16 May How to Deal With a Recurrent Disc Herniation
When a disc herniation occurs, over 90% of the time it can be dealt with non-operatively. A small percentage of patients will need a discectomy surgery to achieve pain relief.
People may think that their horrific situation is over and will never happen again. However, in this case lightning may strike twice. A recurrent disc herniation occurs up to 15% of the time.
Why does this occur? Unfortunately, the outer layer of the disc has a very poor healing potential. When a discectomy surgery is performed, there is no satisfactory method of closing this outer layer. Therefore, the opening where the disc had squeezed out remains open.
If a recurrent disc herniation does occur, an MRI with contrast can show whether or not it is scar tissue versus a new disc herniation. Contrast will flow through scar tissue as it has blood flow. A disc herniation does not have blood flow and will not show up with contrast in it.
Treatment for a recurrent disc herniation should go through the same options as the first time. This includes medication management such as anti-inflammatories, short term narcotics and muscle relaxers
If surgery ends up being necessary for the recurrent disc herniation, typically the success rates are no different than before. However, there may be significant scar tissue so the surgery tends to be more difficult to perform.
In addition, if a significant amount of disc was removed the second time, a fusion surgery may be indicated so that the person is not left with chronic back pain due to not having sufficient disc remaining.
While a recurrent disc herniation is a significantly annoying experience, conservative treatment is really the same as it was the first time around.
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