Pain after lumbar surgery?
Review your options.
A careful second opinion reviews your symptoms, previous surgery and imaging. Another operation is not automatically the next step.
Request a Lumbar Review (Form)Telehealth or in person. Your request does not confirm an appointment.
A careful review before a surgical decision.
Persistent symptoms after lumbar surgery can have more than one cause. Your evaluation connects symptoms, examination, prior operative history and current imaging before discussing nonsurgical care, further diagnostic work or revision surgery when appropriate.
Bring your imaging
Bring available lumbar imaging and prior operative reports.
Discuss the alternatives
Review previous care, nonsurgical options, expected benefits, limitations and risks.
Choose the appropriate next step
Surgery is discussed when symptoms, examination and imaging support it. No outcome is guaranteed.
Experience & careful judgment
Meet Dr. Cornacchia.
Louis G. Cornacchia III, M.D., FAANS, FACS
A board-certified neurosurgeon with 30 years of spinal cord stimulation experience.
More about Dr. Cornacchia’s experience and SCS device decisions
Spinal cord stimulation experience
Experienced neurosurgical judgment before device decisions.
A spinal cord stimulator is a medical device decision, but it is also a diagnosis decision. Apteum’s evaluation is designed to clarify whether SCS is reasonable, whether another spine problem needs attention, and what goals should define success for you.
He works with a community of experienced pain-management doctors and with Medtronic, Boston Scientific, and other manufacturers.
Manufacturer relationships do not imply endorsement of a specific device for every patient. Brand and system selection should be based on clinical need, anatomy, MRI considerations, programming goals, prior device history, and shared decision-making.
Additional systems as clinically appropriateYour evaluation focuses on understanding why symptoms persisted or returned after lumbar surgery, reviewing prior care and explaining which options deserve consideration.
Your evaluation focuses on your diagnosis, prior care and goals. Discuss the expected benefits, limitations, risks and alternatives before choosing your next step. An evaluation is not a commitment to surgery or an implant.
Read Dr. Cornacchia’s training and experience →How spinal cord stimulation works
Watch this explanation created by Dr. Cornacchia. Spinal cord stimulation is one option for selected patients after evaluation; it is not appropriate for every cause of pain and does not replace the discussion of the treatment on this page.
Full revision lumbar evaluation, treatment, risks and FAQs
Revision Lumbar Surgery
If your symptoms continued or returned after a lumbar discectomy, decompression, laminectomy, fusion, or another low-back procedure, the next step is not automatically another surgery.
Your request does not confirm an appointment.
Still in pain after surgery?
Another operation is not automatically the next step. A careful second opinion reviews your symptoms, previous surgery, and imaging to clarify which options deserve consideration.
- Listen
Your history, symptoms, and goals.
- Review
Your imaging and previous treatment.
- Explain
Your options and the next steps.
Information for your evaluation
Still in Pain After Lumbar Surgery?
Talk with Apteum about persistent back pain, sciatica, leg symptoms, failed spinal fusion concerns, or recurrent pain after a prior low-back operation.
If your symptoms continued or returned after a lumbar discectomy, decompression, laminectomy, fusion, or another low-back procedure, the next step is not automatically another surgery. Apteum Spine provides a focused second-opinion evaluation to understand what is happening, review your prior surgery and current imaging, and help you make a responsible decision.
Someone will answer no matter what time you call—either a member of our staff or Jessie, our highly trained AI assistant. We’ll help you get started now.
When Symptoms Continue After Low-Back Surgery
Persistent or recurrent low-back pain after surgery, sciatica, leg pain, numbness, weakness, or walking limitation can be frustrating and confusing. Patients often search for terms like failed back surgery, failed spinal fusion, pain after spinal fusion, or revision spine surgery because they need clarity about what went wrong and what can be done next.
Symptoms can come from many causes. Three common reasons evaluated in revision lumbar care include symptomatic nonunion or pseudarthrosis after fusion, recurrent or residual stenosis or nerve compression including recurrent disc herniation, and symptomatic adjacent-segment degeneration. Other possible reasons include hardware problems, instability or alignment change, scar tissue, hip or sacroiliac problems, peripheral nerve problems, or other pain sources.
Imaging alone, or pain that persists after surgery, does not automatically mean another operation is needed. A careful evaluation connects your symptoms, examination, prior operative history, and imaging before any recommendation is made.
Start With a Second Opinion
Revision decisions require time and judgment. Apteum focuses on direct physician evaluation, a clear explanation of your findings, and a plan that may include nonsurgical care, further diagnostic workup, or revision surgery only when appropriate.
