Cases: Two cases of herpetic neuralgia after lumbar fusion are reported. Although in one case the diagnosis was evident and treatment promptly initiated, the second exhibited a less typical presentation of neuralgia predating the cutaneous rash leading to a misdiagnosis of persistent nerve root stenosis, with additional surgeries and a longer hospital stay.
Conclusion: The cases presented highlight why postoperative neuralgia should be approached carefully and systematically investigated. Although rare, postoperative neuralgia may occur as a consequence of postoperative herpes zoster infection. Failure to promptly diagnose this condition may lead to unnecessary surgery that has associated risks and morbidity.