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Re-herniation after discectomy - where to go from here ??

Hi there,

I had an L4/L5 microdiscectomy on June 1st of this year and have just received confirmation after an MRI that my same disc has re-herniated. It's a broad based 7mm herniation and I am in the most pain I have ever been in.

Saw my doctor yesterday and he is very adamant that we should try 3 sets of epidural steroid shots to see if that can help before approaching the idea of another surgery. He said that after 1 micro discectomy you are at a 15% chance of Reherniation but after 2 microd's you are at a 35% change of having it reherniate a 3rd time. Basically If the shots don't help we would be going for a spinal fusion.

Just wondering if anyone had experienced reherniation after surgery and if the shots helped or if you needed further surgery to correct.

I am 32 and just trying to gain some knowledge on my options before moving forward.



  • Hi there. I have been down the same road you are on. I wish no one had to go through this more than once...it really stinks!

    In my case, the first herniation was the worst, pain-wise. I was almost completely incapacitated for the final couple of weeks prior to the first micro-discectomy. I reherniated about 6 weeks later, had a second micro-discectomy and then herniated once again with about 3 weeks' time. The third time was more painful than the second. I had no other option but to go for a fusion and while it scared me to death, I'm glad I did it. I could have tired more steroid shots, but they never worked for me and knowing what I know now, it wouldn't have helped anyway since I apparently had very bad arthritis in the facet joints, to the point that they just crumbled when the surgeon went in for the fusion.

    Obviously, I am not the typical case and so you have to decide for yourself. I don't see any harm in trying a shot...but I also know that when you are in tremendous pain it's hard to wait and see. Just be sure to do your research before proceeding to a fusion. It's a big surgery and a long recovery. Best wishes with whatever you decide.
    Left leg radiculopathy/sciatic pain
    L5/S1 microdiscectomy - May 30, 2014
    L5/S1 microdiscectomy - Aug 14, 2014
    L5/S1 TLIF - Sept. 24, 2014
    Left-side screws/rod removed along with bone fragment Dec. 29, 2014
  • SouffléGrlSSouffléGrl Posts: 13
    edited 08/14/2015 - 6:13 PM
    Thanks so much for your response Christina!! I am so sorry you had to go through this taxing process too! My doctor seems very anti surgery and optimistic that we can get the pain handled with this shots, I however, am not so sure as the oral sterioids that I have done 2 times now, did absolutely nothing.

    May I ask what your recovery was like with the fusion? I have read so many things about how big of a surgery that is and that if you have a fusion you are normally guaranteed to have to do another surgery down the line due to the stress that is put on the fused vertebrae. Also, my doctor said that incontinence can be another issue with fusions and really none of it sounds fun but at this point I would be thrilled to have 15 years of normalcy before having to endure another operation.

    How has your pain been since your fusion? Gone altogether? Was the majority of your pain back or leg? Sorry for all the questions, I am just trying to be knowledgeable on this front before moving forward.
  • Coltsfan78CColtsfan78 Posts: 182
    edited 08/15/2015 - 12:11 PM
    Hi again. I'll do my best to answer your questions.

    1. Recovery from fusion surgery, for me, was a bit different. I had two microdiscectomies within the previous 4 months, and all three times I herniated, it was quite severe size-wise. I was terrified to have a fusion as I'd never even had a broken bone, much less screws and rods and all that stuff. I was fortunate in that I was able to have a minimally invasive TLIF (through the back) fusion with instrumentation and a spacer. Basically I woke up with two new 2 inch incisions (I now have a total of 3 in a line). I was superglued together and honestly not in a lot of pain immediately after surgery. As I was waking up from surgery, I noticed that I couldn't feel my right foot properly, so I was immediately whisked off for a CT scan which didn't feel great on my newly operated-on back, but otherwise, I did pretty well. I had a rough night in the hospital trying to get comfortable in the horrid bed and felt much better being upright or standing than laying down there. (I also found out that I wasn't given a muscle relaxer while in the hospital due to a meds error, so I'm sure that didn't help!)

    I came home the day after surgery with a walker and a very angry and newly weak left foot (the symptoms in my right foot went away shortly after surgery....still not sure what that was all about). I spent the next 5-6 weeks sleeping on the couch downstairs as it had more support in those early days and didn't require me to use the stairs as much. I ditched the walker within a week of coming home, but needed a cane for several months following the surgery.

