I’m going to have a microdiscectomy next week for a herniated disc at L45. The pre-op papers say that one of the problems that can occur is excess scar tissue. Why is that a problem? It seems like scar tissue would help support the spine where other tissues have been removed. What am I missing here?

Scar tissue in the form of adhesions and fibrosis can wrap itself around nerve tissue during the acute healing phase. This can cause increased pain and loss of function. If enough scar tissue is present, nerve impairment can be severe.

And it’s not a simple matter of going back in and removing the adhesions. If your body produces an over abundance of fibrosis, a second surgery only increases the risk of tissue tearing and nerve root injury.

Surgeons are looking for a way to keep scar tissue from forming. They have tried using a wide range of substances in the peridural (empty disc) space to prohibit fibrosis was developing. So far, no one has found anything that makes a big difference.

Most recently, a group of surgeons from Istanbul, Turkey studied the ability of mitomycin C to inhibit periepidural fibrosis. Mitomycin C is an antibiotic that has proven effective against fibrosis in glucoma and tracheal reconstruction patients. But there was no benefit in using this solution either. More studies are needed in this area.