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My husband is 3 weeks post op from microdiskectomy of his L4 and L5. He had sudden onset of pain 33 days prior to operation with no known source. Spent those 33 days flat on his stomach in agony. His pain was radiating from right hip, down to right foot, with extreme pain in his knee, shin, and calf. Sometimes it would radiate from his groin down the inner thigh. Immediately after surgery he had slight improvement of symptoms. He was able to lay on his back and sit for very short time frames. However, the pain never went away. Two weeks post op he had recovered some muscle strength and was walking well with the aid of his walker. The Dr. Kept saying his nerve needed time to heal and would feel better in time. 4 days ago he took a turn for the worse and he is now back to pre surgery pain levels. I brought him to the ER yesterday. He was admitted and had another MRI done last night. The doctor came in this morning to tell us he saw no evidence of re herniation, and nothing else to explain why he is still in so much pain. We are both scared to death that he will have to live with this pain for the rest of his life. The surgeon is not giving us any other answers besides it just takes time. I am watching my very active 41 year old husband in agony and tears with no end in sight.
Is there anything else we can do or tell the doctor to check for? I just need a little hope.
I should add that he is currently taking large doses of gabapentin and percocet. They have also put him on torradol and steroids since we have been in the hospital. They will keep him at least until tomorrow before discharging him. But I don’t know how we will cope with this level of pain at home. He is so depressed and hopeless.It is possible that the nerve was severely injured by the initial disc herniation and is only very slowly healing. It is possible that an intracanal fragment was missed or that there is an unrecognized disc fragment in the far lateral position that was not appreciated. Normally, after a microdiscectomy, there is significant and wonderful pain relief. Your husband needs a careful evaluation and re-review of his MRI by another radiologist.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.Thank you so much for your reply. I’m sorry I did not update sooner. We were in the hospital 4 days after the above post. His surgeon came in on day 3 and said she did think there may be a sequestered fragment in the L4 region, but that the surgery to explore the area may result in destabilzation of the spine, and fusion. His first surgery was to the right of the spine, I believe the far lateral position. He received a nerve block on 2/6/18 which improved the pain slightly and lasted about a week. He just had another on Monday, 3/11/18. This one only gave relief for 1 day.
We are now at the point of making the decision to allow her to go in and explore the area again to see if there is another fragment. Are we making the right decision? He has been out of work for 3 months and our short term disability is now down to 60% of salary. Our experience has been so atypical that I’m scared we are making a bad choice. He needs this to work, and there is no guarantee it will. The surgeon doesn’t seem convinced that the surgery will relieve his pain. I don’t know if this is simply because she has to prepare us for that possibility, or if she truly doesn’t think it will work.
Have you seen very many cases where there was a far lateral herniation AND a central herniation?
I want to thank you for providing this forum for people like my husband and I. It is a wealth of knowledge and comfort to many people. Even if I don’t get another response from you I am thankful for your commitment to helping people in need. You have gone above and beyond what most surgeons would.
Thank you!
You shouldn’t need an “exploration” as the MRI findings should be clear. Is there a sequestered fragment? Where was the original surgery? Was it intracanal or in the far lateral position? Were these fragments at two different levels? Is there a fragment that is new, has migrated or was missed? Many questions need to be answered.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.The original surgery was in the far right lateral position. The sequestered fragment was missed on the MRI review by the radiologist, and the surgeon who was on call the weekend he returned to the hospital. On Monday morning his surgeon returned and said she believed she could see an intracanal sequestered fragment. She offered to do surgery the same week, but it was phrased as “exploratory” because the fragment was not clearly visible on the MRI. In the original surgery his doctor stated that she removed “3 large pieces of disk” from the area. My understanding was that it was only on one level. It is not clear if the fragment believed to remain is new, migrated or missed. I believe it was missed because it is so hard to see and the pain was believed to be from the far lateral impingement.
We declined surgery that day because she was so unsure of what was there, and opted to try nerve blocks instead. Obviously they have not worked.
I just found some paperwork that shows his original diagnosis as: Right L4 Radiculopathy – L4-5 disc herniation.
Surgery – Right L4-5 far lateral diskectomy.
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