One of the most common questions I encounter as a neurosurgeon is: Is there a possibility of recurrence if I have a herniated disc surgery?.At the same time, this question is one of the concerns that causes many of our patients to delay in deciding to have surgery.The answer is: Yes, there can be relapse. But notice I'm not saying there WILL BE a relapse, I'm saying IT CAN HAPPEN. There are many factors that affect this process. Herniated tissue protruding from a large area of tears, obesity, smoking habit, heavy workload, lifestyle that does not take care to protect lumbar health and some genetic tissue diseases.Although a value of 8-12% is generally used for the probability of recurrence of the herniated disc, there is also a group in which the probability of recurrence is up to 25% in some classifications made according to MR images of the herniated disc.
However, the most important factor we need to evaluate here is this: To what extent is it right that the surgery is postponed or not performed due to the risk of recurrence when the patient definitely needs surgery?If there is a loss of strength in the leg and foot, or even in the case of urinary and fecal incontinence, which we call sphincter defect, waiting can cause permanent damage.Another problem is that while none of these things exist; The presence of pain, which we call conservative treatment, which affects the patient's work and social life despite medication and rest in bed.The pain is sometimes so unbearable that it affects the patient's life very much and increases the patient's quality of life with surgery can remain the only solution.
Another issue that needs to be made in patients who have relapsed is: Is it necessary to perform the surgery called fusion among the people that we call fusion in every recurring patient? Question. The scientific answer to this is whether the patient has a tendency to shift in the vertebrae in the operated area.To determine this, we may need to use X-ray examinations taken with special techniques and sometimes tomography of the lumbar vertebrae.If we do not see a tendency to slip as a result of these tests, we recommend our patient to have a herniated disc surgery performed with standard microsurgery or full endoscopic technique as we did in the first surgery.As a result, what I want to tell our patients is that if you encounter a relapse in any period after lumbar hernia surgery: Do not panic!!It is always possible to produce solutions.