Revision spine surgery is care for people who still have neck or back problems after a prior spine operation. Sometimes pain, numbness, or weakness never fully settled. Sometimes symptoms came back months or years later. Sometimes a new problem showed up next to an old repair.
Dr. Nicholas J. Clark, MD — a Mayo- and HSS-trained orthopedic spine surgeon at HSS at NCH in Naples — evaluates these cases for patients across Southwest Florida. The first job is understanding why you still hurt. Surgery is not automatic.
When another operation is the right next step, Dr. Clark plans the approach around your anatomy, your prior surgery, and your goals. That often includes minimally invasive (MIS), percutaneous, and robotic techniques when they fit the patient and the pathology. When a safer or more complete fix needs a traditional open revision, that is what we discuss — not every revision is MIS or robotic.
Who it's for
This page is for adults who:
Had prior neck or back surgery and still have pain, nerve symptoms, or limited function
Were told they may need a “redo,” hardware revision, or further decompression or fusion
Want a second opinion before deciding on another operation
Prefer a clear, plain-language plan — including nonoperative options when those still make sense
Common situations people bring in (general education, not a diagnosis): ongoing nerve compression, recurrent disc herniation, stenosis that progressed, issues related to prior fusion or implants, or symptoms at a level next to prior work. Exact causes vary. Your history and imaging matter more than any label on a webpage.
Not advertised here: IME or workers’ compensation evaluations.
How evaluation works
A good revision plan starts with records, not assumptions.
History and exam — What was done before, what helped, what did not, and what limits you now.
Prior imaging and operative notes — Bring what you have (CDs, portals, reports). New studies are ordered only when they change the plan.
Match symptoms to anatomy — The goal is to find a treatable source of pain or nerve pressure, not to “operate on the MRI.”
Nonoperative options first when appropriate — Therapy, medications, injections, and activity changes still help many people after prior surgery.
Shared decision — If surgery can reasonably help, we talk through approaches, recovery, and realistic goals in plain language.
Second opinions are welcome. You do not need to commit to surgery to get a thoughtful review.
Approaches when surgery is needed
Revision surgery is not one procedure. The operation depends on the problem — decompression, disc work, fusion revision or extension, implant-related work, or a combination.
How we choose the approach
MIS / tubular / percutaneous techniques — Used when appropriate for the correct patient and pathology: smaller working corridors, less disruption to soft tissue when that still lets us do the job safely.
Robotic guidance and navigation — Used when they add precision for targeting and hardware placement in selected cases — not as a blanket for every revision.
Open revision — Used when needed: scar, complex anatomy, prior implants, deformity, or the need for wider exposure can make an open approach the better (or only) fit.
Honest framing: MIS, percutaneous, and robotic tools are part of how Dr. Clark revises spines when they fit. They are not promised for every patient. The right approach is the one that treats your problem with the least unnecessary tissue disruption — which sometimes still means open surgery.
When fusion is discussed, Dr. Clark still prefers motion-preserving options when they are safe and suitable. Prior fusion, instability, or collapsed disc levels may mean fusion (or revising/extending a fusion) is the better fit. Related approaches on this site include MIS TLIF, MIS LLIF, MIS ALIF, and cervical total disc replacement when motion sparing still applies. For herniated disc or stenosis patterns, see also MIS microdiscectomy and MIS decompression.
Learn more about the overall MIS philosophy: Minimally invasive spine surgery.
Recovery expectations
Recovery after revision is individual. Prior surgery, scar tissue, levels treated, and whether the case is decompression-only vs fusion all change the timeline.
In general:
Some selected MIS or percutaneous cases may still be outpatient or shorter-stay; others need a hospital stay — especially open or multi-level revision.
Early walking is usually encouraged as cleared by the team.
Activity limits, bracing (if used), and physical therapy are set case by case.
Full return to work, sport, or travel depends on healing and the type of revision — ask for a timeline that fits your plan, not a one-size promise.
This page is educational. It is not personal medical advice. Your postoperative instructions come from Dr. Clark's team after your evaluation.
Why Dr. Clark / HSS at NCH
Fellowship-trained orthopedic spine surgeon (Hospital for Special Surgery); orthopedic residency at Mayo Clinic
Practice focus: minimally invasive, navigation, and robotic spine care, including revision when it is the right next step
Bias toward the least invasive plan that still solves the problem — and toward motion preservation when possible
Based at HSS at NCH, Naples — serving Naples, Estero, Bonita Springs, Fort Myers, and the wider SWFL community
Collaborative team including Jorge Monje, APRN
More background: About Dr. Clark. Conditions we commonly evaluate: spine conditions (e.g. spinal stenosis, herniated disc, spondylolisthesis, neck and back pain).
If prior spine surgery did not give you the relief you hoped for — or you want a second look before another operation — we are happy to review your case.
Book an appointment or call the surgery scheduler at 239-624-0306.
Office: 11190 Health Park Blvd, Building 2-2102, Naples, FL
Email: nicholasjclarkmd@gmail.com
Revision Spine Surgery
Revision spine surgery cares for people with ongoing neck or back problems after a prior spine operation. Dr. Clark uses MIS, percutaneous, or robotic techniques when they fit — open when needed.