Buttocks Pain After L4/L5, L5/S1 two level microdiscectomy

Tagged: Russian microdisectomy

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Agon234
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May 19, 2019 at 1:53 am

Post count: 2

#30459

Dr Corenman.

First I want to thank you for having a forum to ask questions.

I am living in Russia and just had this operation done at one of the State Hospitals. I fell the nerve pain gone however the muscles in my buttocks now have a lot of pain when I am walking. It is not a radiating pain as down the sciatic nerve but seems centralized to my upper buttocks. I had the operation on May 15. Since there aren’t any English speakers around a full understanding of what might happening isn’t really given.

I am wondering if this muscle pain might be from the nerve surgery or just the muscles being tired from having to accommodate to more support of my body. Any insight you could provide would be greatly appreciated.

Donald Corenman, MD, DC
Moderator

May 19, 2019 at 8:50 am

Post count: 8660

#30460

You note your buttocks pain with standing/walking but don’t note if it is only one side or both sides. What side is the buttocks pain on or is it both sides? Is pain equally distributed or is it more on one side? What side was the herniation and I will assume the decompression was only on one side? What symptoms did you have before the surgery and how have they changed?

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.

Agon234
Participant

May 19, 2019 at 9:22 am

Post count: 2

#30461

I will try and answer your questions as best as possible. Thank you for responding. It’s really scary when you can’t communicate with the people taking care of you without Google Translate.

What side is the buttocks pain on or is it both sides?

It’s on both sides when I lay down the pain is on the bottom of the buttocks like where the buttocks and the hip connect. I am guessing from stretching when laying down. Maybe nerve pain.

When walking the pain is in the top of the buttocks like towards the tailbone. It isn’t an excruciating pain but more like a feeling of pressure that slowly builds up and up as I walk.

Is pain equally distributed or is it more on one side?

The pain is pretty equally distributed between both types of pain the upper and lower.

What side was the herniation and I will assume the decompression was only on one side?

Actually this is the part where the doctor says it’s really rare. My L5/S1 was protruding to my right side where I had numbness all the way down to the toes. The skin sensation was still fine. I had lost reflexes and was only mobile for about 5 minutes before the pain was too much after the epidurals.

My L4/L5 hernia protrusion was to the left side and would cause sciatica pain depending on my movements down the buttocks and thigh. There was no numbness with this side. The L5/S1 herniation was significantly bigger than the L4/L5.

What symptoms did you have before the surgery and how have they changed?

Before the surgery I had numbness from the buttocks to the toes with pain development after walking on my right side. On my left side it would be sciatic pain in the buttocks to about half way down the thigh depending on movement. I also had numbness on the right side of my genitals.

After surgery there are some steps I can take without any pain. However after about 25 ft the pain stars to develop in the upper part of my buttocks. This pain grows gradually more with each step once it starts.

When laying down depending on my position I can feel pain in the area of the lower buttocks to the thigh. It is pretty severe but not debilitating pain. I also have some numbness now in both sides of my genitals. Before the surgery only the right side of my genitals had numbness.

Donald Corenman, MD, DC
Moderator

May 22, 2019 at 7:23 am

Post count: 8660

#30470

I am still unclear as to what surgery you had, Did you have bilateral surgery (both left and right at left L4-5 and L5-S1 right or did you only have the right L5-S1 level operated on?

A new MRI might be helpful if you can get your Russian surgeon to agree. I’m sorry but I don’t know the Russian system so can’t help you on suggestions to get a new MRI.

You might ask your surgeon to give you an oral steroid. I use dexamethasone 4mg twice a day for 5 days.

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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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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