[Donald Corenman, MD, DC]

#27860

You need a new MRI to determine why you have continued and increased pain.

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.

[tine01]

#28059

Hi Dr Corenman,

Just a follow-up, my leg pain 2 weeks post-op subsides. My post-op MRI shows a buldge a mild indentation of the right S1 nerve root and it is also touching the left S1 nerve root. After the leg incident I feel much better with no pain. I undergone Physical Therapy at this time to strengthened my weak right leg post-op. I can do heel raises using my right leg which I cannot do post-op. But Doctor ordered EMG stating ” Chronic active radiculopathy L5-S1. No focal and diffuse neuropathy lower extremities, gastroc and tibialis anterior shows few polyphasic and reduced energy”. According to my surgeon weakness is mild. But my concern is 10 weeks post-op I am having low back pain without leg pain. Never had back pain before only sciatica. But both of my legs have tingling sensation and my left leg has a slight numb on my sole. Also, my upper back went stiff and has cramps also. MRI result of cervical MRI has mild buldge without impingement. I would really like to ask for your opinion.

Thanks

[Donald Corenman, MD, DC]

#28070

Lower back pain can occur after having a herniation and after a surgical decompression. Remember that the “jelly” cushion in the disc has partially extruded out of the disc and removed by surgery. There is less cushion in the disc and the tear of the disc wall that caused the herniation of the disc in the first place will also be painful. Hopefully, you are in physical therapy to condition your core muscles and give the disc some time to “settle”. The numbness of the sole of your left foot is residual from the injury to the S1 nerve. The weakness is worrisome but if there is no significant residual compression, only time will tell if this nerve will improve.

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.

[tine01]

#28079

Hi, I had a laminotomy/discectomy 2 1/2 montha ago. Post-op my right leg is weak and I cannot tip toe that much using this leg. 2 months after doctor orders EMG , stating more chronic, active radiculopathy affecting the L5-S1 nerve roots. No focal diffuse neuropathy. Gastroc and tibialis anterior is reduced with few polyphastic. What does this means? I can now do 10 calf raises as compared to 0-3 1-4 weeks post-op. I am scared that I might not regain my foot strength and that my leg weakness is the result of my surgery.

[Donald Corenman, MD, DC]

#28120

Was the leg weak prior to surgery? Sometimes, it is hard to ascertain weakness prior to surgery as the leg is so painful, you have a limp and that limp may or may not be due to weakness vs. pain. A good physical examination prior to surgery can differentiate the two.

Gastrocnemius muscle is innervated by the S1 nerve and Tibialis Anterior muscle is innervated by either L4 or L5 nerve so your weakness does not fit with an individual nerve compression. The L5-S1 level 90% of the time compresses only the S1 nerve so having two nerves involved is highly unusual. It is possible that a disc herniation could compress both nerves if the fragment was large enough and extended up at least 1.5 centimeters (one half inch) to the L5-S1 foramen which houses the L5 nerve.

Your ability to perform 10 calf raises now where before only 0-3 right after surgery indicates nerve root healing and is a very good sign. See https://neckandback.com/conditions/how-muscles-recover-from-nerve-injuries/.

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.

[Elevi25]

#32264

I hope this chain still exists. I am one day post microdiscectomy on my left L4/5. My previous symptoms were pain in my left buttocks and down my left leg.

I am still having these symptoms. Does that mean the operation yesterday was unsuccessful?

Thanks in advance.

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