[professorW]

#32958

Hi. I’m 10 days post op from a 360 fusion at L5/S1. In the hospital, had no leg pain, just back pain from incision. When I came home, this continued until day 6 post op. Then, I began having symptoms in my legs, but they are different from any sciatica I’ve ever had.

-It’s in both legs, and started when I had sat on the toilet for a moment, and stood up and had excruciating and worsening pain in both lower legs for about 10 seconds, then it would pass. Now I get the pain as soon as I sit on the toilet, and it worsens like this whenever I stand up.

-The exact same pain happens if I stand still for more than a few seconds. It begins 3 seconds within standing still, and within 15 seconds it is 10/10 pain. This will NOT go away until I start moving again.

-I called my surgeon, and his PA ordered five days of dexamethasone BID. I have taken three doses and no relief yet. Have you ever heard of such a presentation of sciatica? It is only in my lower legs, primarily calves, and only during these two activities.

[Donald Corenman, MD, DC]

#32963

The first thing to clear up is to make sure the post operative X-rays demonstrate the cage and hardware are in the correct position and are not impinging the nerve roots. The second is to use decadron as you have noted to see if this is simple inflammation that will clear with steroid. If symptoms persist after the steroid is completed, a new MRI would be helpful to make sure you don’t have a seroma (fluid collection) or some disc material that inadvertently pushed out into the canal during the ALIF portion of the procedure. Make sure also that this pain is not derived from blood clots in your legs (DVTs).

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.

[professorW]

#32964

Thanks. I have seen a little improvement from the steroids today, in terms of pain, but seem to have some weakness when I first start walking. Like I have to shuffle a moment to get going. If this continues even though the pain has eased some, i should still report that? If it’s a seroma or piece of disk I assume surgical intervention?

[Donald Corenman, MD, DC]

#32965

This may not be weakness but pain inhibition. After you “get going”, do you seem to be better?

Seromas can be aspirated through a needle, disc material needs to be surgically removed. DVTs need a venous ultrasound diagnosis.

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.

[professorW]

#32966

Yes once I get going I am able to walk. So it is probably inhibition.

The steroids seem to have helped with the leg pain a lot on the right, but much less on the left where the pain remains significant. If the left side doesn’t improve like the right, imagine an MRI would still be indicated?

[Donald Corenman, MD, DC]

#32972

If the left sided symptoms are still significant, in my practice this would warrant a new MRI,

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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