Had l5-s1 disk herniated with cauda equina syndrome 3 months before, i just did my mri and think the disc slightly herniated again, do i need surgery?

Hard to say: This is impossible to answer without getting more details. If you had cauda equina syndrome, surgery is definitiely indicated. However, not every disc herniation requires surgery. In fact many disc herniations do no not cause symptoms. The best way to answer this question is to see your doctor who treated you and get his or her opinion about the need for further surgery. Good luck.

Risk of recurrent : Disc herniation is only 5%. If the MRI was done without contrast, it is difficult to distinguish between scar tissue post op & a recurrent disc herniation. Less than 1% of disc herniations lead to cauda equina syndrome and only 10% of all disc herniations need surgery. The need for surgery depends on response to non op care and degree & type of symptoms.

If no pain...no: If your symptoms are minimal or nonexistent at this point, you do not need surgery. The fact that you had cauda equina syndrome indicates that the prior disc herniation was very large and it is fortunate you had the care you did at the time. The fact that it looks like it may be "slightly" herniated again does not mean that you absolutely need surgery particularly if you have minimal symtoms.