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  • Dallasbranton
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    Post count: 1

    I have had 4 microdiscectomies at l5/s1. At times my butt feels like it is going to fall off. My first 2 surgeries were in 2006. At that time the pain radiated down my right leg. Then the pain came back in my left leg when I was 6mos pregnant in 2012. After I delivered by C-section I had my other 2 surgeries.(10-17-12 & 12-19-12) Now I am having pain down both legs. I am confused about my last MRI(3-12-13). My Dr. is wanting to do a fusion. will that help. He gave me the option to try steroid injection first. will that help or should I just go with another surgery?

    Comparison is made to examination from November 12, 2012.

    Findings- Images again intervertebral disc space narrowing with disc desiccation at the level of l5/s1. A degree of left paracentral disc protrusion causing effacement of the lateral recess on the left side appears to be stable. There is very minimal encroachment to the anterior aspect of the spinal canal without evidence for high-grade spinal canal stenosis. No significant neural foraminal canal stenosis is evident. At the level of L1-L2, L2-L3, L3-L4, and L4-L5, there is no significant spinal canal or neural foraminal canal stenosis. There is some mild endplate change involving l5/s1. The remainder of the marrow signal of the lumbar spine is unremarkable. No evidence for avascular necrosis involving the visualized proximal femurs. Visualized retroperitoneal structures demonstrated no acute abnormality. Following the administration of intravenous contrast, there is no significant enhancement.

    Impression- Stable left paracentral disc bulge causing abutment of the lateral recess on the left side abutting the traversing S1 nerve root without evidence for significant neural foraminal canal stenosis or spinal canal stenosis. There is a degree of enhancement along the more lateral aspect which may be related to scarring.

    Could you please explain

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    The problem with multiple disc herniations is that the nerve becomes injured with each herniation and the more herniations that occur, the more the injury “adds up”. The nerve eventually can become “battered” and develop chronic changes that cause chronic pain. See the section under “chronic radiculopathy” to understand this concept.

    “Butt pain” can occur from this chronic radiculopathy but can also occur from the degenerative nature of the disc itself. One test that can help evaluate this is the discogram (see website for description). A positive test (reproduction of the buttocks pain) may indicate that a fusion will help the symptoms of buttocks pain.

    Dr. Corenman

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