Our Summary
In simpler terms, this research study looked at past studies to see if there was a connection between the size of the hole left after lower back surgery (lumbar discectomy) and the chance of symptoms coming back or needing another operation.
They found and reviewed 696 studies, and finally used data from 7 of these, involving 1653 patients who had lower back surgery. Out of these patients, 499 had a large hole left after surgery and 1154 had a small hole.
They found that the risk of symptoms coming back or needing another surgery was higher in patients who had a larger hole after surgery. This was true even when they checked their findings in different ways to make sure they were accurate.
The researchers concluded that the size of the hole left after lower back surgery is not often reported but it does affect the patient’s outcome. The risk of symptoms returning or needing another operation is higher in patients with a larger hole left after surgery.
FAQs
- Does the size of the hole left after a lumbar discectomy affect the likelihood of symptoms returning?
- How many studies were reviewed to determine the connection between the hole size left after surgery and the chance of symptoms coming back?
- Does the hole size left after a lumbar discectomy influence the need for another operation?
Doctor’s Tip
A doctor might tell a patient undergoing a discectomy that the size of the hole left after surgery can impact their risk of symptoms returning or needing another operation. It is important to follow post-operative instructions carefully to minimize the risk of complications and ensure a successful recovery.
Suitable For
Patients who are typically recommended for discectomy are those who have severe and persistent symptoms of lower back pain, leg pain, or numbness and weakness in the legs that do not improve with nonsurgical treatments such as physical therapy, medications, or injections. These symptoms are often caused by a herniated or bulging disc in the lumbar spine, which can put pressure on the spinal nerves and cause pain and other symptoms.
In addition, patients who have a herniated or bulging disc that is causing severe neurological symptoms such as difficulty walking, loss of bowel or bladder control, or weakness in the legs may also be recommended for discectomy. These symptoms can indicate a more serious condition called cauda equina syndrome, which requires immediate surgical intervention to prevent permanent nerve damage.
Overall, patients who have tried nonsurgical treatments for their lower back pain or leg symptoms without success, or who have severe neurological symptoms, may be recommended for discectomy to relieve pressure on the spinal nerves and improve their symptoms.
Timeline
Before discectomy: Patient experiences symptoms such as lower back pain, leg pain, numbness, or weakness due to a herniated disc pressing on a nerve. They may undergo physical therapy, pain management, or other non-surgical treatments to alleviate symptoms.
During discectomy: Patient undergoes surgery to remove the portion of the herniated disc that is pressing on the nerve. This procedure is typically done under general anesthesia and involves making a small incision in the back and using specialized tools to remove the disc fragment.
After discectomy: Patient may experience some pain and discomfort at the surgical site, which can be managed with pain medication. They are typically encouraged to gradually increase their activity level and may undergo physical therapy to strengthen the muscles supporting the spine. Recovery time varies but most patients are able to return to normal activities within a few weeks to a few months.
Follow-up: Patient may have follow-up appointments with their surgeon to monitor their progress and address any concerns. It is important for the patient to adhere to post-operative instructions and maintain a healthy lifestyle to prevent recurrence of symptoms.
Overall, the goal of discectomy is to relieve pressure on the nerve and alleviate symptoms caused by a herniated disc. The size of the hole left after surgery can impact the risk of symptoms returning or needing another operation, highlighting the importance of careful surgical technique and post-operative care.
What to Ask Your Doctor
Some questions a patient should ask their doctor about discectomy include:
- What is the size of the hole that will be left after the discectomy surgery?
- How does the size of the hole left after surgery affect the likelihood of symptoms returning or needing another operation?
- Are there any specific factors that can influence the size of the hole left after surgery?
- Are there any additional steps that can be taken during surgery to minimize the size of the hole and reduce the risk of symptoms returning?
- What can be done post-surgery to help prevent symptoms from coming back?
- Are there any alternative treatments or therapies that can help improve the long-term outcome of the surgery?
- What is the overall success rate of discectomy surgery in terms of preventing symptoms from returning?
- Are there any lifestyle changes or modifications that can help improve the outcome of the surgery?
- How often will follow-up appointments be needed to monitor the success of the surgery and address any potential issues?
- Are there any red flags or warning signs that should prompt immediate medical attention after the surgery?
Reference
Authors: Miller LE, McGirt MJ, Garfin SR, Bono CM. Journal: Spine (Phila Pa 1976). 2018 Mar 1;43(5):E308-E315. doi: 10.1097/BRS.0000000000002501. PMID: 29176471