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Herniation 8-days Post Microdiscectomy - More Surgery?

I am a 27 yo female in otherwise good health, but have had back pain for 3 years and left leg pain for 5 months (3 months severe). I had a L4/L5 microdiscectomy on November 14. I recovered well for 8 days, with my numbness and pain decreasing. I was feeling good and recovering well. All of a sudden (after getting out of bed) I was unable to walk across the room without intense pain. My surgeon ordered another MRI, and today I learned that I now have a larger herniation in the same space. It has been 10 days since the reherniation, and I am now able to do simple tasks around the home, but I still can't stand for longer than a few minutes at a time (which is where I was before surgery).

I am at a loss for what to do - I am hesitant to go under the knife again. I felt I was incredibly careful post-surgery and fear that I have kicked off a terrible cycle.

The surgeon is game to try some alternative methods again, like oral and injected steroids (we have already done one turn of oral steroids), but thinks I am going to end up needing more surgery.

Should I seek a second opinion, and how long should I wait to see if things improve? I am concerned about long-term damage to my nerves and I am going stir crazy. I have basically been house-bound for months and as a newly-wed, would like to have a more active life with my husband.


  • My thoughts are that microdiscectomies have inherent risk of re-herniation.
    There is likely nothing you did or didn't do to cause it.
    It could have been that more 'fell out' before the scar tissue could form or it could be that there was another piece 'free' that was out of site of the surgeon that has dislodged (NOTE: there is no way to tell so not even worth discussing that with your surgeon).

    Your surgeon sounds great. Most surgeons will not re-MRI for 6-12 weeks if you don't recall any 'incident' of tripping, falling, or getting bumped. I would be very pleased that he took you seriously and identified the issue early.

    So, what to do?
    Get a 2nd opinion. It is very easy. You tell your surgeon thank you for taking your change in pain so seriously. Tell him that you trust him but it's a 'new' situation that poses a new surgery, that you'd like to get a 2nd opinion b/c your head is spinning with this new information and you want to be sure you just get another set of eyes. Your surgeon, I'm sure, will say absolutely.

    See what the other surgeon says. Don't tell him what your doctor thinks you should do, just say "Hey, I had this, then surgery, then pain, then learned I reherniated....can you look at me and my records and let me know your thoughts on what I should do next". You will get a recommendation. You an ask that doctor the same questions about waiting vs. doing the surgery quickly.

    As for how long you should wait? That's up to you but I think you have some time to get a 2nd opinion so I would think you have a couple of weeks. Perhaps you try to alternative methods while you are seeking another opinion??? Just a thought.

    On a side note --> similar thing happened to me but I do not recall one incident that made me feel worse. I actually do not remember ever feeling better after the MD. At 2-week post op I let the doctor know this. He said give it time, I probably had post-surgical inflammation. At 6-weeks, no change and felt I was actually worse. He said give it time and put me on prednisone. At week 10, he was ready to release me to PT and tried to let me know that I was just one of those patients who needed more healing time. I told him that I would be upset if I left his office without a re-do MRI so he sent me for one without thinking anything would come of it. But I had re-herniated.

    Long story short...my new surgeon said it probalby happened when they flipped me back on the table. He told me that I could wait through the holidays for the 2nd surgery. He also told me I could try to wait it out longer but that since I had already waited 2 months, it probably wouldn't heal itself. I had 2 options - revision MD or Fusion. Mixed input from various doctors but went for revision. Was EXTRA careful and things went well. My surgeon told me that being careful was key but he did tell me it was probably nothing I did the first go around...it probably just happened. But I was careful with everything from only sitting 10 min 3x/day, avoided being in a car for 2 weeks and then limited my time in a car the next 4 weeks, I took medication to make "going" easier so I wouldn't strain, and walked frequently on flat surfaces. I hope this helps.

  • I am sorry to hear that you have re-herniated after your first MD. As DNice stated, it is good that your Dr. ordered the post-Op MRI and you now have a clear diagnosis, rather than spending more time waiting to see if its just part of the "healing process."

    From all that I have read prior to and after my MD, there seems to be mixed opinions about the correlation between activity levels and re-herniation. Unfortunately, some people re-herniate quickly, or while being very careful, and others are active and "push it" fairly soon and have no issues.

    There is no way that a second, and even third opinion, can't help. Again, as DNice stated, do not lead these extra opinions by stating what your first surgeon wants to do. Bring them the data and see what they say.

    I wish you all the best. Make yourself as comfortable as possible in the time it takes for you to make a decision. As far as a "terrible cycle" - I think its pretty natural to think that way for a lot of people with back issues, myself included, and at times I find that overwhelming. Its part of the reason I cant fully appreciate that my own MD 9 weeks ago seems to have good results so far. I think all you can do is take it one day, and one hurdle, at a time. Don't look to the past with too much regret or second guessing, and don't look too far ahead with unfounded fears or prognosis. Easier said than done, I know.

  • On a positive note, you won't have to go through months of worry and uncertainty before finding out what's wrong. I saw a statistic in a really great book I'm reading at the moment. When are herniation consists of several large disc fragments, then there 25% chance of recurrent herniate on at the same site at a later time. Please realise that you are not the cause of this reoccurrence, it's just what sometimes happens. This book likened a badly degenerated disk to a rotten tree trunk, that doesn't take much to dislodge a chunk of it, as its falling apart. (Sorry, I'm only the messenger). If your interested, I can provide the info on the book.

    Anyway, there was a recent post (if my memory is getting the details right) of having 3 MDs on same disc and now looking at fusion.

    Risk of nerve damage vs recovery without further surgery. That's a hard one. You really need to have this discussion with the surgeons. And make sure you have effective neuropathic pain management in the meantime.

    Yeah, this is going to extend the time that this issue has and is going to consume of your life, but that's the hand you've been dealt and now need to adjust your life accordingly. As you read many other posts here (which I encourage you to do with the time you now have available) you will see that after a period of time people often see positive side effects to their lives and come realise and appreciate things that they had taken for granted. Enough of this, you will see and experience this when the time comes.
  • I had a the same thing happen to me. I had a microdiscetomy and a couple other little things done for stenosis. I woke up in extreme pain (back) but my leg pain and toe numbness was all but gone. I had a very hard time getting out of bed to do my PT and use the restroom and the following day while up for my afternoon PT session I had a horrible pain go down my right leg and my toes instantly went numb. They checked me for a blood clot which came back negative. I was in the hospital for 4 days and still had severe pain but I think the Dr. who was filling in for my surgeon thought I was half faking it and she told the nurses to discharge me. I was on Oxycontin 20 2x a day and Percocet 2 every 4 hours along with the standard muscle relaxer gabapentin and steriod pack. I was still in severe pain taking all of those meds. I went in for my wound check after a week and told my surgeon (first time I saw him since the surgery) that I was still in extreme pain with sciatica. He ordered another MRI that day.

    The MRI came back somewhat inconclusive so my surgeon wrote the pain off as swelling etc which normally produces some pain after surgery. I struggled through a month of pain, some days better than others. I went in for my 1 month checkup and saw another Dr. who was doing the office visits that day. She looked at my MRI again and saw something that didnt look quite right. She then went and interupted my surgeon who was seeing another patient and they both looked at the MRI and agreed that something wasnt quite right. 3 days later I was in surgery again. I woke up feeling 20x better than my first surgery. I had no trouble getting out of bed or walking. my leg pain and toe numbess was gone. This lasted about 10 weeks. I believe I re-injured it at work and am now going to be getting a 1-level fusion this month.

    I'd get a second opinion and see if they recomend another Micro or a fusion.

    Good luck!
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