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A personal note from Dr. Cornacchia
If This Sounds Like You, I Want to See You.
If you have had low-back pain with shooting leg pain for more than four months — and you have already tried a dozen or more physical therapy sessions, epidural steroid injections, or other appropriate treatment without sufficient relief — I will examine you personally and review your MRI, X-rays and CT scan.
If you have already had lumbar surgery and the pain never went away — or it came back — that is particularly important for me to understand.
What is causing your pain?
Is there a problem that surgery can actually correct?
How likely is surgery to meaningfully help you?
If surgery is not the right answer, what should you do instead?
Within a one-hour evaluation, our goal is for you to understand what we believe is wrong, what your treatment choices are, and what surgery can — and cannot — reasonably be expected to do.
— Louis G. Cornacchia, MD
The Role of a Revision Lumbar Spine Surgeon
A revision lumbar spine surgeon evaluates problems that persist or develop after a previous low-back operation. The surgeon reviews your symptom timeline, prior operative reports, examination, and updated imaging to identify whether there is a surgically correctable problem.
Common reasons for revision evaluation include a fusion that has not healed fully, recurrent or residual pressure on a nerve, recurrent disc herniation, symptomatic changes at a neighboring level, hardware concerns, instability, or alignment change. Scar tissue and other pain generators can be present after surgery, but they are not always problems that another operation can correct.
What a Revision Lumbar Evaluation Includes
- ✓ Review of prior lumbar surgery and operative reports
- ✓ Review of symptom timeline, therapy, injections, and changes after surgery
- ✓ Review of current MRI, CT, standing X-rays, or flexion-extension X-rays when indicated
- ✓ Focused examination of back pain, leg symptoms, strength, and walking limitation
- ✓ Discussion of surgical and nonsurgical options, including whether more diagnostic workup is needed
Revision Options When Surgery Is Appropriate
When another procedure is truly necessary, the plan should be based on the specific diagnosis—not simply the fact that prior surgery did not provide the expected relief. Depending on the findings, revision lumbar spine surgery may involve individualized decompression, repeat discectomy, revision or extension fusion, hardware evaluation or revision, treatment of adjacent-level disease, or another plan tailored to the anatomy and symptoms.
- ✓ Nonsurgical care when another operation is not the best next step
- ✓ Decompression for recurrent or residual nerve pressure when symptoms and imaging correlate
- ✓ Repeat discectomy for selected recurrent disc herniations
- ✓ Revision or extension fusion for symptomatic nonunion, instability, or adjacent-level disease
- ✓ Hardware evaluation or revision when implants contribute to symptoms or mechanical problems
Insurance and Records Help Before Your Visit
Revision patients often have prior records, imaging discs, operative reports, therapy notes, injection history, and insurance questions. When you call, either a member of our staff or Jessie, our highly trained AI assistant, can help you get started now and understand the next step for requesting an evaluation. Apteum can review the insurance information you provide and explain scheduling requirements whenever possible.
No insurance coverage, authorization, or payment outcome is guaranteed on this page. The goal is to reduce confusion before your consultation and help you arrive prepared.
Robotic-Assisted Technology When Clinically Appropriate
Some revision lumbar cases require careful planning around prior hardware, altered anatomy, fusion status, or adjacent-level disease. When surgery is appropriate, robotic-assisted planning or navigation may be considered for selected instrumented lumbar procedures as part of an individualized surgical strategy.
Robotic technology is not necessary for every patient and does not replace clinical judgment. The decision depends on your anatomy, diagnosis, imaging, prior surgery, and the goals and risks of the procedure being considered.
Why Revision Patients Seek a Second Opinion at Apteum Spine
Revision decisions require time, clarity, and careful judgment. Apteum Spine is an independent private-practice spine surgery practice focused on direct physician evaluation, patient advocacy, and individualized decision-making. Your evaluation is not a rushed review of a scan. It is a detailed discussion of your symptoms, prior procedure, current imaging, and realistic options—including when another operation is not the right next step.
- ✓ Independent second-opinion perspective
- ✓ Direct physician evaluation of prior surgery and current findings
- ✓ Individualized treatment planning, including conservative care when appropriate
- ✓ Clear discussion of what surgery can and cannot reasonably address
A Careful Review With Dr. Louis G. Cornacchia
For patients considering revision lumbar spine surgery, the most important question is not simply whether another surgery can be done. It is what is causing the symptoms, whether the finding is surgically correctable, and what the most responsible next step should be. Dr. Cornacchia and Apteum Spine help patients understand whether symptoms after prior lumbar surgery may be related to nerve compression, fusion status, adjacent-segment degeneration, hardware concerns, scar tissue, or another issue.
