Undergoing a lumbar discectomy surgery for extreme sciatica from a herniated disc can be an extremely gratifying procedure. It is an excellent surgery after nonoperative treatments fail for eliminating the pain from sciatica, and getting patients back to work and playing with their children.
One significant issue that arises often is chronic back or leg pain that develops after a lumbar discectomy surgery.
One of the main reasons for this is that when a piece of disc is removed that was herniated and pressing on a nerve root, the remaining spinal disk does not regenerate that tissue. With further degeneration and scar tissue back pain may intensify.
The second issue that may occur is when scar tissue surrounds the nerve root that was freed up. This may cause persistent leg pain that is not amenable to another surgery and is termed post laminectomy syndrome.
The spinal disc itself has a very slow metabolism and an extremely poor capability to heal itself. If an individual has a large disk herniation and undergoes surgery to remove it from pinching on a nerve, there exists a deficit in the remaining disk space that may present a significant future problem.
The remaining disc after a discectomy surgery may not be competent enough to withstand the shock being placed upon it during walking and running and twisting. The disc has sensory nerve endings in the outer part which can lead to chronic pain when irritated. It is very common after a discectomy surgery to end up with chronic and an aching back pain due to degeneration of the remaining disk.
Another problem that may be seen is arthritis of the facet joints. With an incompetent
remaining disc, it is unable to handle all of the stresses coming in on a daily basis. The stresses can be shifted backwards to the small facet joints of that level. These joints can undergo degeneration and cause significant back pain as a result.
Usually, this back pain is manageable with nonoperative treatments such as physical therapy, chiropractic treatment, and pain management medication and interventional procedures such as facet blocks. In the case of post-laminectomy syndrome, another surgery is not going to help. So nonsurgical methods including pain management medication, PT, chiropractic, massage may help and as a last resort – a spinal cord stimulator.
If a disc herniation recurrence at that level occurs (10% chance), it may become necessary to not only perform another discectomy, but to fuse that level to achieve pain relief in the legs and also in the back.
If you have had a previous discectomy surgery or a fusion procedure, and are now left with chronic back or leg pain, help is available. The California Pain Network connects those in pain with the best pain providers in the state. Simply fill out the contact form on this page or call (310) 626-1526 today for pain management Los Angeles trusts!