Viewing 6 posts - 49 through 54 (of 55 total)
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  • Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    “L5-S1:…moderate-sized right paracentral and subarticular disc protrusion, and facet hypertrophy result in moderate overall narrowing of the right lateral recess with abutment of the descending right S1 nerve root”. I assume this was the MRI prior to your surgery.

    This would fit with inability to walk on your toes (heel raise loss) and pain radiating to your right buttocks and down the leg. Bilateral symmetrical foot burning fits better with peripheral neuropathy (discussed previously) and sacral pain is consistent with pudendal neuropathy-not the S1 root compression.

    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.
    zlwalker
    Participant
    Post count: 31

    Dr. Corenman,

    Thanks for your response! In terms of pudendal neuropathy, what could be causing that issue and what would be a possible solution?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Neuropathy can be mechanically based like carpel tunnel syndrome or inflammatory/degenerative like peripheral neuropathy. I think pudendal neuropathy is of the latter origin but no one knows exactly how this disorder develops. Epidural steroid injections can help in some cases.

    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.
    zlwalker
    Participant
    Post count: 31

    Dr. Corenman,

    I did get referred to a second neurosurgeon. My foot tingling has increased significantly, and I am starting to have the shooting pains down my leg, which I know is coming from either my L4 or L5 herniation. I am guessing that one of those two discs is impinging on a nerve, thus causing the neuropathy we have discussed (I am obviously just guessing).

    My pain management doctor told me that I will need an EMG, but there’s most likely a pinched nerve. He does believe that an epidural could fix the issue, but he also noted that another microdiscectomy might be needed at a lower level. I am kind of at a loss with all of the information presented.

    Is it possible for an epidural to relieve a pinched nerve permanently? Also, have you ever seen this type of scenario where a successful surgery occurs at one level (thoracic), but then a second one is needed in the same year for a different area? It just feels so overwhelming!

    Thanks for all you do.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    All of your nerve compression at L4-5 was mild while the L5-S1 level was “moderate” so my money would be on the L5-S1 level. If you have no significant motor weakness, then an EMG will be helpful. Using discriminatory diagnostic nerve blocks would be a useful tool to diagnose the origin of pain.

    An epidural will not help nerve compression motor weakness but can help pain. It won’t “decompress the nerve root” Unfortunately, disc herniations can occur multiple times in different locations in one year with each needing to be addressed surgically.

    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.
    zlwalker
    Participant
    Post count: 31

    Dr. Corenman,

    I am back after a long hiatus! I have recently started having pain again with my surgery sites from my thoracic discectomy. I had rib pain and stomach pain from my previous surgery, and those have started again. However, the twist is that I am a cross country coach, and I have had a ton of meets in a short amount of time. I have had about eight meets in three weeks with minimal rest in-between. I have these pains, and they are getting worse, but I also know I have done a lot of work recently that my body is not used to. I had an epidural done in February at this site, and it seemed to work well, so it could also be wearing off.

    I guess my question is the following: Should I be concerned about a reherniation? I am worried because I have the same pains as before, but I know that I have pushed myself too much recently as well. I am trying to discern the difference between a reherniation and just a flare-up. Do you have any advice on what my next steps should be or general reherniation symptoms? I know that reherniation symptoms are close to the original symptoms, but I am just lost because I have low level pain instead of aggressive levels of pain. I also have more burning and tingling in my feet than before with this pain as well. Any thoughts or helpful advice?

    Thanks!

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