gu2002MemberJune 2, 2011 at 11:04 pmPost count: 5
hello doctor, I Say That I Had two years ago for a herniated disc surgery
L5-S1 discectomy, laminectomy, That is the reality after the operation, pain Disappeared, But The Doctor Said May Have Been the nerve resent by the surgery, pero, and Spent two years and much pain Sometimes strong grabs me in the right buttock, no branching leg (right) I inject vitamin B12 and passes, pero entumese leg, it hurts to move and bend and stretch, I CAN NOT spend much time sitting, etc, etc.
my question is Which Is Probably a good solution to this, the Humid climate of Buenos Aires (average 70%) Affects Inflammation in the area? Physical activity relieves the pain? What kind of activity? Would think or at Some point in some kind of surgery again?
is good in a disc replacement.
I have 43 years I am Physically active, or WAS, (athlete), But now the truth, I put an end to the Activities out of fear or anything living!
I hope Not to bother with this Consultation and I thank you!Donald Corenman, MD, DCModeratorJune 7, 2011 at 11:39 amPost count: 8459
By your history, it appears that you have had a discectomy at L5-S1 two years ago and surgery was a success as the pain disappeared initially. I am unclear when the pain returned, but apparently it did at some time. The pain now is intermittant in your right buttocks. The pain is aggrevated by bending and sitting. You do not report any back pain.
This is speculation but by the sounds of your symptoms, you may have a recurrent disc herniation at the same location as your first herniation. The chance of that occurance is 10% in the active population.
Without significant back pain, you don’t need to think of a disc replacement or a fusion. What you need is a diagnosis. Either go back to your original surgeon or find a spine surgeon with a good reputation and ask to be looked at. You most likely need a new MRI with gadolinium (the dye that lights up scar tissue) to determine what the next step is.
Dr. Corenmangu2002MemberJune 7, 2011 at 9:36 pmPost count: 5
ok, thanks for the reply,
This week I will authorize an MRI to see if the problem is in the L5-S1 or elsewhere, I think it is in the same place where they performed the discectomy (L5-S1)
the pain is intermittent, and started a week ago, not down the leg, only the right buttock, I entumesimiento and burning, but intermittent, I am taking anti-inflammatory painkillers and icing I do not know if this well but it calms me.
to you, it seems if I perform, eg. swimming?
from already adradezco your time and response.
I weigh 77 kilos and my height is 1.76 meters. osea I’m at my ideal weight
thanks!!Donald Corenman, MD, DCModeratorJune 7, 2011 at 11:05 pmPost count: 8459
If there is no motor weakness (calf muscles- try tip toe walking- if OK- most likely no weakness) and the pain is only a week old, there is a very good chance that physical therapy, medications and epidural injections will relieve your symptoms.
Dr. Corenmangu2002MemberAugust 3, 2011 at 5:32 amPost count: 5
OK, doc, tell him that they delivered me the results of the latest NMR dated June 24, and reads as follows:
a lumbosacral spine MRI had been cut at the levels of profile and transversus. They used techniques to study tissue T1 and T2 relaxation times
the review shows:
* Tracks surgical at the level of the lower lumbar segment to correlate with a history of the patient.
* There is dehydration of the L4 – L5 disc
* Decrease in altitude and dehydration of the L5-S1 disc
* Hernia occurs posterocentral with predominantly clockwise at the L5-S1 level.
* It descends to flow occupying the right lateral recess and making contact with the nerve root on the right side
* Morphology and sign of the vertebral bodies is preserved.
* Medullary Cone and horsetail without specificities.
This is the summary of the report of the MRI and let me know if you, also believes that this can be absorbed over time, and that kind of activity can I do? According to my doctor neurologist, I have two options, wait for it to absorb or to operate on me again. you view on the subject?Donald Corenman, MD, DCModeratorAugust 4, 2011 at 1:26 amPost count: 8459
This MRI report was written very poetically. This indicates that the “tracks” are the surgical scar tract that is always visualized after a lumbar spine surgery. The L4-5 disc has some degenerative changes. The L5-S1 disc where the previous surgery occurred obviously has some degenerative changes and the “altitude” changes are the narrowing of the disc space after the herniation.
There apparently is a recurrent herniation at that level that causes some compression of the S1 nerve root in the lateral recess.
Your doctor is correct. Without motor weakness, you have two options: to wait or to have surgery. This is a value judgement that only you can address. Benefits of waiting are that you avoid another surgery and the benefits of surgery are that a direct decompression of the nerve root has a good chance to give you relief of your buttocks pain.
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