The Role of Fusion for Recurrent Disk Herniations

For patients with symptomatic recurrent disk herniations that have failed nonoperative treatment, surgical treatment can be considered. Although simple repeat diskectomy can be an effective treatment for first time recurrences, many surgeons would consider the addition of fusion, particularly for second or third recurrences. With a lack of high-level evidence, decision making concerning when and how to fuse for a recurrent lumbar disk herniation remains largely surgeon-dependent because a variety of options are available. Although there are limited data, both posterolateral and interbody fusion can be effective. Future study is needed to better define the indications and ideal method of fusion for recurrent disk herniations.