• Information
• Publications
  • Brain and Spine Booklets
  • Forthcoming titles
  • Get involved publications
  • Case studies
• Glossary
• Neurological centres
• Headstrong
• Information Access toolkit
• Communication skills project

|

Occasionally, symptoms are simply no better after surgery. Sometimes, after initial improvement, pain may recur. The surgeon will then re-evaluate matters. There may have been an initial diagnostic error or a fragment of herniated disc material may have been missed during surgery. On other occasions, despite adequate decompression in the first place, further disc material prolapses. This is known as a recurrent herniation. A number of options are available if surgery is unsuccessful.

Repeat investigation
MRI imaging is the best means of re-investigation and is often accompanied by an injection into a vein to help distinguish post-operative changes from other features on the scan. Any of the other investigations described in the earlier sections of this booklet may also be recommended on occasions.

Revisional surgery
An obvious missed or recurrent disc herniation may lead the surgeon to recommend re-exploration of the spine. The decision to carry out further surgery has to be considered carefully because, statistically, the chances of a second operation succeeding when a first failed are not particularly high and they decline with each successive operation.

Pain relief clinics
When a surgeon recommends referral to a ‘pain clinic’ this will often seem like an admission of failure. To some extent this is true, but a responsible surgeon will not go on pursuing surgery if it’s unlikely to help the patient. Pain relief clinics offer a variety of treatments which can help relieve symptoms in many cases.