Neurosurgeon Questions

Sciatica after microdiscetomy

I'm 7 weeks after Microdiscetomy of the l5, s1. I'm having intense sciatica pain with some numbness that comes and goes, especially when standing. When I sit I feel fine. I have no back pain. What should I do?

Male | 39 years old
Complaint duration: 7 weeks
Medications: Gabapentin
Conditions: Sciatica following microdiscetomy

8 Answers

You need to talk to your surgeon again. In some cases patients can have reherniation after surgery since there is a hole in the disc from the original herniation where additional material can come out. This is particularly true if your symptoms got better after surgery and then returned. An MRI is usually indicated in those cases.
If your pain was resolved after surgery and has suddenly returned, I would reach out to your surgeon .Recurrent lumbar disc herniation is a concern for younger patients
Let your surgeon know. This question is impossible to answer without seeing your imaging before and after surgery, and knowing what was done during surgery.
This may be part of a normal recovery depending on timelines, size of disc and location as well as other factors such as pre-existing Neuro exam.
Would contact your surgeon ( the one who did the procedure), for close follow up
It is not uncommon to experience pain after microdiscectomy. Majority of the symptoms should improve with time and certainly should not be as intense as symptoms prior to the operation. This type of pain is often referred to as radiculitis. Having said that, recurrent disc herniation can occur in 5% of patients and if symptoms are not improving, further evaluation is warranted.
You should return to your surgeon for follow up and possibly a repeat MRI.
Have your surgeon get a lumbar MRI with and without contrast
If you are having significant symptoms as you describe, AFTER microdiscectomy, a repeat MRI is indicated to make sure that there is no re-herniation, or persistent herniated disc material that can be missed. The MRI should be of HIGH quality (i.e. not an open MRI) and preferably 3 Tesla.