Question: How to handle continued pain after a discectomy for lumbar herniated discs?

I had two lumbar herniated discs at L4 and L5-S1. The surgeon performed a discectomy at L4. Since then, I had a really bad episode of lower back pain and pain in both legs. My symptoms radiate down my inner thighs and big toes. I get numbness and pain in my pelvic area and a warm, sore feeling all over my lower back.

A more recent MRI showed I still had the L5-S1 herniation, along with scar tissue from my previous surgery. During the past six months, I've been lying in bed, unable to walk for long periods of time and now I’m experiencing upper back pain.

Can scar tissue alone give me this many problems? I've heard an endoscopic discectomy has helped many patients because it's less invasive. Do you have patients that underwent this procedure?

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Doctor’s response: Obtain a more accurate diagnosis of pain after discectomy

Scar tissue would not usually give you these symptoms, and it is unlikely that scar tissue is causing any of your symptoms at all. It is also unlikely that a disc herniation alone would be giving you all your symptoms. Taking out a disc is much more reliable for treating radiating pain down one leg (e.g. a radiculopathy caused by a herniated disc) than for treating low back pain.

At present, the endoscopic microdiscectomy is no less invasive than a well done microdiscectomy using traditional minimally invasive surgical methods. My understanding is that the visualization through the scope in the endoscopic method is so limited that many patients are not even a candidate to have it done. In my opinion, a microdiscectomy is more reliable than an endoscopic discectomy.

First of all, you will need to get a more accurate diagnosis. If the last surgery was not all that helpful, then another discectomy, no matter how it is done is unlikely to be helpful. The disc spaces may be the cause of your pain (degenerative disc disease) and a fusion surgery may be more reliable than a discectomy.

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In Spine-health’s Doctor Advice section, physicians respond to frequently asked questions about back pain issues. These responses represent the opinion of one physician, and do not necessarily reflect the views of the broader medical community. The advice presented has not been peer reviewed by Spine-health’s medical advisory board.