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  • AvatarMidwestW
    Participant
    Post count: 14

    I’m five days post laminectomy for lateral recess stenosis at L4/L5.

    I am having some continued sciatica in my shin, actually became a little worse than pre surgery on third post op day. I obviously didn’t reherniate since I didn’t have a discectomy. Could this simply be irritation of the nerve root?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7481

    The surgery for lateral recess stenosis requires removal of the offending structure which can occur from ligamentum flavum hypertrophy or facet hypertrophy or both. If there was no disc work performed, your symptoms should improve within 2 weeks. Sometimes a seroma (collection of fluid) can occur which can increased root pressure temporarily.

    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.
    AvatarMidwestW
    Participant
    Post count: 14

    Thank you–so there is typically not nerve root irritation as can be seen after discectomy (I had one of those last year).

    Also, my op report says I had a left hemilaminotomy and foraminotomy at L4-L5. Specifically: “using the high speed drill and Kerrison rongeuers the bony laminectomy was performed at L4-L5. The facet was overgrown. The ligamentum flavum was carefully elevated and resected into the lateral recess. This fully decompressed the segment. I was able to palpate freely along the course of the nerve root as well as ventral to the sac.”

    Does his description include the foraminotomy? It is listed as part of the surgery but I am not seeing that in the actual report.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7481

    The description does not include the foraminotomy, Normally, an up angled curette and angled Kerrison rongeuer are used to perform the foraminotomy (sometimes with a tip of the superior facet resection). He might have done that but failed to dictate it. Foraminotomies are notoriously hard to perform sometimes.

    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.
    AvatarMidwestW
    Participant
    Post count: 14

    Ok, thanks so much. He told me that my scan showed issue with L lateral recess stenosis, but on the MRI I see:

    L4-L5: There is shallow posterior bulging of the disc with mild
    facet and ligamentum flavum hypertrophy. There is mild bilateral
    foraminal encroachment
    and moderate lateral recess stenosis greater
    on the left. The L5 nerve roots are contacted and the left L5 nerve
    root is compressed.

    I will ask him about the foraminotomy at my follow up. I am just wanting to make sure that all the stenosis was taken care of.

    AvatarMidwestW
    Participant
    Post count: 14

    As an update: I’m 9 days post decompression without discectomy, and yesterday my back and leg pain got worse. I called my surgeon and nurse said to calm down on the walking, so I did. Woke up today and it’s even worse–deep back pain radiating into butt and leg, feels like it did at its worst before surgery. Could all of this be from walking too much?

    I am starting to panic that something did not work or went wrong. I was told to walk as much a I wanted, as tolerated. It was definitely fine while I was doing a lot of walking (up to 15,000 steps on one day), but the next day felt like I was at square one with my stenosis!

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