3 Weeks Post Microdiscectomy Pain

Tagged: Back pain symptoms after a microdiscectomy

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zzab
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December 22, 2020 at 1:09 pm

Post count: 23

#33489

Hi Doc,

Met with a new surgeon a few weeks ago and he does not believe I a have re-herniated. Instead he believes I am having discogenic pain. Overall I have been doing okay, no where near 100% but functional.

I am now concerned regarding a nerve feeling I have started having in my right leg, which was the non-operative side. Before and after surgery I never once had any nerve sensations in my right leg which spans a period of 2 years. The pain was always my left leg. Yesterday I started noticing a slight trace of something near my right upper glute. This morning I tested pulling on my spinal cord by sitting in a chair and flexing my neck forward. This amplified the pain in my right leg.

My MRI states “4.5mm posterior central/left paracentral disc protrusion. Disc material encroaches on the left greater than right subarticular zones near the descending L5 nerve root but without clear contact. Mild bilateral neural foraminal stenosis without exiting nerve root contact.” Since my fall I have not had any nerve pain on my left side, only periodic numbness. 3 surgeons I have seen do not believe I have re-herniated but all do agree I still have a bit of stenosis at L4/L5. Any idea on why I might be having this pain on my non-operative leg. Any chance this is mechanical crosstalk even at 7 months post op?

Donald Corenman, MD, DC
Moderator

December 24, 2020 at 7:56 am

Post count: 8660

#33497

Crosstalk due to cord tract crossover is the most likely culprit.

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.

zzab
Participant

February 25, 2021 at 1:40 pm

Post count: 23

#33652

Hi Doc,

It has been a while but I have finally got to the bottom of most of my issues. I recently flew out to see a trainer who specializes in low back rehab. The majority of his work is with well known professional athletes so I trust his judgement given the caliber of clients he works with. As I have discussed with you on here, at 4 months post op of my L4/L5 md I felt 100%. No back pain, no nerve pain, no numbness and was back to living completely normal. A little past the 4 month mark I had that fall off a tree and have not been the same since.

The trainer diagnosed with me with lower lumbar instability and lack of lower abdominal function/respiration. He does not see a re-herniation although I do still have a 4mm protrusion. Additionally a 3rd surgeon I saw before him had me take a flexion/extension X-Ray which showed a tiny bit of instability at my operated level which I was told is common after an md. I still have plenty of disc height left and no noticeable vertebra slippage on my MRI.

The trainer gave me some breathing exercises along with other stability exercises that finally got that knife in my back feeling to go away. I have seen a drastic improvement in pain during these two months which I am thankful for. I was told my rehab will have to continue for roughly 2 years so I am still in the early stages.

I am still struggling in one area in which I hope you can advise on. I still get periodic numbness and occasional muscle twitching in both legs. No nerve pain thankfully. The second I fell off the tree my left foot became hot and numb. Prior to my fall numbness had been gone for months and I never had muscle twitching. The numbness and twitching is not permeant either. I would say 80-90% of my day it is not there but sometimes the numbness can linger for hours on end. This has improved since seeing this new trainer but I do worry about permanent nerve damage since it appears daily at some point. What do you think is going on? Is there a chance I have permanent nerve damage or will this likely diminish over the next year as I continue to stabilize? My MD was 9 months ago.

Donald Corenman, MD, DC
Moderator

February 27, 2021 at 8:06 am

Post count: 8660

#33661

Generally ,nerve twitching that lasts for multiple months after a fall (on top of a prior microdiscectomy) is not nerve injury related, especially if the twitching is in the opposite leg. You could have some mild permanent nerve damage but you should be able to overlook these mild symptoms. If these symptoms really bother you, you can try some supplements such as Magnesium or Quinine. Ask you primary doctor what would be appropriate for you.

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.

zzab
Participant

February 27, 2021 at 9:08 am

Post count: 23

#33663

What dosage of magnesium and quinine would you recommended?

Donald Corenman, MD, DC
Moderator

February 27, 2021 at 10:53 am

Post count: 8660

#33664

Please ask your PCP.

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.
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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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