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Microdiscectomy Twice?

KSinKKSin Posts: 1
edited 06/11/2012 - 8:42 AM in Back Surgery and Neck Surgery
When I was eighteen I herniated two discs (L4 was 2.0 centimetres and L5 2.3+ centimetres... can't remember exact amount).

I had a microdiscectomy last March that removed three 'extremely large' fragments and felt immediate pain relief in my leg. Still have numbness and no reflex to this day, but the pain left and I could stand, sit, and lie down again.

The past few months I've slowly been getting the "bone crushing" leg pain back (and the inability to lie down, stand up, or walk).

I was wondering if anyone has had more than one microdiscectomy on the same location? If it's possible?

Or if anyone went through something similar and what their doctors' did about it...?


  • Hi KSin...yes, revision microdiscectomy is possible.

    Have you been overdoing it physically? I only ask b/c perhaps the area is just inflamed vs reherniation. I would reach out to your doctor.

    I had herniated L5-S1 in August. Had a large mass sitting on my left sciatic nerve and like you lost feeling, strength, ankle reflex. Upon waking from the microdiscectomy, I may have gotten 2-weeks of relief but never really felt any better than that. Anyhow, at month 3 (after also trying a round of prednisone to see if inflammation was my issue), I went for a contrast MRI and confirmed I had reherniated (or a piece was left behind).

    Long story short, they will look at your case. The text book answer is try the microdiscectomy a 2nd time if the chief complaint is leg pain. I'm not a doctor though. I also got some opinions that I should fuse but I just didn't feel the pain warranted that. So I did a ton of research.

    I went for the revision. But that was a decision good for me. I failed within 3 months, it was the same leg, and since it was early on, I felt there was not true way to tell if I re-herniated or if a piece was left behind. My disc height was not good so that was a concern to some doctors which is why fusion was an option. However, my disc above is not strong either which posed problems with fusion since that disc would be carrying extra load.

    I did find a new surgeon who is a NS (my first surgeon was an OS, was out of network and while excellent, just felt I had to find an in network surgeon). He was very conservative. He told me I could do nothing, try revision, or fuse. He said based on my records, my history, and my story...he was inclined to give it another month to see if the additional herniated piece would dry out just a few mm to come off the nerve. We waited through the holidays and it didn't get better. So he agreed to try the revision. He felt, as did my original surgeon, that a fusion is very invasive and that it is permanent. He felt it was worth trying the revision.

    Now, statistically if you did re-herniate (10% chance) the success rate of a revision goes from 90-95% down to about 70-80%. But I compared that to satisfaction rate of fusions and possible long-term issues. I opted for revision which was 4-weeks ago.

    I have been extremely careful this time. If I herniate again, the disc is just bad and I know that is a possibility. My doctor is being extremely cautious. I'm not even driving yet and I am trying to stay out of a car except for necessary trips (to see him).

    It is possible, the success rate just drops from 90 down to 80%, and it really depends on what your MRI shows. You may not have reherniated. You may have inflammation from scar tissue build up.

    Good luck.
  • DNice pretty well covered your question. I would just like to add that sometimes all fragments are not removed during the first surgery. It may be that there is still a small piece that is irritating the nerve or even compressing it.

    It seems to be fairly common to perform two discectomies on the same level. If a problem develops again, the patient is usually advised that the third surgery will have to be a fusion.

    You might want to get an opinion from a different spinal specialist to confirm what you suspect.

    Good luck.
  • Its much better to do revision minimally-invasive surgery... You don't want to make trauma to your muscles and tissue again.

  • Yes, my L4-L5 was "touched up" when I was in having my L5-S1 being worked on.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
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