Did this MRI have gadolinium (a “dye” injected into your vein) right before imaging? Gadolinium would have been necessary to differentiate scar from recurrent (or residual) disc HNP. If no gadolinium, you need to go back to the imaging center and demand a gadolinium series so this can be ferreted out. If there was gadolinium, you need an “over-read” where another neuroradiologist reads the film and gives his or her opinion.
With no relief after surgery, my bet is that the root was not fully decompressed. If it really was, it would be quite unusual to have such a large mass of scar tissue present. I would suspect there is a mix of herniated disc and scar as I’ve seen many times before but that would require gadolinium imaging. Even if it was only scar, the nerve can be re-decompressed but with less success rate.
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.