Tagged: Microdiscectomy post op pain
Linda1123ParticipantDecember 1, 2022 at 4:52 pmPost count: 7
Hello, I am 7 weeks post surgery for Microdiscectomy. L5 S1. I have mild disk degeneration as well. My nerves We’re compressed for a little over 2 years before I finally had surgery..
Immediately after surgery for about 10 days I felt fantastic! It’s been a bit of a roller coaster as far as recovery and the level of pain from day to day. The last few days have been horrible as far as the familiar burning sciatic pain down the leg. I have tried to do everything right as far as Bending lifting or twisting. I have been very careful. I make sure that I walk 30 to 45 minutes every day besides just around the house. Is it uncommon to have increased pain before Hopefully, eventually, pain free?
My surgeon and the nurses both said that they felt that my surgery was a success, there were no complications no surprises.
I’m just looking for confirmation if this kind of pain 7 weeks after surgery could be considered normal after having my nerves compressed for so long. I feel that if I understood the healing process better I could maybe be able to better handle this.
Thank you!Donald Corenman, MD, DCModeratorDecember 2, 2022 at 10:16 amPost count: 8455
It’s not uncommon to have root swelling after a surgical decompression causing recurrent leg pain.
The possible causes of increased leg pain after a period of relief post-microdiscectomy surgery are inflammation of the nerve, seroma, recurrent herniation and infection with much more rare conditions like facet fracture.
Inflammation is common after decompression of the root. A compressed structure that was injured will “swell” and become congested. Oral steroids and time are the best treatment.
Seroma is a common condition. Fluid exudes from surgical sites and can build up and congest and compresses the nerve root. Seromas typically resorb after some time but occasionally need to be aspirated by needle. This is diagnosed by MRI and treated by needle aspiration.
Recurrent herniation occurs in 15% of patients and normally increase pain significantly. Recurrent weakness and a “tighter” leg (SLR) are common. If the recurrence is not too large, sometimes an epidural injection can be helpful. A redo microdiscectomy is not uncommon in the face of a recurrent herniation.
Infection should be rare at less than 1% of all surgeries. Interestingly, many patients do not have fevers or chills but have increased back pain that translates to leg pain eventually. Lab tests are the beginning for diagnosis. Diagnosis is by lab tests and patient symptoms.
Dr. CorenmanLinda1123ParticipantDecember 6, 2022 at 12:05 pmPost count: 7
Thank you for your response..if I may have reherniated, would the pain be constant or could I have some good days and then bad ? On a day like I had yesterday, the burning pain down the leg was as bad as before surgery. Now today, although not pain free, it’s nothing even close to what I had yesterday. Maybe another MRI is a good idea. My PA doesn’t seem too concerned, however, I cannot live with the kind of pain I had. The PA told me that at 7 wks, most of her patients are 100%. With no pain. That was very discouraging to hear. Is that correct??
Thank you again
LindaLinda1123ParticipantDecember 13, 2022 at 8:30 pmPost count: 7
So I did have a follow up MRI yesterday and have found out that I have reherniated. Can imagine what I’ve done I have been so incredibly careful! Will they be able to go back in and do a revision most likely? And are revisions usually successful? Is there a way I can send you the MRI report ? Although I will be speaking to my doctor I’m sure within the next couple days, I always would like to know a second opinion and I value yours.
Thank you again, LindaDonald Corenman, MD, DCModeratorDecember 14, 2022 at 5:37 amPost count: 8455
You can cut and paste the MRI report here (after taking out identifying features). If the motor weakness is not worse, these can be treated with an epidural steroid injection. If not, a revision discectomy would be called for.
Dr. CorenmanLinda1123ParticipantDecember 14, 2022 at 10:28 amPost count: 7
Here is my report from my MRI on Monday…
3:46 0n &
Intervertebral disc: Right
lateral recess disc herniation
with extruded disc
fragment extending caudally
within the right lateral
recess epidural space to
the upper $1 vertebral level.
Facet joints: Moderate right
greater than left arthropathy
Spinal canal: Right latera
recess spinal canal
narrowing with compression
the descending right-sided
S1 nerve root
Neural foramen: Mild
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