DOES LUMBAR DISC HERNIATION RECUR?

Lumbar disc hernia is one of the diseases that we most frequently encounter in the practice of neurosurgery. Our website contains information about many subjects that will shed light on your surgical decisions. However, I would like to clarify the question that all of our patients ask: ‘DOES LUMBAR DISC HERNIATION RECUR AFTER SURGERY? The answer is ‘YES, IT MAY RECUR’. However, the rate of recurrence varies between 5 and 11% in the researches carried out until now. This rate is similar in all the procedures performed for herniated lumbar disc surgery.

What is the concept called ‘recurrence’? There is confusion in the minds of our patients regarding this issue because the concept of recurrence has not been defined well enough. As you know, a lumbar disc hernia is defined with its location as well as the numbers of the lumbar vertebrae. For example, RIGHT L4-5 disc hernia (lumbar herniated disc). This case can be considered to be a recurrence if the patient has a RIGHT L4-5 disc hernia again. A herniated lumbar disc at the same distance on the LEFT (opposite side of the operated side) or at a different distance is not considered to be a recurrence. It means a new lumbar disc hernia but should not be named as a ‘recurrence’.

  • Patients should be more attentive to their life after surgery, and should thoroughly follow the post-operative recommendations to prevent recurrence. To sum up these;
  • I will instruct you to stand up 8 hours after surgery if it will be performed with microdiscectomy or 2 hours after if it will be performed with the full endoscopic technique. Patients operated with microdiscectomy can be discharged after 1 night, whereas patients operated with the full endoscopic technique can be discharged after 6 hours.
  • There will be no problem with going back your home by sitting in a vehicle. If possible, travelling on the front seat and tilting the seat backward at an angle of about 110 degrees will minimize the risk of pain.
  • If you need to use stairs in the first 3 postoperative days, please climb the steps one by one and bring your foot next to the other one at each step.
  • You can have your meal while sitting. If possible, please pay attention to ensure that you have a back support while sitting on a chair for eating.
  • Please take care to act as instructed to you when sitting and standing up.
  • Patients treated with microdiscectomy may complain of lumbar pain and burning and stinging sensation in lumbar region in the initial  postoperative days. Do not worry about that. Take a bed rest in such cases.
  • Please make sure that your bed is suitable for lumbar health. Do not lay on armchairs, sofas etc. for the rest of your life.
  • When you intend to get out of bed, first completely turn to the side-lying position, consequently turn to the sitting position by getting support from the sides using your hands, and then stand up.
  • Please come for the control examination on the day of your postoperative appointment. I will give you the required information about bathing during the control examination.
  • When you consume the medicines that I will prescribe for you at the time of your discharge, you will not need to take the same medicines unless told otherwise.
  • You must definitely use a closet (not a squat-toilet) to meet your toilet needs.
  • Take care to wear your shoes while sitting. Extremely high-heel or flat shoes are not suitable for our female patients. With middle-heels and wedge shoes, you will feel more comfortable.
  • When taking something from a high place, try to take it after you get an appropriate height.
  • Do not plop down on a chair or armchair when sitting, as if you are falling down. Place yourself in a sitting position slowly and in controlled way. Take support from your knees and the armrests while standing up.
  • Our patients treated with microdiscectomy can begin to go out for a walk from the 7th postoperative day, whereas those treated with the full endoscopic technique can do this from the 2nd postoperative day. Please initially walk for a short distances (for 20 to 30 minutes).
  • If you work at a desk job, you will be able to return to work 15 days after microdiscectomy or 4 days after the operation if it will be performed with the full endoscopic technique. Those who work under more difficult conditions can return to work 2 months after microdiscectomy, and 1 month after a surgical operation performed with the full endoscopic technique.
  • Pay attention to avoid carrying heavy things in the first 30 postoperative days, and then carrying things totally heavier than 5 kg in your both hands. When lifting something heavy, crouch down and hold it as close to your body as possible.
  • Avoid weight gain, and try to lose weight if you are overweight. For doing so, it would be appropriate for you to get professional support from the dietary department.
  • Avoid sports involving physical contact after surgery. Prefer walking and swimming (if possible).
  • Do not drive any vehicle in the first 20 postoperative days if you have been treated with microdiscectomy or in the first 5 postoperative days if you have been treated with a surgical operation performed with the full endoscopic technique. Afterwards, you can do short-distance driving in the city. You can make long-distance journeys, by driving the vehicle yourself, 20 days after if you have been treated with microdiscectomy or 7 days after if you have been treated with a surgical operation performed with the full endoscopic technique. However, have a break for 10 minutes once every 1.5 hour for taking a short walk, and then get back on the road.
  • You can make short-distance journeys by plane 7 days after if you have been treated with microdiscectomy or 2 days after if you have been treated with a surgical operation performed with the full endoscopic technique. Longer journeys (transoceanic) should be made after the first 30 postoperative days, and the patient should take a short walk in the plane once every 1.5 hour.
  • Those working at desk jobs should use orthopedic chairs with back support, and take a walk around the office for 5 minutes once every hour.
  • You should start doing the lower back exercises prescribed to you after the 60th postoperative day. You may initially feel a mild pain, but the exercises will be painless in the course of time.
  • You can call me for any problem related to your surgery. Hope to meet you in healthy days…