    Pain-wise, the first week or so were uncomfortable, but not nearly as bad as I was expecting and nothing like the pain I had experienced during my original herniation. I took my pain meds round the clock those first few weeks even setting my alarm for overnight. For me, sleeping was definitely the hardest part. I think the pain meds played a role in keeping from sleeping well, but also just general discomfort. Around 6-7 weeks following the fusion, there was a definite turning point when I started to sleep better (I was also mostly off my pain meds by then...maybe just taking them first thing in morning or once a day as needed.) I was able to sleep in a real bed and stay asleep most of the night, so that made everything better.

    I did physical therapy for a couple of months, but unfortunately, it seems I have pretty stubborn likely permanent nerve damage in my left foot/leg as a result of all this. I still walk with a limp and tire easily because of it. My back will never be the same and I've had to learn to ask for help and take things slower than I otherwise might. I'm 36 and have a 10 year old and 6 year old, so life is never slow, but we've all had to adapt a bit. I am no longer in pain, although the nerve damage in my foot is not exactly fun, but I take Lyrica to try to counter that. Otherwise, nearly 11 months post fusion surgery, life is mostly back to normal.

    I think my recovery might have been a tad bit longer than some simply because I had 3 surgeries in 4 months' time and then a follow-up surgery a couple months later, making it 4 in 6 months' time. That's a lot for a body to heal from. I also have a pretty high pain tolerance, so that helped a bit.

    My pain from the herniation was almost 100% in my left hip/butt/leg. I never really had back pain. As I understand it, back surgery tends to benefit those who have radicular (radiating elsewhere) pain the most and it definitely made a difference for me. I went from being unable to sit, stand , walk or sleep to having a very normal life again. As for your question about incontinence, I can only tell you that leaving a large herniation can also cause that if you would happen to develop cauda equina syndrome. I believe I was only a day or so from that, as I was beginning to lose sensation in that general region before my first surgery. It was concerning enough that my surgeon moved the surgery date up several days. I personally don't have issues with incontinence and I don't remember reading a lot of info about that being a potential downside to the fusion, but I suppose it certainly could be. Maybe ask your surgeon for more clarification on that one. I do know that he is correct about the fusion pretty much guaranteeing that there will be more stress on the adjacent levels and thus future surgeries, but if you need it...you need it. I couldn't live as I was, so for me it was the only real option. I wish there had been an easier way, but then I also have to remind myself that there are so many so much worse off than I am...so I try to stay positive.

    I hope that helps. I know it's long, but hopefully you'll be able to get a feel for at least the recovery aspect of the surgery.
    Left leg radiculopathy/sciatic pain
    L5/S1 microdiscectomy - May 30, 2014
    L5/S1 microdiscectomy - Aug 14, 2014
    L5/S1 TLIF - Sept. 24, 2014
    Left-side screws/rod removed along with bone fragment Dec. 29, 2014
  • Wow, thank you so much for your story! I am sorry that you had to go through all of that, but glad that you are doing much better now!

    My situation is different cause i got hurt at work and this is a workers comp claim, so I have to fight to get things done. They are requiring me to go to physical therapy which I start this coming Monday. Not really sure why PT is needed now when I still have the herniation. One would think they would send you to PT once you are on the mend, but who knows.

    Then they have lined up 3 sets of the epidural shots, which I don't have any faith in. The pain I am having now is definitely the worst I have had since this all begun and I pretty much daily find myself getting stuck, unable to move, with crazy electric feelings jolting through my body. I wholeheartedly feel like I will also end up with a fusion and I very much hope it turns out as well as yours did.

    Thank you again for all your insight it has greatly helped to shape my opinion!

    Be well,
  • Unfortunately Christina & I share a similar story, I had 3 surgeries in 8 months (2 discectomies & a TLIF). 12 months out I still have some nerve pain in my right foot BUT I waited too long to get diagnosed & later realised/was told that my sciatic nerve was impinged for around 2 years prior to diagnosis.

    On the PLUS side I am much better than before, working, studying, being a mum, travelling (road trips) & living life.

