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  • jayc2019
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    Post count: 1

    hello Dr Corenman,

    it started with a pain between on the left side between the calf and the foot (left leg). when standing more than 30 min the pain goes all over to my left side of the back and the longer i stand it even goes more.

    i had 2 cortisone injection within 20 days with no positive results, physiotherapy (a bit of relief), lyrica 2x25mg helped better. the pain started to increase more. i decided to have an MRI. it shows a disc hernia on L4/L5 (both sides) and L5/S1 on right side. i have seen 2 surgeons and both told me it is an hernia on the L5 left. i decided to remove it with endoscopic as being the faster recovery. two days after surgery i started having burning on my left side of my back and the pain on my legs never changed. i had another MRI after surgery and it shows that hernia is gone. the doctor told me i should wait more because it needs time. now it is already 7 weeks after surgery and i am on 3x75mg daily and cannot work. sitting a bit better now as i could sit more time but standing after 30 min the pain starts.

    short history of my back: i had before 4 disc hernia surgeries l4/L5 and L5/S1, last one was year 2000 endoscopic before the one i had on 17 jan, 2019. now L4/L5 and L5/S1 between the vertebra is little space and almost collapsed. do you think that might be the reason of this pain in my nerve. do you think i have DDD ? maybe stenosis as well?

    i would appreciate your kind comment

    thank you

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    Endoscopic microdiscectomy is not the “minimally invasive” and safe procedure that it is advertised as such. There is very little room in the canal for the nerve roots and a disc herniation causes significant crowding which is why the pain and numbness occurs in the first place. Putting a scope in the canal through the foramen will crowd the nerve even more and the nerve has to be manipulated through the scope to get to the disc herniation. The canal is not enlarged to make more room as is in a typical microdisectomy.

    The reason you have no significant pain in the first day or two is that steroid and narcotics are placed nest to the nerve root after the endoscopic microdiscectomy so only when these “wear off” do you feel the discomfort.

    If you have discal collapse, you could have foraminal stenosis as the nerve exit hole narrows considerably with loss of disc height.

    See: https://neckandback.com/conditions/lumbar-foraminal-stenosis-collapse/ and https://neckandback.com/conditions/chronic-radiculopathy/

    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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