Medical questions & health advice by board certified doctors
"I have had three L5 S1 lumbar diskectomy surgeries where the same disk herniated on three occasions, how at risk am I for having the disk herniate a fourth time and is it likely that the same diskectomy surgery would be required or a more complicated surgery to fix the probolem?"
I had the three diskectomy surgeries over a two year period approximately 5 years ago. I still have stiffness and occasional lower back and sciatic pain at times. I like to workout, and do some light weight training, but at times I feel like I'm straining something and get some warning pains. I would like to know if multiple diskectomy surgeries on the same herniation are common and if it is possible that I might herniate that same disk again. Also, I wonder what the next step up in surgery procedures might be if a simple diskectomy would not work for a four time herniation. Thank you!
In patients such as yourself, who have had more than one herniated disc at the same level, and have had multiple surgeries to try and correct this, the next step is to perform a somewhat more involved procedure called a fusion. It is unclear why some patients develop recurrent herniated discs, although it is believed that there is continued motion at that level and for reasons that are beyond the scope of this discussion, the disc continues to herniate, leaving you with the nerve pains (also known as radicular pains) that you are experiencing. The fusion procedure involves placing screws and rods into the bones of your spine at that level, and placing bone along the edges of the spine. In the long run, the bone will eventually fuse and the motion that you are experiencing at this level should cease. When the motion ceases, it is expected that the disc will stop herniating. Some of the main risks of this procedure include spinal fluid leakage, nerve damage, infections, and bleeding, amongst a host of other risks. It is best to discuss this with your spine surgeon (neurosurgeons and orthopedic surgeons perform this most commonly) for more information and further work up.