Our Summary

This study looked at the rate of reoperation and the time until reoperation for patients who had undergone a specific type of spine surgery called a discectomy. This procedure involves removing a disc from the spine, usually due to a herniation (or bulging) of the disc. There were two types of surgery the study looked at: primary discectomy (the first time the surgery is done) and revision discectomy (a follow-up surgery done if the first one doesn’t work).

The researchers used a database of patient records from 2010 to 2019 to find people who had undergone these surgeries. They found over 20,000 patients, most of whom had a primary discectomy.

They found that about 6% of patients who had a primary discectomy needed a reoperation, compared to about 10% of those who had a revision discectomy. They also found that those who had a revision discectomy had to have their reoperation sooner than those who had a primary discectomy.

In conclusion, if a patient had to have a second discectomy (revision), it was more likely that they would need another operation (either another discectomy or a spinal fusion), and they would likely need it sooner, compared to patients who only had one discectomy.

FAQs

  1. What is the difference between a primary discectomy and a revision discectomy?
  2. What percentage of patients needed a reoperation after a primary discectomy compared to a revision discectomy, based on the study?
  3. According to the study, if a patient had a second discectomy, what is the likelihood they would need another operation?

Doctor’s Tip

A helpful tip a doctor might give a patient about discectomy is to follow post-operative instructions carefully, including proper wound care, physical therapy, and avoiding strenuous activities that could put strain on the spine. It’s important to listen to your body and not push yourself too hard, as this could increase the risk of needing a revision surgery. Additionally, maintaining a healthy lifestyle with regular exercise and proper nutrition can help support a successful recovery and reduce the risk of complications. Regular follow-up appointments with your healthcare provider are also important to monitor your progress and address any concerns.

Suitable For

Patients who are typically recommended for a discectomy are those who have not found relief from conservative treatments such as physical therapy, medications, or injections for their herniated disc symptoms. Additionally, patients with severe leg pain, weakness, or numbness that is not improving with conservative treatments may also be candidates for a discectomy.

Patients who have had a previous discectomy and are still experiencing symptoms may also be recommended for a revision discectomy to address any remaining issues. However, as the study mentioned, patients who undergo revision discectomy may have a higher likelihood of needing additional surgeries and may require them sooner than those who only have a primary 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

Overall timeline for a patient before and after discectomy:

Before discectomy:

  1. Patient experiences symptoms of back or leg pain, numbness, tingling, or weakness.
  2. Patient undergoes diagnostic tests such as MRI or CT scan to confirm a herniated disc.
  3. Patient may try conservative treatments such as physical therapy, medications, or epidural injections before considering surgery.

During discectomy:

  1. Patient undergoes discectomy surgery to remove the herniated disc.
  2. Surgery typically takes 1-2 hours and is done under general anesthesia.
  3. Patient may stay in the hospital for 1-2 days for monitoring and pain management.

After discectomy:

  1. Patient begins physical therapy and rehabilitation to improve strength and mobility.
  2. Patient may experience some pain and discomfort post-surgery, but this typically improves over time.
  3. Patient gradually resumes normal activities and may return to work within a few weeks.
  4. Patient follows up with their surgeon for post-operative care and monitoring.
  5. If necessary, patient may undergo a revision discectomy if the first surgery is not successful.

Overall, the timeline for a patient before and after discectomy can vary depending on individual factors such as the severity of symptoms, response to treatment, and recovery process.

What to Ask Your Doctor

Some questions a patient should ask their doctor about discectomy include:

  1. What are the potential risks and complications associated with a discectomy surgery?
  2. What is the success rate of a discectomy in relieving my symptoms?
  3. How long is the recovery time after a discectomy surgery?
  4. Are there any alternative treatments or procedures that I should consider before undergoing a discectomy?
  5. What can I do to optimize my chances of a successful outcome after a discectomy surgery?
  6. Will I need physical therapy or rehabilitation after the surgery?
  7. How likely is it that I will need a revision discectomy in the future?
  8. What are the signs and symptoms that I should watch out for that may indicate the need for a reoperation?
  9. How soon after a discectomy surgery can I return to work or normal activities?
  10. Are there any long-term implications or considerations I should be aware of after a discectomy surgery?

Reference

Authors: Dalal SS, Dupree DA, Samuel AM, Vaishnav AS, Gang CH, Qureshi SA, Bumpass DB, Overley SC. Journal: Spine J. 2022 Dec;22(12):1983-1989. doi: 10.1016/j.spinee.2022.06.005. Epub 2022 Jun 18. PMID: 35724809