[tk2007]

#28841

My husband is 36 years old and has had back problems since he was a teenager. He was diagnosed with degerative disc disease at 15 years old. A few years ago he went down on his right side and after a while it improved. In May he woke up one day and couldn’t sit or walk more than a few feet without being in execruiating pain. After jumping through all of the hoops we finally got him in with an orthopedic PA June 9th. She scheduled him for a follow up appointment the following Monday and decided to by pass the insurance waiting time and have him go to the ER the following morning for a direct admit microdiscectomy on L4/L5. She basically said it would immediately relieve his pain and most patients walk out of the surgery feeling 100% better. The only downfall is 6 weeks of wearing a brace to prevent bending and twisting. The surgery was June 12th, 2018. Immediately after surgery he was still in pain. He was in tears being wheeled down to our vehicle post surgery. They released him with prescriptions for Gabapentin (300 mg 3x/day), Oxycodone (5 mg as needed), and Cyclobenzoprine (10 mg 3x/ day). Within 2 or 3 days the burning in his leg started. He was in horrible pain. Prior to surgery laying day he was 100% relieved of pain. Now even laying down didn’t help. The pain just didn’t go away and now it felt like his leg was ripping in half. I called the doctor and the PA called me back and upped his dose of Gabapentin to 600 mg 3x/day. Still no releif. At his 2 week follow up, my husband still can’t walk more than a few feet or sit at all. She said then that she may have bruised his nerve during surgery. She said stay the course and that it’s just the nerve regenerating. It’s something that can happen. Prior to this appointment we noticed my husband could not raise his foot up or move his big toe. He did not have this problem prior to the surgery. We brought this concern up and she said she wanted to start physical therapy and do electrical shock to “Wake the nerve up”. His dose of gabapentin was increased to 900 mg 3x/day. We started physical therapy 3 x a week and therapy said that his symptoms are from nerve damage at the L5/S1 disc and they seem to think it’s may not be fixable. We saw his primary care doctor to see if we could get a new MRI. Of course insurance denied it. Is this all normal? Or should be be concerned. The gabapentin isn’t helping him. Pain meds aren’t helping. He’s basically restricted to laying flat on his back 23 hours a day and still having horrible pain in his leg even when he’s laying flat on his back.

[tk2007]

#28842

I forgot a few details..
Procedure was a left lumbar laminectomy, lumbar 4-5 with microdiscectomy, medial facetectomy, foraminotomy (left).

MRI prior to surgery:
L3-4:Mild diffuse annular bulge. There is a broad-based central disc protrusion. Narrow AP diameter of the lumbar spinal canal due to short pedicles. There is moderate spinal stenosis with mild bilateral subarticular narrowing Inferior foraminal narrowing, right greater than left.

L4-5: Large left paramidline disc extrusion with inferior migration occupying the left lateral ses L5. Compression o the L5 root in the lateral recess is noted. There is moderate to severe spinal stenosis. Mild to moderate right lateral recess narrowing due to facet and disc changes.

L5-S1: Mild difuse annular bulge with central protrusion. Flattening along ventral thecal sac CSF and contact o the right greater than left S1 nerve root sleeve.

The PA also says he should get injections for bursitis.

[Donald Corenman, MD, DC]

#28844

Increased pain and new onset motor deficit (weakness) after a surgery deserves an immediate new MRI in my opinion unless there is some obvious reason for this pain and weakness.

Your comments; “Prior to this appointment we noticed my husband could not raise his foot up or move his big toe. She said then that she may have bruised his nerve during surgery. He did not have this problem prior to the surgery”. Yes, the nerve root could have been injured by retraction but you need to know there is nothing to correct surgically like a missed fragment of disc, a spur or anything that could cause nerve compression.

I would make sure this surgeon does everything she can to make sure there is nothing correctable.

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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