I did not learn until after my recent (almost 4 weeks ago) Endoscopic Micro Discectomy that my “large” L5 disc herniation was a contained protrusion.
Since then I’ve read online that contained herniations may have higher rates of recurrent sciatica, reherniation and/or revision surgery. I now obsessively worry I will end up with one or all three outcomes!
I would greatly appreciate any insight/wisdom you could share on the likelihood/unlikelihood of these outcomes. (Please note I have a normal BMI, am a non smoker, and have educated myself on lumbar spine sparing habits.)
Here is part of my neurosurgeon’s operation report: “…A blunt dissector was then used to separate the yellow fibers of the ligament which gave us enough room to resect this in piece meal fashion. We were then able to identify the traversing nerve root and the ventral epidural space. We used a ball tip probe to carefully palpate the plane under the nerve root, and we were able to identify the bulging disc space. Because no annular tear was evident, we opened the disc using a dissector. We then decompressed the disc in piece meal fashion. There were no dominant free fragments evident. Once we finished the decompression in piece meal fashion, we were able to appreciate free ventral epidural space under the thecal sac which was pulsating free. Once full decompression was achieved in this fashion, hemostasis was then confirmed and our cannula retractor was slowly withdrawn…”
Contained protrusions are disc herniations that don’t tear through the posterior longitudinal ligament (PLL) and are “contained” underneath this ligament. Contained herniations are more common than uncontained and generally cause less injury although the injury can still be significant. I think there is no reason to be concerned with your injury or the surgical report.