Our Summary

In simple terms, this research aimed to understand the chances of needing a second spinal surgery after having a first operation called a lumbar discectomy. This first operation is a common treatment for lumbar disc herniation, which is a condition that affects more than 3 million people in the U.S. each year, especially those over 60.

The researchers looked at more than 200,000 patients who had this first operation and found that the likelihood of needing a second surgery, known as a lumbar fusion, increased over time. After one year, about 1.7% of patients needed the second surgery, but after 10 years, this increased to 8.5%.

When they compared these results to a group of patients who had not had the first operation, they found that those who had the first operation were almost three times more likely to need the second surgery. This is an important finding as it can help doctors discuss the potential need for a second operation with their patients before the first surgery.

FAQs

  1. What is a lumbar discectomy and who typically needs this operation?
  2. Based on the research, what is the likelihood of needing a second spinal surgery after a lumbar discectomy?
  3. Why is it significant that patients who had a lumbar discectomy are almost three times more likely to need a second surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about discectomy is to maintain a healthy lifestyle and follow proper post-operative care instructions to reduce the risk of needing a second surgery. This includes regular exercise, maintaining a healthy weight, avoiding smoking, and following any physical therapy recommendations. It’s also important to listen to your body and report any new or worsening symptoms to your doctor promptly. By taking care of your spine and overall health, you can help reduce the likelihood of needing additional surgeries in the future.

Suitable For

Patients who are typically recommended for a discectomy are those who have tried non-surgical treatments such as physical therapy, medication, and injections, but continue to experience severe pain, weakness, or numbness in the legs due to a herniated disc pressing on a nerve in the spine. These patients may also have difficulty walking or performing daily activities due to their symptoms. Additionally, patients who have evidence of nerve compression on imaging studies such as MRI or CT scans may be recommended for a discectomy. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if a discectomy is the best course of action for their specific condition.

Timeline

Before discectomy:

  1. Patient experiences symptoms of lumbar disc herniation such as back pain, leg pain, numbness, and weakness.
  2. Patient undergoes diagnostic tests such as MRI or CT scans to confirm the diagnosis.
  3. Doctor recommends a lumbar discectomy as a treatment option.
  4. Patient undergoes pre-operative evaluations and consultations.
  5. Surgery is scheduled and performed to remove the herniated disc material pressing on the nerves.

After discectomy:

  1. Patient experiences immediate relief from symptoms post-surgery.
  2. Patient undergoes post-operative care and rehabilitation to aid in recovery.
  3. Patient may experience some residual pain or discomfort during the healing process.
  4. Patient gradually resumes normal activities and physical therapy to strengthen the back muscles.
  5. Patient is advised to follow-up with their doctor for monitoring and to discuss any concerns or complications.
  6. Research indicates that there is a risk of needing a second surgery, lumbar fusion, in the years following the initial discectomy, with the likelihood increasing over time.

What to Ask Your Doctor

  1. What is a lumbar discectomy and why is it being recommended for me?
  2. What are the risks and potential complications associated with a lumbar discectomy?
  3. How long is the recovery period after a lumbar discectomy and what can I expect during that time?
  4. What are the chances of needing a second surgery, such as a lumbar fusion, after a lumbar discectomy?
  5. What factors may increase my risk of needing a second surgery after a lumbar discectomy?
  6. Are there any alternative treatments or therapies that I should consider before opting for a lumbar discectomy?
  7. How will a second surgery, such as a lumbar fusion, impact my long-term recovery and quality of life?
  8. What can I do to lower my risk of needing a second surgery after a lumbar discectomy?
  9. How often will I need follow-up appointments to monitor my recovery and potential need for additional surgeries?
  10. Can you provide me with any resources or information to help me better understand the process and potential outcomes of a lumbar discectomy and any subsequent surgeries?

Reference

Authors: Castillo H, Chintapalli RTV, Boyajian HH, Cruz SA, Morgan VK, Shi LL, Lee MJ. Journal: Spine J. 2019 Mar;19(3):487-492. doi: 10.1016/j.spinee.2018.05.016. Epub 2018 May 21. PMID: 29792995