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  • CCLi
    Member
    Post count: 2

    Dr Corenman,

    Thanks for having this forum and answering our questions.

    On 1/11/13 I had a microdiscectomy for a L5S1 9mm protrusion pressing on my right S1 nerve which was causing pain, numbness, and weakness in my right leg. I am male and 32. After the surgery the pain was gone, but numbness remained.

    On 1/20/13 I noticed that the sciatia was getting a bit worse in my right leg and was now in my left leg too! What could be causing the sciatia in my left leg? Is a re-herniation the most likely cause? And if so, when and should I get another MRI? If the pain is bearable, should I avoid a second microD?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    Mild increased pain sometime after a microdiscectomy is not uncommon. It doesn’t necessarily mean that you have a recurrent disc herniation even if you have opposite sided pain. If your pain is not impairing then you can give it some time to improve.

    You might ask your surgeon if he or she will give you an oral steroid. Even if there is a new small recurrent herniation but your symptoms are tolerable, time might reduce symptoms to a more tolerable level.

    If you have no motor weakness and you can tolerate the symptoms, you do not need another microdiscectomy. See the section on the website “When to have lower back surgery” for more information on this.

    Dr. Corenman

    AlbertDisuza
    Member
    Post count: 26

    A lot of time minor sciatica pain can be treated with physiotherapy and exercises. I have heard that certain stretching and back exercises can be great reliever to such pains. Doctor could you please throw some light on this and share what kind of exercises are beneficial and if they are a permanent solution.

    CCLi
    Member
    Post count: 2

    Thank for you for your response Dr. Your forums are an excellent resource for us in pain.

    I have motor reduction (as evidenced by the calf raise test), but had this before the surgery as well. If I have motor weakness and a slight reherniation on the same nerve and causing slight pain in the calf, do you suggest a second microD?

    A second question is, what criteria do you use in determining whether a second MRI is warranted after a first micoD?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    Motor weakness that was present both before and after the microdiscectomy you underwent (no motor recovery) is now difficult to use as an indication for surgery. If the motor weakness can be quantified after the initial surgery and now is worse than before, this qualifies for another MRI scan. That is, if there is new noticeable increased weakness by you or the surgeon. The surgeon might not be able to quantify the new weakness unless there was a record of how many repetitive heel or toe raises you were capable of in the chart.

    A second MRI is warranted after surgery in my opinion if the pain has increased to the point that it has become intolerable, the symptoms have changed or there are new physical examination findings that are unexplained.

    Dr. Corenman

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