Bipul70ParticipantJune 28, 2021 at 4:14 amPost count: 1
Hi Dr. Corenman, Hope you are doing well.I had back pain for about a year and started feeling pain down the left leg towards end of 2019.Got MRI and it was L5/S1. The doctor recommended epidural injection, which helped the pain but started feeling numbness and pins & needles. It lasted for about couple of months before getting better up to the point where I had almost no pain. Just as I was getting back to normal I had another back flare up while trying to lift a rug and fell back to the excruciating sciatica pain. My surgeon suggested microdiscectomy which I said yes to without thinking too much due to the pain I was in.
Got Microdiscectomy done early February this year. No leg pain for about 2 weeks (I was in complete bed rest with few mins of walking every hour) but slowly the pain crept back in the leg but nowhere as bad as before. Started physio & returned to work week 4. I got back flare ups and mild sciatica pain once every couple of weeks which the surgeon put down to back and nerve still in recovery process.
However last week (5 months post op) my back started hurting really bad after a 2 hour drive and the sciatica pain started the very next day. Its getting worse everyday and the shooting pain moving down the leg giving me memories of the first time I had the excruciating pain (it’s not not reached that point but it’s moving down the leg). I had an MRI done last week (requested by my surgeon) which says below:Findings: There s loss of signal intensity from in the L5-S1 disc there is a posterior annular tear and some posterior disc bulgng more towards the right of midline. Minimal indentation on the theca! sac. There is some loss of signal intensity n the 1_5-S1 disc The other discs were of normal signal intensity and were intact. The canal was of good dimensions. No canal stenosis seen. There was a partial laminectomy Solving the left lamina of 1_5. Postsurgical changes noted in the soft tissues of the back to he left of midkhe. Post contrast there was enhancing tissue to the left of the spinous process extending through the surgical defect and enhancing tissue on be left lateral aspect the theca! sac and tissue enhancement extendrg u;) to the adjacent nerve root. Them was some fluid the left 1_5-S1 apophyseal joint. No abnormality seen in the cauda equine or cones. A very smaN Tarim cysts noted in be sacral canal.
Does this mean I have re-hearniated? My next appointment is about 10 days away but fearin— \/ it’ll get way worse before thatDonald Corenman, MD, DCModeratorJune 28, 2021 at 9:28 amPost count: 8455
According to this report, you have at least a seroma surrounding the root. The radiologist does not talk about the possibility of infection but of inflammation.
“Post contrast there was enhancing tissue to the left of the spinous process extending through the surgical defect and enhancing tissue on be left lateral aspect the theca! sac and tissue enhancement extendrg u;) to the adjacent nerve root”
He does not discuss nerve root displacement or tension on the root. This nerve pain might all be post-op inflammation/seroma but the jury is still out. I would consider lab tests to rule out infection and if “normal”, then an oral steroid for starters.
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