[metallikat]

#32745

Also, over the years I had episodes of sciatica that were just pain in the back without radiating down leg, and I would get antalgia, sometimes deflected to the left, and sometimes deflected to the right. That makes me wonder if this protrusion has been there a long time.

[Donald Corenman, MD, DC]

#32746

Your new MRI notes: “Broad-based disc protrusion measure 5mm without significant central canal stenosis. Previously seen right subarticular disc extrusion has resolved. No significant foraminal stenosis.”
Your new MRI notes no significant compression as the herniated disc mass was successfully surgically removed. You do have a somewhat larger (5mm) broad based disc bulge but this radiologist does not seem too concerned with that and does not believe that this is causing root compression.

Weakness is a red-flag concern but can be caused by pain inhibition (inability to contract the muscle due to pain increases with contraction) which is not a neurological compression problem. Your MRI does not seem to trigger the need for immediate surgery.

Traction does not improve the canal size or restore the disc height in any meaningful way. “Protrusion” means the annulus has failed either by tear or stretch and is incompetent. Inflammation/irritation in the general region is caused by the surgery and takes some time to “calm down”.

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.

[metallikat]

#32751

The thing is, I am 100% sure I have neurological weakness. Every day since surgery I have tested leg strength by balancing against a wall and doing one-legged toe raises to test calves, and one-legged knee bends to test quads. I saw right leg steadily improve for three months after surgery, and left leg always had full strength. Now, for the last some weeks, both legs have definitely gotten weaker, and have subtly different sensation throughout that I know is neurological. And when I stand, both feet have developed a tendency to roll onto their outsides. This is definitely recent decline. My balance is still not too bad, but it has clearly declined. I can especially feel those same outside calf muscles not working right when I do toe raises as well. This, plus increased tingling and burning in both legs, permanent reduction in sensation in left heel which onset at same time as reduced sensation in middle three right toes, plus increased pain in back right on spine, something mid-line has to be an issue. I have no pain at all that would inhibit the toe raises and knee bend tests.

[Donald Corenman, MD, DC]

#32752

The motor-strength testing you are performing tests the S1 nerve (calf muscles) and the L3-4 nerves (quad strength). Also your comment; “And when I stand, both feet have developed a tendency to roll onto their outsides” notes weakness of the peroneal muscles which is an L5 enervated group.Your previous herniation compressed only the S1 nerve on one side.

The fact that you are progressively becoming weaker in multiple muscle groups serviced by different nerve roots is a real problem that you need a neurologist (not neurosurgeon) consult ASAP. There is a syndrome called Gullian Barre Syndrome that is an ascending “paralysis” due to an autoimmune phenomenon that is a possibility here. Your weakness in multiple muscle groups serviced by disparate nerves does not fit with your previous herniation or current MRI findings.

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.

[metallikat]

#32757

I will see a neurologist next week. But from the time of getting up after the first surgery, the right glute, right quad, and right hamstring all had a little weakness. Right calf had the most weakness and the foot would roll. So I definitely associate all of that with the surgery, or else it was decline just days before the surgery that I could not note due to being bedridden for 10 days.

Can you humor me for a moment? If the recent protrusion did significantly compress the spinal cord, could that cause these bilateral weaknesses and changes in sensation?

[metallikat]

#32759

And now that I think of it, even before surgery, I tried decompression by hanging from a Teeter Dex 2 (back extension exercise equipment) and both legs would totally fall asleep while on it.

[Author]

Posts