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  • Donald Corenman
    Keymaster
    Post count: 52

    Dear Sir, I am a 25 year Master’s student (Male) from India. I had a complain of Low back Pain since last 1 year which started due to heavy weight handling. Introductory treatment includes few medicines and Physiotherapy Exercises, showing good response. As the scenario of pain was continuing I had an MRI which shows L5-S1 disc bulge. After that also I was quite good with regular exercises.Until and unless its too much paining I avoid taking pain killer tablet. For last few days the situation is getting worse as I am not able to stand properly/straight without the support of LS Belt. Doctor suggest me surgery where they will remove the disc from that very portion. Do I seriously need a surgery at this point of time. Please advise me. My Height: 5 ft 5 inch, weight: 65 kg, a bit fatty, Age:25 years. Also I like to know whether the surgery (if taken) may have any prolonged effect in my career life where I need to serve an IT industry probably as a Software Developer.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    Surgery is necessary for four reasons in the lumbar spine. Nerve compression tha causes motor weakness in important muscle groups, cauda equina syndrome (which you do not have- see website), increasing deformity and the most common reason- pain that you cannot tolerate.

    I will assume that you do not have motor weakness (which would be revealed by an examination) and have no signficant deformity. My question to you is do you have pain you cannot tolerate? If the answer is yes and you have failed a course of physical therapy and injections- then you are a surgical candidate. If the answer is no- you do not need surgery.

    If you are a surgical candidate, then the question is where the pain is located. If it is back pain only (in the center of your back), you need a work-up for the cause of back pain. If it is leg pain and the examination correlates with the MRI findings (herniated disc) you would be a candidate for a microdiscectomy.

    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.
    malikfida
    Member
    Post count: 25

    respected SIR
    I malik fida 25 years from pakistan I had done laminectomy on 14 december 2011
    as on MRI report I have L5S1 disc protrusion. sir by profession I am dental surgeon
    and untill now I am facing difficulty in ward work and having slight leg pain,SIR i
    just want to know that do you recommend me for ward work(dentistry)?
    waiting 4 ur helpfull reply.
    wishing u all the best.thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    My understanding is that you underwent surgery at L5-S1 for “disc protrusion”. Did you have a bilateral or unilateral decompression? What were the symptoms preop and what are the results post-op? For example, did you have left leg pain radiating from the buttocks to the foot with an intensity of 8 over 10 which is now lessened to a 2 over 10?

    What are the current symptoms that make ward work difficult? Do you have any weakness? Do you have any lower back pain?

    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.
    malikfida
    Member
    Post count: 25

    Sir i had this condition unilateral on right side and microdisectomy is done.
    pre operative condition was I have lower back pain radiating to the right buttock and
    down the leg to the foot, the pain was excruciating and cutting type along with significant
    numbness,My post operative condition is good pain had covered by 2 and 10, numbness is still there, I primary objective is whether in this condition I continue my ward work(dentistry)
    as there is sitting alittle bending and tilting in ward work, I am extremely anxoius about recurency that might not happen, SIR moreover after my duty in the dental hospital I have slight pain in the butt area radiating downward,SIR I need your kind advice what should I do I continue my duty or stop it? thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    It appears that you had a good result from surgery. Your leg pain has improved significantly. The numbness can be present for as much as 6 months and will slowly fade away. Try not to pay attention to it.

    Recurrence rates for disc herniations are in the neighborhood of 10%. There is a slight increase if you are an athlete. If another herniation occurs- the solution is another microdiscectomy so don’t be too concerned. Many professional athletes have had a microdiscetomy and have returned to competitive sports.

    I think you should continue your ward work. Work on your core strength for prevention of further back problems. (See video on core strength on web site). The one position that puts the disc at risk is BLT (bending and lifting while twisting). Try not to twist when you bend and you can mitigate the risks.

    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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