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  • davidjr74
    Post count: 1

    Okay around mid-January of 2011 I herniated a disc at the L5-S1. I don’t have a copy of my report but I actually have the link of my MRI image on wikipedia:

    It is pressing on the S1 nerve and since February I have had to deal with sciatic pain in my right buttocks and right leg. 95% of my pain is sciatic- there seems to be little to no pain in my lower back itself. I have problems sitting in one spot for very long and can’t bend at the waist much before pain stops me.

    So far I have gone through typical medications (Motrin, flexoril, etc), and physical therapy (stretches and a back traction table). I have also been given one epidural steroid injection.

    The injection itself helped relieve pain for a day or 2 but after 2 weeks I seem to be back to normal. Didn’t get worse or better. I have 2 more shots to receive and a visit with a surgeon about surgical options if these shots don’t work (which I don’t think they will, my problem seems to be a mechanical issue of a spinal nerve compression, not inflammation).

    My questions are is there anything I can do to help heal my recovery up that I haven’t already tried? And what are the main differences between a microdisectomy and a regular discectomy?

    Donald Corenman, MD, DC
    Post count: 8507

    By the single MRI image, it appears you have a disc herniation at L5-S1 on the right compressing your S1 nerve. You have already had physical therapy and medication as well as one epidural steroid injection. The injection gave you short term temporary relief and you are scheduled for two more.

    In regards to treatment, as long as you have no motor weakness, you have some options. You can test your motor strength by holding onto a counter, lifting up your left leg and doing ten heel raises rather quickly on your right leg. You can compare to your left leg if you have questions regarding weakness. If you fatigue rather quickly and cannot perform ten heel raises on your right leg, there is motor weakness present and the options diminish.

    If there is no motor weakness, you can try another injection. If you gain the same limited results as the first one, a third epidural is not advised.

    Surgery is a good option for continuing leg pain. A discectomy is the removal of the herniated fragment under direct visualization (the surgeon can use magnifying loops) vs. a microdiscectomy in which a microscope is used to visualize the surgery. See the website under lumbar herniated disc for a surgical video of an actual microdiscectomy.

    Dr. Corenman

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