    I have also been told that the next level up will at some point likely cause an issue. For me the fusion was necessary as I was in a lot of pain & not coping too well. I won't lie, I do suffer a little with incontinence mostly if my bladder is full & I laugh or sneeze or wait to long to go. Could also be getting old! (I'm only 38). If I keep up with pelvic floor exercises its a bit better.

    It has taken me most of the past year to feel 'better' . Each week I notice a change. I initially took 4 months off work from my fusion. I work casually & was able to take most of the year off. I went back to work 6 weeks after my first discectomy on light duties but had already reherniated at that stage.

    I hope the shots help you,
    Microdiscectomy L5S1 January 2014
    Microdiscectomy L5S1 March 2014
    Fusion L5S1 11th August 2014
  • How did you guys re-herniate? What caused it?
  • I'm feeling your pain. I'm 52 had 1st surgery june 2014 for herinated disk l4-l5 and buldge l5-s1. Went hack to work sep 2014 and reinjured same herination. Tried steroid shots in Oct-Nov with no relief of pain from numbing right and left foot. Overtime right leg below knee is severly sensitive to touch and right foot is 100% numb with burning while left foot is 75% numb with burning. Had 2 level fusion in Jan 2015 and I've been going downhill ever since. My feet have gotten worse since the fusion and back pain is still here 7 months later. DR has me on 900mg gabapentin and 10mg norco for pain. Recent EMG shows nerve damage and nk sign of healing these feet within the next 9 months. I'm at a loss and hope if you decide to go back into surgery yours goes a lot getter then what I'm going through. My DR says he could get me some instant relief with another surgery where he would do a spine block and cut signals to the brain but feet would still be numb and I wouldn't be able to feel a cut or anything with my feet..... I said no thank-you, you've cut me open twice in the last year and I'm worse now then a year ago. Havent been able to work in a yeaf, receiving work-comp checks and now they are placing me on SS Disibilty. Good luck on whichever way you choose to go. I would try steroid shots first because these rods and screws don't feel right on my spine.
  • thank you everyone for chiming in. I really feel like this community has helped me to learn so much and make better decision in my health care. I just wanted to give a small update and ask for any advice anyone wants to perhaps through my way.

    It's been 4 days since I tried the epidural injections. They did my L4, L5 and S1 levels and I tried very hard not to go into this with any expectations one way or another, as I am really used to being let down lately. Anyway, the shots took place at 4:30 pm and I had complete numbness in my right leg and foot for about 4 hours. Which I got a little excited about. I figured if the numbing medication was in the right spot, which it most certainly was, the steroid would have to work. But alas, as soon as the numbing medication wore off my leg pain came right back with a vengeance. I am usually at 7/8 on the pain scale on the daily but this felt like a 13. They told me the first 48 hours I could be hyper sensitive and my nerves would be still getting used to the trauma of the needle and that would hopefully calm down and I should know pretty immediately if the shots were going to give me relief. Well no such relief has come and now I am realizing, yet again, I will need to go the surgical route.

    So my choices so far seem to be another discectomy or a fusion and both are not amazing options. I am just so frustrated and want this to be done and over with, I feel like I would rather have them do the big bad fusion and be done with it all, but so many things I read say that fusions really are effective for back pain, which I have none of, and are only sometimes effective for leg pain. I know some of you have had great fusion results, what would you choose?
  • PlumbTuckeredOutPlumbTuckeredOut Philadelphia, PAPosts: 325
    I ALWAYS feel horrible right after the injections like new insult to old injury but, within a few days I feel "back to my old self" but now, in retrospect I'm wondering if the injections don't help even a little bit. It's been a long while (January to August) since my last injection and I'm just noticing the foot drop issue again. (Looks like I've been drinking too much!) So, maybe the epidural injections don't feel like they have helped but they may be keeping the affected nerve from being too inflamed. It's SO hard to make comparisons even with ourselves!

    Wishing you the best!

    Two roads diverged in a wood, and I took the one less traveled by...... (Robert Frost)
    I still don't know if I should have taken the one that said, "Caution! Dead End" (Me)
  • Tiff329TTiff329 Posts: 4
    edited 08/31/2015 - 7:03 PM
    I am actually 6 days post-op from my second MicroD on my L4/L5. My surgeries were a day shy of being 3 months apart. Both of my herniation were followed by sever lateral shifts of at minimum 3" and severe debilitating nerve pain to where it took an hour for me to get out of bed and attempt that first step... Errr... Hobble.

