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  • firemedic81
    Member
    Post count: 2

    I am a fire fighter in Texas and in may 2011 i injured my back lifting a patient into the ambulance. MRI shows an extrusion at L5, S1, have tried cortisone and steroid injections with some improvement. The Doctor is suggesting surgery, although from all the research i have done i can’t find any benefit to it. I have slight loss of motor function and only slight pain, often times it radiates midway down the anterior of my left leg, also slightly difficult to bend and touch my toes. My question, is surgery something that will help or cause more problems cause i don’t want to go through this again in 2 years. Would a second opinion from a neurosurgon be a good start? or should i continue with the injection as they do provide some comfort and seem to work.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8379

    You mention a herniation at L5-S1 which I assume is pressing on the S1 nerve. This nerve innervates the calf muscles (gastroc-soleus group) that pushes the foot down against the ground when walking. This muscle group is responsible for “push-off” at the end phase of gait and important for climbing stairs and also in your case, ladders. You mention weakness of these muscles. That by itself would be a consideration for surgery as decompression of the nerve root allows the best chance for strength recovery of a weak muscle.

    If the muscle weakness is not significant or you can live with it, surgery is then considered for pain relief. If you can live with and manage the pain with medications, therapy and occasional injections, you do not have to undergo surgery. However, if you have the pain for longer than six months without surgery and eventually decide to have surgery, the success rate for surgery is diminished by waiting so there are timely decisions to be made.

    Will surgery cause problems? There is a slight chance but the success rate should be at least 90% in most cases for relief of pain. You theoretically could have an infection, nerve injury or dural leak but these should be exceedingly rate in the hands of a good surgeon.

    There should be no difference between a good spine surgeon and a good neurosurgeon, so pick the surgeon who you feel most confident with if you choose surgery.

    Good luck on your decision.

    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.
    firemedic81
    Member
    Post count: 2

    Thank you for your time and information regarding my condition. I feel a little better knowing that but i still find a problem in finding a good surgeon that i can trust. When this first started there would be frequent times through out the day where i could hardly walk and the pain would be so bad that i would have to sit down almost in tears. after the first set of injections i received the pain had diminished significantly and i was able to resume my daily activities with minimal problems. the pain is still present and i am still unable to work due to company policy. I know this would be a standard procedure but i’m still concerned with nerve damage or possible lose of motor function to my legs. If you know or have heard of an really good surgeons in or around Houston Texas that i can contact, that information would be greatly appreciated. again, thank you for your time.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8379

    I cannot personally recommend any particular surgeon in Houston. I understand it is not easy to know who is good. Recommendations from prior patients is generally a good sign and possibly something positive from the internet can be helpful.

    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.
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