[Chris86]

#28979

Now, 11 weeks post-op, I had the routine appointment with my surgeon. I told him about my remaining buttocks pain when doing certain movements (e.g. stretching the ham string, like when doing the slump test) and that my range of movements improves greatly throughout the day (slump test in the morning: barely possible, in the evening: much much better). Also told him that during the 11 weeks, my development was very slow. I would say it got a little better, but REALLY slowly.

He told me that after this time my nerve should be ok (just like what you told me some weeks ago, see above) but wound tissue around the nerve / disk still needs time to heal and stretch. He said that he would advise against an MRI at this point because of the fact that I’m generally much better than before and that I have a positive development throughout the day. He told me that I should at least wait the same amount of time I had the pain before (6 months).

After you told me that any nerve irritation should be gone after 12 weeks, I’m a bit unsure now. Is waiting still the best option or should my problems be gone by now and any further waiting is only postponing a real fix?

[Chris86]

#29231

Dear Dr. Corenman,

have you maybe overlooked my previous post? I would be very glad for a feedback. I have no problem to keep waiting for improvements, if that makes sense to you in addition to my surgeon. But I feel like I need a second opinion to calm down because it really feels like waiting for something that isn’t going to happen…

Thank you!

[Donald Corenman, MD, DC]

#29274

Sorry for the delay but I am just now available to answer.

He is generally correct that 12 weeks, a nerve root should have recovery but not always. It depends upon how severe the compression was, how significant your physical examination findings were and the length of time that the root was compressed. I would say if you were in my practice with impairing but not disabling symptoms at 3 months, I would order 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.

[Chris86]

#29396

No problem, thank you for replying!

My surgeon said that my compression was severe and also calcified (hope that is the correct word for it). After the OP he told me that it took much longer as the disc “material” was stuck to my nerve and had to be “pulled off” piece by piece. Also, I was in severe pain for half a year.

Physical exhamination findings, as far as I can describe them, where clear: Straight leg raise triggered at about 1cm above the ground. I immediately told the exhaminer to stop as soon as my leg was lifted off the bed. I was really very restricted in possible range of movements. No idea how I lived with that level of pain for 6 months from my current perspective…

These facts and the fact that at no point a re-herniation seems to have happened (no sudden worsening after surgery), are the reasons he explicitely disadvised against an MRI at this point. He urged me to wait at least for the same amount of time I was in pain in before, before thinking about further steps.

So, considering your advise and combining it with is, I would now wait for 2 more months. After that, I’ve waited nearly the same amount of time I was in pain in (~6 months) and would then push towards an MRI.

Do you think this would be a great mistake? From my understanding there’s nothing else that can be done – except the removal of a possible re-hernation – anyway, right?

If no re-herniation (and no other obvious problems) are visible on an MRI, there’s only the possibility of chronic nerve damage that, at this point, would only be addressed by waiting more, correct?

[Donald Corenman, MD, DC]

#29399

There are many different disorders that can cause continued pain including a seroma, a bone spur, foraminal stenosis, recurrent herniation and adhesions that can occur with continued pain. I would have you obtain a new MRI if you were in my practice.

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.

[nbassano82]

#30620

Hi Dr. Corenman

I had my l5/s1 done about 6 weeks ago. I felt very well for about 4 days post op. Then all my nerve pain came back much worse than before. I’ve had two MRI’s since then which both show a lot of improvement but don’t explain the worsening pain. I even got a epidural steroid injection to try and reduce the possible nerve inflammation but it hasn’t helped. The only thing that helps somewhat is gapapentin an muscle relaxers.

My surgeon offered to go back in and try to make a little more space by the nerve 1mm or so. Maybe wash the nerve out. How long should I wait until thinking about a potential revision.

Prior to surgery my pain was annoying but I could still do a lot. However now I’m limited to walking. Any other activities aggravate my pain. Even light stretching.

Thanks!
Nick

[Author]

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