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  • arshad80
    Member
    Post count: 3

    Hello Dr Corenman,

    Thanks for creating and maintaining this spine encyclopedia, it is definitely helping people like me living in pain.
    My question, I am 32 years old i had a MicroDiscectomy surgery done in 2008 because of Sciatica L5/S1 on right leg and weakness
    main reason i was over weight 232 pounds and i had very stiff muscles with undiagnosed Hypothyroid.
    by the time i started taking thyroid medication it was too late and i was suffering pain for over 8 months and couldn’t work and i had to go for surgery. the surgery went successful and rehab was done for next 6 months using exercises
    i changed my life style and started gym and lost my weight to 185 pounds with 6ft height and i was doing elliptical for 40 minutes every day
    just 2 months ago i started weights training and on 5th of july i lift some weights around 80 pounds and i felt some thing in my back and now it has been almost a month i am on bed. I can not sit and walk for more than 10 minutes or go on elliptical for longer period then 8 minutes.
    I feel wound like feeling in my lower back if i sit for more than 30 minutes
    and when i walk i feel pain in my back and thighs.
    if i dont take pain anti inflammatory drugs given by family doctor i have burning sensation in my both thighs more on the right side.
    My MRI is on 20th of this month.
    The good part is that after the 21st of july i started my lower back exercises again and i spend 30 minutes twice every day stretching and strengthening the core
    and inversion 15 minutes twice every day
    but this doesn’t help reduce my pain in sitting or walking or the burning sensation. The pain goes maximum to my thighs / right knee. and on the left thigh middle. I am stretching thigh front / back muscle but doesn’t help

    I would like to get your advise and help?

    Thanks in advance

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    Congratulations on your weight loss and fitness gain! This will be better for you in function and longevity over time.

    In regards to your new symptoms. more likely than not you have a new tear of a disc or a recurrent disc herniation. The MRI will be revealing and then you can make decisions regarding the treatment.

    Dr. Corenman

    arshad80
    Member
    Post count: 3

    Hello Doctor, Thanks for your reply.
    It has been almost month and half I am posting question for regarding my back.
    This is my MRI Finding

    L5-S1
    there is an evidence of previous surgery but no evidence of recurrent disc herniation or spinal stenosis.
    L4-L5
    there is a degenerative disc disease with some mild disc space narrowing. there is some mild facet arthropathy. there is mild posterior vertebral spurring. there is a large posterior central disc herniation a little bit more prominent on the left than right. due to technical factors this is little bit difficult to assess but there is no obvious enhancement at this level. there does appear to be severe compression of the thecal sac and compromising of the left lateral recess and to lesser extent compromise of the right lateral recess. there is a severe spinal stenosis. the neural foramen are patent.
    This is my MRI Impression
    “L4-L5” there is a posterior disc herniation causing severe compromise of the spinal canal and a severe spinal stenosis.

    I have been told by the NS to go for L4/l5 left Microdisectomy

    PAIN:- I have pain on the left but now its gradually moving more towards the right side then left .but pain exist on both side, I have tingling sensation in both left and right but more on the right side . from front of my thigh + right big toe and heel

    My question will a left Disectomy will improve the conditions on right or it is only good for left side. or what can be done to make it fix on both sides in one surgery. my NS is on vacations for three weeks i would really appreciate your suggestions.
    I have started going back to Gym walking or elliptical 35 minutes and then i perform back exercises and stretches but still have pain sitting in my back and buttocks and right thigh and tingling in my legs more on the right feet while sitting and more when i lay down flat on bed.

    Thanks in advance for your reply. and please also tell me how can i see you with my MRI . I live in Canada

    Thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    You have a large herniation at L4-5 that causes canal compression (stenosis) as well as nerve root compression. Your neurosurgeon has recommended a left sided microdisectomy at L4-5. Obviously, without a physical examination or reviewing the films, my information is conjecture.

    If this is a standard large central disc herniation, the left sided microdiscetomy is a good choice for surgery. There are two variations of this herniation; sub-ligamentous and extruded/sequestered. The sub ligamentous variety is typical. The herniation fragments are located under the posterior longitudinal ligament. During surgery, the ligament is opened and most if not all of the herniation fragment can be removed from both sides from the left sided approach.

    If the fragments are in the canal (extruded/sequestered), I still think this surgery is a good choice but there are some potential problems. Most of the time, there are two to three large fragments in the canal and these are generally visible or reachable by the left sided approach. There are rare times that these fragments are multiple and small and cannot be fully reached from the left side. Nonetheless, removing most of the fragments will debulk the nerve root compression and any small fragments “left over” are generally not symptomatic.

    You can send your MRI to my office. Please call the 888 number and talk to my nurse Margaret.

    Dr. Corenman

    arshad80
    Member
    Post count: 3

    Hi Doctor,

    I spoke to Margaret on friday regarding sending my MRI, But she has asked me to get an XRAY as well for my spine, It’s going to be hard to get an XRAY now as I have already got 2 MRI’s with in last 3 months.
    and my family doctor wont write it any more because it’s all Government paid in Ontario Canada. Is there any way you can look at the MRI only? and when i come over to see you in person i will get my XRAY done from there.

    Thanks
    Arshad

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    I understand your dilemma with Canada’s National Health Care Service. The MRI images will be enough.

    Dr. Corenman

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