Recurrent disc herniation is a challenging problem for spine surgeons. They occur in approximately 6-24% of patients after a discectomy procedure. They are defined by at least 6 months of symptom improvement following the index procedure with subsequent recurrence of symptoms with MRI evidence of a new disc herniation. The differential diagnosis includes epidural fibrosis. Without neurologic deficit, initial non-operative treatment modalities are employed. If symptoms persist after non-operative treatment attempts, or if there is significant neurologic deficit, surgery is indicated. Surgery entails either a revision decompression alone or a decompression with interbody and posterolateral fusion depending on the size of the herniation, associated instability, and surgeon preference and experience. Revision decompression risks include neurologic injury and spinal fluid leak.
ASJC Scopus subject areas
- Orthopedics and Sports Medicine