A revision microdiscectomy is performed when a previously herniated and surgically repaired disc herniates again. This is a risk with all partial discectomy procedures. In the primary microdiscectomy, the surgeon will remove the herniated portion of the disc and then reshape and trim it. However, some patients will experience repeated herniation, requiring revision surgery to correct the problem. Depending on the severity and any additional symptoms (such as degeneration at adjacent vertebras), the surgeon may recommend a full removal and spinal fusion. For more information about your options for treating back pain, contact Dr. Chetan Patel. Make an appointment for a consultation at AdventHealth Medical Group Spine Health by calling Call407-303-5452.

Minimally Invasive Surgery

A revision microdiscectomy performed at AdventHealth Medical Group Spine Health is a minimally invasive procedure. Dr. Chetan Patel will use micro-cutters, lasers and other specialized tools, including x-ray imaging to ensure minimal trauma to the soft tissues of the back. In addition, the incision is located to the side of the spine and is usually very small (often requiring nothing more than two sutures, or even a Band-Aid to close).

Access to the spine is gained by moving the back muscles out of the way utilizing graduated dilators. The initial dilator is small, and they increase in size, eventually creating a tunnel between the soft tissues. This ensures that the surgeon does not have to cut the tissues, which would increase pain and require considerably longer healing times (due to trauma).

Once access to the vertebra is created (usually through a laminectomy or laminotomy), the surgeon will remove the newly herniated disc material. In the case that the revision surgery is necessary to due disc collapse, the degenerated disc will be removed. This will require either the installation of an artificial replacement disc or spine fusion.

The Case for Fusion

In some cases, the disc will need to be removed and fusion of the spine performed. This is done if the disc is degenerating, rather than herniated, or if the hernia is such that the disc cannot be saved. If fusion is necessary, the surgeon will perform this at the same time. Fusion will require the installation of hardware to stabilize the spine, the removal of the disc and the installation of a bone graft. Graft material can be taken from the patient’s hip, but this will lead to an increase in recovery time. Donor bone can be used, as can new genetically engineered protein.

In most instances, the hardware installed will be plates and pedicle screws. However, the surgeon may recommend the use of rods and screws instead, or a dynamic stabilization device if the patient leads a particularly active lifestyle and needs to retain some of the mobility in the fused areas (dynamic stabilization can also help combat stress added to adjacent areas after fusion).

To find out if a revision microdiscectomy is necessary, contact Dr. Chetan Patel at AdventHealth Medical Group Spine Health. Revision surgeries are highly successful, and patients report a decrease in pain almost immediately. Call Call407-303-5452 for an appointment.