L5-S1 Microdiscectomy post op

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teorudabah
Member

November 25, 2011 at 5:25 am

Post count: 3

#5153

Hi there,
I was in for a lumbar microdiscectomy at L5-S1 last thursday afternoon. My surgeon came around after I had come around from the anesthetic but I’ll be honest with you, I don’t remember anything! All I remember him saying was that the herniation was much larger than the MRI disk I had given him showed and that he had “shaved” some off which should help. Have tried calling since as I just had a few small questions, but no answer! Can’t believe I missed my opportunity to talk to him. Maybe you can help with a few questions?

– Having some tightness/burning down my leg the odd time but nothing you could compare to the pain before. Also get numbness in my foot the odd time. Is this anything to worry about or just normal for recovery after nerve exposure?

– How long should I stay off work? I work in IT so spend nearly 9hrs sitting at a desk in the day which possibly is what caused the herniated disc in the first place so just want to be sure before I go back. I was told six weeks by one nurse, 4 by another and 2 on the initial letter from the surgeons.

– Should I be lying for the majority of the day and walking when possible? Do I need to do physio at some stage?

– Am I ok to take Ibuprofen? The main pain I have at the moment is my muscles in lower to mid back seizing up. A friend who had the same op told me his surgeon recommended he stay away from ibuprofen as a pain killer as it can cause scar tissue to build up near the nerve?

Much appreciated,
Teo

Donald Corenman, MD, DC
Moderator

November 26, 2011 at 12:54 am

Post count: 8660

#5156

Short term memory always suffers immediately after anesthesia. I have had patients mad at me for not seeing them immediately post-op even after I had spent ten minutes talking with them in the recovery room.

I cannot answer for your surgeon but I will tell you what I would answer to my patients.

Tightness and some mild burning in the leg is not uncommon after a surgical decompression for a disc herniation. Most patients have had significant pain prior to the surgery and after the pain is gone, these symptoms are uncovered. The symptoms were actually present before the microdiscectomy but were not noticed because the searing pain covered these symptoms up. It might take as long as three months for these symptoms to fade away.

Intermittent numbness can take as long as six months to disappear. The area of numbness will shrink down over time.

I cannot speak for your surgeon as far as going back to work but for my patients, they can go back to a sedentary job within one week to as much as six weeks. It depends upon how well the symptoms are relieved and if the job allows frequent position changes and part time work in the beginning.

I want my patients to walk after surgery a reasonable distance. Short walks are better and multiple “laps” instead of one long walk are preferred. Sitting time is to tolerance.

Ibuprofen is OK to use after about one week from surgery. Ibuprofen will not cause scar tissue to form.

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.

teorudabah
Member

November 26, 2011 at 10:33 am

Post count: 3

#5159

Thanks so much for your advice, really helpful. My own doc still hasn’t come back to me so it’s been great to get a professional point of view. It’s a really great thing you are doing here for people. Thanks

teorudabah
Member

December 11, 2011 at 11:36 am

Post count: 3

#5203

Hi there,
Just another quick question relating to the my surgery described above. I am now 3.5 weeks post op and am now having sciatica pain not only in my left buttock as before but also in my right one from time to time(which i never had before, herniation was on the left). Is there any reason why this could be happening now on the right side? It’s only maybe a 4/10 level pain but is uncomfortable.
Thanks again,
Teo

Donald Corenman, MD, DC
Moderator

December 12, 2011 at 4:09 am

Post count: 8660

#5208

Pain in the same distribution 3 weeks after a microdiscectomy is not necessarily unusual. The compressed nerve can swell after the pressure is taken off and the swelling can take some time to dissipate. If that is the case, an oral steroid can be effective to reduce the swelling as long as you understand the potential side effects of oral steroids.

Pain in the opposite side is somewhat more unusual. Inflammation in the canal can affect the opposite nerve. If there is a post-operative hematoma (a small collection of blood that causes some nerve compression in the canal), that can cause this pain. A recurrent disc hernation can occasionally cause this type of pain. Infection can also produce these symptoms but most likely, significant back pain would also accompany an infection.

You need to contact your surgeon for further follow-up.

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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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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