    I was given the option of the epidural steroid injections and was given one. I woke up in severe severe excruciating pain like I've never felt before.

    Like I said, i'm 6 days post-op from my second MicroD. My surgeon was more aggressive with this surgery so it's a little more sensitive (and my herniation was a lot larger). But I wasn't even able to walk, even while being on 1800mg of Gabapentin and hydrocodone. Personally, I didn't want another surgery, but I also wanted to walk. Lol. But in all honesty, I'm glad I had the second MicroD. Sure, there's always a chance you might have to have a fusion later on or you may herniate the disc again. At the same time, now that I've gone through this more than one time, am more aware of my body, careful, etc., what if I never have to have a fusion...?

    Feel free to ask me anything.... Oh, and like you, well, close.... I'm 33. I herniated my disc when I was 32 - waited 8 months before I sought out treatment. SMH. Never again!!!
    Bulging discs - L2/L3, L3/L4, L5/S1
    Extrusion herniation - L4/L5
    Severe lateral shift (3-4") due to herniation
    Herniated disc (L4/L5) on 9/2014
    MicroD on L4/L5 - 5/26/2015
    Reherniated disc (L4/L5) on 7/11/2015
    Second MicroD (L4/L5) on 8/25/2015
  • Tiff329TTiff329 Posts: 4
    edited 08/31/2015 - 7:13 PM
    Lifting_Injury said:
    How did you guys re-herniate? What caused it?
    I attempted to catch a fork as it fell - one of those quick, jerking, arms flailing around type "catches". The type of "catches" that results in, wow, nice catch or, Ummmm, what the heck was that?!? In my case it was a Fail... Epic fail. Guess the 13 years of playing catcher will have to be unlearned.... Plus, this was 6 weeks post-op. Not the smartest idea...
    Bulging discs - L2/L3, L3/L4, L5/S1
    Extrusion herniation - L4/L5
    Severe lateral shift (3-4") due to herniation
    Herniated disc (L4/L5) on 9/2014
    MicroD on L4/L5 - 5/26/2015
    Reherniated disc (L4/L5) on 7/11/2015
    Second MicroD (L4/L5) on 8/25/2015
  • Skyppr84SSkyppr84 North CarolinaPosts: 1
    This has been an interesting and informative read. I had an L5/S1 discectomy in 2007, and everything has been fine up until recently. I had quite a few falls living in a house with stairs and I think it's finally caught up with me. I'm still waiting on a formal diagnosis, but I have copies of my most recent MRI and I've looked at them. It's most definitely bulging, it not completely reherniated. I'm terrified of whats going to happen down the road. PT and steroids (oral and epidural) never worked for me, before or after the surgery. I was 19 when the injury happened, and 22 when I had the surgery. I'm now 31. I'm just so tired of living in pain. Based on the comments here, I'll likely end up going with the fusion before doing a second discectomy. The odds are just so bad, and I feel like I was lucky that the discectomy worked so well the first time.
  • Hi, I first would like to say I'm so sorry your going through this. In January of this year I woke up screaming in pain and apparently herniated a disc in my sleep. This herniated was so bad I lost the use of my right leg completely before my first laminectomy/discectomy. 5 weeks after that surgery MRI confirmed I had in fact reherniated. In May I had the second laminectomy /discectomy.  6 weeks after that one MRI again confirmed yet another very large herniation. At this point I had no choice but to have the fusion surgery so I put it off for enough time to get a few financial things done and in August I had the fusion. Since the fusion I have been in extreme pain and have been put on morphine er as well as oxycodone 15mg for pain with little relief. I go to have another MRI in the morning to find out why. The Dr seams to think there may be hardware failure and I'm terrified at the thought of a fourth surgery in under a year. I would love any advice or comforting thoughts at this point. Let me also say that I have not gotten most of the feeling back in the right leg however I can walk now so I feel blessed for that. But after the second herniation I also started getting numbness in the left leg which I also haven't gotten back. Also my newest symptom includes cramping behind my right knee that triggers almost Charlie horse type pain in the entire lower part of the leg and foot. I'm very nervous about all of this. Please some advise would be great! Thanks!
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