[Iklepickle]

#35958

Good Afternoon

I hope you are well and had a good Christmas and New year?

It’s been a while since I have posted and I would like to ask if possible some questions about medical terms that have been used in communications in response to concerns relating to what actually was done and happened during my primary surgery and my re do surgery 9 days afterwards.

I wasn’t sure whether to post the questions that are confusing me all in one thread or seperatly and have decided to ask the questions I really need your help with seperatly, so anyone else confused or struggling to understand the medical terminology and what is involved in such as a lumbar Microdiscectomy or laminectomy or decompression can easily find if they also are confused.

My question is really important in my case as the terms Microdiscectomy and decompression via a Microdiscectomy have been recorded in discussions about what surgery I had agreed to and was told needed.

Prior to my elective day case procedure in March 2017 my husband and I were told that the surgery I needed was a “Left Sided L5 S1 Microdiscectomy” the surgery I was listed for and recorded on my patient care plan also record’s the procedure/operation as “left sided L5 S1 Microdiscectomy”

The surgery performed and completely unaware had been performed until my emergency readmission 9 days later resulting in my return to theatre for a Redo Microdiscectomy ” is recorded as “L5 S1 Decompression surgery”. No discectomy

When I woke up in recovery from my primary surgery I initially was unable to feel my legs, was on oxygen and coughing my guts up. The loss of feeling in my legs was short lived and I quickly after telling staff in pacu started to get feeling back in prickle pins and needles sensations.
I then experienced sudden onset of acute constant stabbing pain in my left and right groin. The pain was agonasing and went into the middle of lower back were my surgical incision area was. I also couldn’t feel the last two fingers on my left hand and remember shaking my hand trying to wake them up and get feeling back.

Embarrassed to say I wet myself and couldn’t stop it while on the trolley and had to be cleaned up.

I was given intravenous fentanyl in doses totaling 200 ml as well as iv paracetamol, diamorphine

My surgery listed in my medical records for theatre booking time needed is 90min

However the Theatre record shows I was under x-ray at 07.45 am and in recovery at 11:25 am
Over 3 hours

During my surgery it is noted help had to be called,up proned, difficult to ventilate, small plug yellow secretions bronchospasms X3 on intubation and extubation anaesthesia deepened, ketamin, proprofol, sabutamol by nebuliser given.

Disc palpated no longer compressing so disc space not entered

I was in recovery from 11.25am until 1.45 and notes record advise ward admission and emergency physio

I received oxogen as I was taken to the ward by portable oxygen and coughing that much I wet myself and unable to reach the buzzer walked to the door of my side room wet through and in agony. Thankfully my husband arrived and daughter in law so helped me get changed.

I was discharged the next day unaware no discectomy performed in agony and on opiates no medication review or anything

At home I was unable to put any weight through my left big toe, couldn’t sit, stand lie down, I was a mess

I was readmitted on the 8th April having been discharged on the 31st march

Repeat MRI records l5 S1 broadbased central disc extrusion impinging nerve root not dissimilar to pre op exam sep 16 no discectomy performed

I was then told I had had a laminectomy without discectomy and now needed redo surgery Microdiscectomy and decompression. Before going into surgery second time I struggled to wee had to push to get a dribble
I woke up from the second procedure pain free however on returning home I started with sores on my chin my lower legs back of thighs. I had cellulitis, abscesses and multiple vitamin deficiencies iron, vitamin d, . I was unable to go for physio as I was so poorly and scared the infection get in my surgical site,

My bloods all over, ddimmer through the roof, x-ray showed no DVT and bilateral changes lower loves particular left lower lobe athetelatosis sorry can’t spell. Had blood thinning injections

Repeat admissions , gastroenteritis, vertigo, and then I started with pins and needles in my left leg which travelled up my left arm,side of my face and tongue.i couldn’t talk, arm weak unaware of were was , being sick mood changes

This happened three times. The third time I was told possible infective episode and given anti virals . The neoro thought hemiplegic migraines

Now I have lost muscle in my bottom, it’s square, my legs are tiny like sticks my back is rigid flextion in all direction limited particular if lean forward slightly and have to hold that position my back really aches hurts .

I can’t walk far. Walk fine to begin with but get slowe and slower and pain calf back ache
Rest sitting helps

Most recent MRI shows

L5 S1 note Microdiscectomy/laminectomy seen odema possible soft tissue in contact with left S1 nerve root at site of origin left nerve root marginally thickened in comparison to right. Loss of lordosis

I have been diagnosed with neorogenic bladder and bowel

But told the primary surgery was always meant to be decompression surgery with or without discectomy and until in surgery difficult to no if discectomy needed and as adequate decompression achieved it was decided that entering did. Space could worsey pain and symptoms

That the terms decompression and discectomy were used interchangeabley and that the purpose of the surgery was to decompress the nerve root via a Microdiscectomy also known as Micro-decompression

That unfortunately I woke up in alot of pain and although this isn’t common it does happen and that the second surgery involved a discectomy and a more thorough decompression something and I would have been no different and still needed a second surgery and that my surgery first went without complications and the details of the surgery would be discussed in outpatient r6 weeks later and only if complications would i have been told discectomy not performed and thst it is standard practice that ig during surgery the disc considered not significant would be left by many. I’m UK based please can you make any sense of this

[Donald Corenman, MD, DC]

#35960

Boy, there is much to digest and much of it does not make sense. You first note: “The loss of feeling in my legs was short lived ….I then experienced sudden onset of acute constant stabbing pain in my left and right groin. The pain was agonasing and went into the middle of lower back were my surgical incision area was. I also couldn’t feel the last two fingers on my left hand and remember shaking my hand trying to wake them up and get feeling back”. You are describing two different conditions, the unilateral surgical site pain and ulnar neuropathy from cubital tunnel compression.

You then note; “I woke up from the second procedure pain free however on returning home I started with sores on my chin my lower legs back of thighs. I had cellulitis, abscesses and multiple vitamin deficiencies iron, vitamin d, . I was unable to go for physio as I was so poorly and scared the infection get in my surgical site”. This most likely speaks to your physical condition at the time and preexisting medical problems along with the demands of healing.

“L5 S1 note Microdiscectomy/laminectomy seen odema possible soft tissue in contact with left S1 nerve root at site of origin left nerve root marginally thickened in comparison to right”. This does not sound like there is remaining compression but I can’t tell what the original compression was present and the reason for your two surgeries.

“I have been diagnosed with neorogenic bladder and bowel”. This makes no sense as the canal generally needs bilateral compression to create cauda equina syndrome.

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.

[Author]

Posts