ajlabuyMemberAugust 28, 2012 at 2:57 amPost count: 2
Injured L5/S1 in 2008 running = unrelenting sciatic pain. Had Microdiscectomy in April 2008. Had a baby in June 2009. Re-herniated in 2010. Had another baby in July 2011. Currently suffering. More sciatic pain and back going “out” once a week. MRI revealed narrowing greater than 70% and also good news that all other discs are “perfect.” Plan on having one more child soon, I’m 34 now. How would you proceed in the short term. And would you recommend waiting until I’m done having children for a fusion?
Thank you so much for your time. Colorado is lucky to have you!Donald Corenman, MD, DCModeratorAugust 28, 2012 at 4:13 amPost count: 8459
When you say your back “goes out”, are the symptoms severe lower back pain and inability to stand or is there leg pain involved? If leg pain is present, what is the percentage of back vs. leg pain (see section under “how to describe symptoms”).
I assume that when you say “narrowing”, this is of the L5-S1 disc space. You might have isolated disc resorption or IDR at this level (see website for description). This “lack of shock absorption” will increase the load on the bony endplate of the vertebra and cause stress fractures. Patients with this disorder will complain of delayed pain after impact activities or travelling in a car as well as immediate pain at the time of activity.
If you are a candidate for fusion, a successful fusion will not cause any problems with child bearing. If you feel your “clock is ticking” however, you cannot carry a child for at least six months after a lumbar fusion.
Dr. CorenmanajlabuyMemberAugust 28, 2012 at 5:06 amPost count: 2
Thanks for the reply! By “goes out” I mean severe lower back pain on each side of the spine. Cannot get out of bed or move without extreme pain. An episode usually lasts 2 to 3 days. And leg pain is always the primary problem at 80%. It is either isolated mid left thigh (vs. running down leg and stopping at mid thing). And it is always after activity or a car ride that I have problems. I can go on a run or a ride, but will pay for it days after. Only recently has the leg pain been an issue during running especially.
Correct – narrowing of the disc space. Will look up IDR – sounds like a fit. Thank you again for the information!Donald Corenman, MD, DCModeratorAugust 28, 2012 at 7:48 pmPost count: 8459
Your complaints are typical for IDR with foraminal collapse. The back pain is most likely from the loss of shock absorption. The episodes of “going out” are typical from certain impact or vibration activities that overload the bony endplates and cause small fractures (not dangerous but painful).
The leg pain is most likely from the loss of height of the foramen. This foramen is the exit zone for the nerve root. The height of the normal foramen is normally at least 50% from the height of the disc. When the disc rebsorbs, this height is lost. To add insult to injury, bone spurs form in the foramen as a result of bone on bone impact which additionally “clogs” this hole.
The foramen actually changes in volume from flexion to extension (bending forward to backward). Forward bending opens this hole and backwards bending narrows it. The acts of standing and walking cause this hole to narrow- further compressing this nerve. Leg pain can develop immediately and last sometimes for days.
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