Symptoms Reviewed
Persistent low-back pain
Sciatica and leg pain
Numbness or weakness
Walking limitation
New or recurrent symptoms after surgery
Possible Causes
Nonunion or pseudarthrosis
Recurrent stenosis or disc herniation
Adjacent-level degeneration
Hardware problems or instability
Other pain sources
Related Services
Revision spine surgery
Lumbar spine surgery
Spinal fusion
Second opinions
Frequently Asked Questions
Why am I still hurting?
There are many reasons pain can continue after lumbar surgery. The nerve may still be compressed, the fusion may not have healed, another level may now be causing trouble, the hardware may be contributing, or the pain may be coming from something the original operation was never designed to fix. The first job is not to schedule another surgery. It is to understand why you still hurt.
Did my fusion actually heal?
That is one of the first questions I want answered. A fusion can look acceptable on one study and still require a closer look. I review the prior operation and the imaging, and when appropriate use CT, standing X-rays, or flexion-extension X-rays to determine whether the bones actually fused and whether the construct is stable.
Do I need another operation?
Maybe—but that should never be assumed simply because you still have pain. Before recommending another operation, I want to identify a problem that can realistically be corrected and make sure the symptoms, examination, and imaging tell the same story. Sometimes the right answer is another operation. Sometimes it is not.
Is revision surgery riskier?
Revision surgery can be more complex because anatomy has been changed by the first operation and there may be scar tissue, implants, altered landmarks, or a fusion that did not heal as expected. That makes careful planning especially important. The actual risk depends on what needs to be revised and on the individual patient.
What if my surgeon says nothing more can be done?
That may be correct—but it is reasonable to understand why. A second opinion is not a promise that another operation will help. It is a fresh review of what was done, what has healed, what has not, what is causing the symptoms now, and whether there is a realistic treatment option that has not been considered.
What can surgery realistically improve—and what can’t it improve?
Surgery works best when there is a clearly defined structural problem that matches the symptoms and can be corrected. It may improve nerve pain, weakness, walking limitation, instability, or pain caused by a specific mechanical problem. It cannot guarantee that every source of chronic pain will disappear. I want patients to understand both sides before deciding on another operation.
Does persistent pain mean my lumbar surgery failed?
Not always. Persistent or recurrent symptoms can come from several causes, and not all require another operation. A focused second-opinion evaluation helps determine whether symptoms are related to nerve compression, fusion status, hardware, adjacent-segment degeneration, scar tissue, or another pain source.
What should I bring to a revision lumbar spine consultation?
If available, bring prior operative reports, imaging discs or reports, injection records, therapy history, and a timeline of symptoms before and after surgery. Current MRI, CT, standing X-rays, or flexion-extension X-rays may be helpful when indicated. The team can also advise what records may be useful when you request an appointment.
Is revision fusion the only option after prior lumbar surgery?
No. The right plan depends on the source of the symptoms and the anatomy involved. Options may include nonsurgical care, additional diagnostic workup, decompression, repeat discectomy, revision or extension fusion, hardware revision, or treatment of an adjacent level when appropriate. Imaging findings must be interpreted in the context of symptoms and examination.
Can robotic technology help with revision lumbar surgery?
Robotic-assisted planning or navigation may be considered for selected instrumented lumbar procedures, especially when prior surgery has changed the anatomy. It is not necessary for every patient and does not replace careful diagnosis or surgical judgment.
When should symptoms after low-back surgery be treated urgently?
Seek urgent or emergency care for new bowel or bladder dysfunction, saddle numbness, rapidly worsening leg weakness, fever with severe postoperative pain, or any sudden neurological change.
This page is for general education and is not a substitute for medical advice, diagnosis, or treatment. For urgent symptoms, call 911 or go to the nearest emergency room.
Get Clarity Before Another Low-Back Operation
If you are dealing with persistent low-back pain, sciatica, leg numbness, weakness, walking limitation, suspected nonunion, recurrent stenosis, recurrent disc herniation, adjacent-level degeneration, or concerns about lumbar hardware, Apteum Spine can help you understand your options.
Take your next step with clarity.
Request an evaluation of your condition and options. Our team will contact you to discuss your request and arrange the next step.
Your request does not confirm an appointment.
Understand your options after lumbar surgery.
Request an evaluation to review your symptoms, imaging, goals and prior treatment history.
The team will contact you to discuss your request. No outcome is guaranteed.
Persistent nerve pain: another option to discuss
For selected patients after a careful evaluation, spinal cord stimulation may be an option. Explore spinal cord stimulation evaluation at Apteum Spine.