Continued pain after disc surgery can have a number of potential causes. The first is simply that the nerve was injured by the disc fragments compressing the root and time will tell as to the nerve root recovery.
Nonetheless, there are other treatable potential problems associated with continued nerve pain. A hematoma (collection of blood products) could be compressing the nerve. A recurrent herniation (another disc fragment from the same hole in the disc) could have occurred. There could be some missed fragments still in the canal that were not revealed when the initial surgery occurred. Rarely, another level could cause these symptoms.
If the symptoms are at least 50% better, I tend to wait 6 weeks to see if some improvement occurs. If the symptoms are much less than 50% improved, a new MRI with gadolinium should be considered. If it is blood products (hematoma) causing compression, then an aspiration by an interventionist should be considered. Recurrent disc hernation or retained fragments should be considered for a redo microdisectomy.
The spine does not lose 20% of its efficiency after a microdiscectomy. You can rehabilitate the spine back to pre-herniation levels generally.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
