking
- Obesity
- Physically demanding occupations
The majority of reherniations occur within the first year after surgery, with the risk decreasing significantly after this period. To minimize reherniation risk, patients should follow their surgeon's post-operative instructions carefully, which typically include:
- Activity restrictions for 4-6 weeks
- Proper body mechanics when lifting (using legs rather than back)
- Gradual return to normal activities
- A structured physical therapy program focusing on core strengthening Reherniation occurs when disc material protrudes through the same defect in the disc's outer layer (annulus fibrosus) that was addressed during the original surgery, often due to mechanical stress before complete healing has occurred. A study published in 2017 found that preoperative radiographic parameters, such as disc height index, segmental range of motion, and central angle of lumbar lordosis, can be used to assess the risk of recurrence after microdiscectomy 2. Another study published in 2017 identified migration of LDH as a significant factor related to recurrence, with patients having caudal migration of LDH experiencing recurrence more frequently than those with rostral migration or without migration 1. Overall, while the risk of reherniation after microdiscectomy is significant, careful patient selection, proper surgical technique, and adherence to post-operative instructions can help minimize this risk.