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  • Dweber
    Participant
    Post count: 3

    Firstly thank you Dr Corenman, your website has been super helpful (long time reader and lurker) and the fact you take the time to reply is amazing.

    I will keep it brief and to the point as best I can

    M(38) ex athlete (rowing/crew) – non smoker/otherwise very healthy

    had MD on L5-S1 October 2020 – nothing in particular caused it. Over the course of a week I couldn’t walk or sit and after 8 weeks it was really bad but no foot drop etc

    After surgery everything was going fine (even started light machine weights at the gym at week 10-12..nothing more exciting then some bicep curls) then at 3.5 month mark (again feeling great) I went to the beach (live In florida) and I left something in my car (a bucket with a few water bottles in it) so I jogged back to go get it maybe 500m round trip total. I used to crank out 5-10mile runs several times a week just before the injury in October

    The following day I had lower back pain about a 4/10 (took prednisone and it went away in a few days ) but I developed much more numbness in my original affected foot (left) and also some pain in my right foot which before had not been effected at all. And my left glute would twitch all the time

    I had a second MRI taken and it does not look like I re-herniated it (the radiologist couldn’t rule it 100% out however it was unlikely and the Neuro looked at the CD and said I didnt). My Neuro told me to just get off my feet and decompress my spine.

    I, like many sit down for work (a lot of driving) and at 6 weeks since that beach moment I started to develop occasional pain 4-6/10 in the bottom of my left foot (causing me to let out a light yelp when I was driving) with my glute randomly twitching again (it had stopped by week 3 after the re-injury)

    Wondering if you might have any nuggets of information. My neuro suggested that if it is still acting up that perhaps trying an injection (though I am told they aren’t as effective after an MD due to scar tissue).

    I live in the USA by byself with the rest of my family in Europe and there is no way I could survive a 10 hr flight home presently and not that it matters to you but I haven’t seen my parents for over a year and they are very much older and im concerned for their health etc. Before I reinjured it at the beach 6 or so weeks ago I for sure would have been fine on a flight of that length

    Any suggestions would be great.

    Thank you and all the best

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    You might have reherniated a small fragment which can be easy to miss on a repeat MRI. Did you get gadolinium in an IV during the procedure? If there is not a recurrent fragment present, I would consider an epidural steroid injection (TFESI-see https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic/).

    Dr. Corenman

    Dweber
    Participant
    Post count: 3

    Thank you Dr Corenman for replying, I can only imagine how busy you are.

    My PCP was the one to order the repeat MRI and they did not do it with contrast/Gadolinium, just a regular old MRI. The radiologist report did recommend to 100% rule out a reherniation to repeat the MRI with contrast.

    I have a follow up appointment with my Neurosurgeon on Monday – are there any questions you would recommend I ask?? (currently at 5 months post op on march 16th)

    Just an idea but if you had a charity fund etc on here I would happily donate to your cause of choice for your helpful replies. thank you

    Thank you again

    the report for the L5/S1
    The large extruded disc fragment present on the prior study has been resected with a new left laminectomy defect. There is abnormal soft tissue surrounding the left lateral and anterolateral thecal sack as well as the origin of the left S1 nerve root. Soft tissue extends into the left neural foramen. increased signal intensity along the posterior annual margin extending into the left neural foreman is noted. difficult to exclude a recurrent foramina disc herniation given this appearance without IV contrast as granulation tissue may sometimes simulate the appearance of a recurrent disc herniation. prominent transverse processes of L5 are noted but no definite sacralisation . Sacroilac spurring noted with osseous bridging on the right

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    I would recommend an MRI with gadolinium to different recurrent herniation from epidural scar formation.

    Dr. Corenman

    Dweber
    Participant
    Post count: 3

    Thanks for the input – I will keep you updated on the progress

    Thank you

    D

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    Thanks,

    Dr. Corenman

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