Why is recurring pain present after disc herniation surgery?

Question

Hi doctor,

Five months ago, my wife had a disc herniation surgery. She was fine for the next two to three months, but again she is getting the pain. Her doctor advised us to go for repeated MRI. We are yet to meet her doctor, But, I am looking forward to know what is going on. I have attached the reports for your reference. Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I have read through your query in detail. Please find my observations below.

There is disc problem in the L4-L5 disc level. Though the pressure on nerve roots might have decreased after the disc herniation surgery, it is possible that the recent activity is causing pressure on the nerve roots again.

There is persisting mild right lateral recess obliteration in the L4-L5 disc level. The spinal canal shows slight narrowing as a result of ligamentum flavum hypertrophy.

It is important to review the images of first MRI scan to know how the situation was before the herniated disc surgery. I want to compare the new and old images.

There is a congenital sacralization of L5 vertebra (L5 get fused with sacrum below or with the ilium on the side), which can predispose to the disc problem which she has.

Herniated disc surgery cures the patient in 20 percent cases. In 40 percent, the pain and symptoms come back after surgery and in another 40 percent there is worsening of the condition after surgery.

Any heavy physical work in recent time can bring back the symptoms after surgery. You can please upload the first MRI scan and send me in the follow up. You can also mention the details of the surgery and send me the discharge summary of the surgery.

Answer 2

Hello,

Welcome back to icliniq.com.

The problem is not too serious, but even this can cause significant pain. Since surgery is done five months back, we can still think of going for medical treatment for at least a year from surgery.

I will say that this surgery is a partial success and there is scope of improvement by physiotherapy under supervision.

The exercise given on internet sources are good, but not a complete set. I request you to get physiotherapy sessions from a professional neurorehabilitation physiotherapist for at least 15 days and continue the exercise for few months.

Please ask the physiotherapist in detail about how to participate in daily activities and how much weight to carry. They will also guide you on what can be done and what is to be avoided.

Disc desiccation is loss of water content in disc. This is a degenerative change and not a serious condition. You should not worry about it.