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  • AvatarLA_Frankie
    Participant
    Post count: 18

    Dr. C,

    MRI 10 weeks post-op, after re-herniation, states, “At L5-S1 again seen is a right subarticular disc protrusion resulting in severe right subarticular zone stenosis, not substantially changed from before. Again seen is displacement right traversing S1 nerve roots.”

    Symptoms are not debilitating as they were right before surgery, but they all too familiar. The shooting pain in gluteal, hips, hamstring, calf, etc. This is how it all began in February.

    *IF* I do nothing and leave the S1 nerve displaced and constantly subjected to daily irritation — not severe irritation I assume since symptoms are mild — could nerve damage become permanent?

    I feel as though my improvement has plateaued. Calf weakness has improved but not improving past 75% of the good leg. Radicular pain has subsided in intensity but still occurs daily.

    Could ‘waiting it out’ actually do more damage versus going back in for revision?

    Ty!
    Frankie

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7626

    Nerve compression by itself might be tolerable if there is no motor weakness. Without weakness, there can be some consequences to prolonged compression (some numbness and paresthesias-“pins and needles”) but generally these are tolerable and can fade over time. However, I draw the line at motor weakness as weakness is a problem you generally cannot compensate for and can significantly limit your normal day-to-day function. Even with a large herniation, you can still recover motor weakness but the chance of recovery is about 1/2 that of surgical decompression.

    “Could ‘waiting it out’ actually do more damage versus going back in for revision”? In the face of weakness, he answer is yes.

    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.
    AvatarLA_Frankie
    Participant
    Post count: 18

    Thank you for your reply.

    Is ‘displacement’ as described on the MRI report the same thing as compression?

    I definitely had compression the first time around with all the tell-tale signs such as pins and needles, numbness, weakness/pain in calf.

    But this time there are no pins and needles or numbness. Calf strength has recovered some in the 3 months following decompression. But seems like it has plateaued.

    I’m worried that if I leave the protrusion alone continuing to displace the nerve that damage to the nerve will worsen (as it did earlier this year) or possibly become permanent.

    Sincerely,
    Frank

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