kcarpenterParticipantAugust 18, 2020 at 5:00 pmPost count: 3
Good evening Dr. Corenman! I went approximately 4 months with a broad based central herniation at L5-S1. I tried all conservative measures until I couldn’t tolerate the symptoms anymore. Prior to surgery I had extreme debilitating sciatic pain on the right side with weakness in my calf and foot. I was unable to do more than 2 heel raises. I had pain with any position that nothing relieved I opted to proceed with open discectomy. After surgery I did not feel the intense pain down my leg. Just mainly the surgical site pain. I was on Gabapentin 300 mg twice a day for two weeks and tapered off. About week 2-3 I noticed slight sciatic pain in glute and upper hamstring if my posture is not proper. I’m unsure if I just didn’t notice this right after surgery because I didn’t have full ROM yet and/or the Gabapentin was masking the symptoms. For instance if I slouch any little bit or sometimes look up at the sky etc I can feel a twinge. Its not getting worse but not getting better. I am now 7 weeks post op and two days ago started having tingling sensations down my entire right leg, thigh, calf and foot. I called my surgeon and have a follow up next week but I am certainly concerned about reherniation as NSAIDS and medrol dose pack do not seem to be alleviating the symptoms. Is this just a normal process of nerve healing?kcarpenterParticipantAugust 18, 2020 at 5:58 pmPost count: 3
I should add also that before surgery sneezing, coughing and even bearing down to have a BM caused significant pain. Post op I am able to do all of this pain free so farDonald Corenman, MD, DCModeratorAugust 19, 2020 at 8:33 pmPost count: 8465
You note “4 months with a broad based central herniation at L5-S1” and “weakness in my calf and foot. I was unable to do more than 2 heel raises”. This worries me as motor weakness due to prolonged compression might not fully recover after decompression.
The fact that a medrol dose pack did not seem to be alleviating the symptoms is somewhat concerning. With symptoms somewhat progressing 7 weeks out from the surgery, I think that an MRI would be a good idea.
Dr. CorenmankcarpenterParticipantOctober 14, 2020 at 8:57 amPost count: 3
Good Morning again Dr. Corenman. Sorry for the delayed response. I am now 3.5 months post op and I am still having intermittent feelings of “numbness”, pins and needles in my right leg and foot. It feels as if my leg/foot is asleep and trying to wake up so to speak. It feels numb but I can feel any type of touch along my skin. These symptoms seem to dissipate during the night but as the day goes on returns in a waxing and waning fashion. I have very mild glute pain with certain movements that cause nerve tension. I have since follow up with my neurosurgeon and had an MRI a month ago which read as the following
“Status post right hemilaminectomy at L5-S1. There is bandlike enhancement in the laminectomy defect and in the right lateral recess with encasement of the S1 nerve root. Findings are concerning for fibrosis. Disc bulging with a superimposed left paracentral disc protrusion/extrusion otherwise contributes to mild bilateral foraminal narrowing and mild narrowing of the left later recess at this level”
I have been put back on neurontin 300mg TID for symptom relief and am supposed to follow back up in 2 months. My symptoms have not been touched at all by this and I really do not want to keep taking more meds if it can be avoided. Do you have any other suggestion?Donald Corenman, MD, DCModeratorOctober 15, 2020 at 7:08 amPost count: 8465
You might have scar formation (epidural fibrosis) that is constricting the nerve. It is a good sign that your symptoms abate when you rest but increase when you are up and around as that can occasionally indicate continued mechanical irritation. I would say the next step is to consider an epidural steroid injection (TFESI).
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