Postoperative Chemical Radiculitis Mimicking Recurrent Disc Herniation: A Case Report

Early recurrence of radicular pain after lumbar discectomy is commonly attributed to recurrent disc herniation; however, non-compressive inflammatory mechanisms such as chemical radiculitis should also be considered. We report the case of a 30-year-old patient who underwent L5-S1 discectomy for S1 radiculopathy with motor deficit, with an initially favorable postoperative course and complete pain relief. Three weeks later, the patient developed severe recurrent S1 radicular pain without any new neurological deficit. Magnetic resonance imaging suggested recurrent disc herniation, leading to surgical re-exploration, which revealed no evidence of recurrent herniation or hematoma but instead an inflamed and swollen S1 nerve root. The patient was subsequently managed conservatively, with progressive resolution of symptoms. This case highlights the importance of recognizing chemical radiculitis as a potential cause of early postoperative radicular pain to avoid unnecessary reoperation.