Leg Pain after Microdiscectomy

///Leg Pain after Microdiscectomy
Leg Pain after Microdiscectomy
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  • AvatarQrkr0730
    Participant
    Post count: 4

    Hi Dr. Corenman,

    I am new to his forum. This is my story. I have been working a computer job since 2013. Up until a year ago everything was fine. I started getting left leg pain and buttock pain. Right leg is pain free. I tried PT, injections, chiropracting, etc. and nothing worked. The pain would be worse when I sit for a long time. I then went to a neurologist who ordered an MRI. Here are the findings:

    Findings:
    The lumbar veritable bodies remain normal aligned. The veritable body heights are maintained. The veritable bodies themselves display normal signal throughout the lumbar segment. The conus medullaris terminates at the L1/L2 level.

    L1/L2
    This level is normal

    L2/L3
    This level is normal

    L3/L4
    Mid loss of disc height and signal. The spinal canal is normal in caliber centrally. There is 1 to 2 mm of lateralizing disc material in the neutral foramina bilaterally, appears some partial compromise of the neural foramina, left greater than right. The exiting dorsal root ganglia are surrounded by fat.

    L4/L5
    There is mild loss of disc signal and disc height. There is 1 to 2 mm of disc material lateralizing to the right. There is some partial compromise of the right lateral recess as well as inferior aspect of the right neural foramen. The exiting dorsal root ganglia are surrounded by fat.

    L5/S1
    Mild loss of disc signal with 1 to 2 mm of disc material lateralizing to the left. There is partial compromise for the inferior aspect of the left neural foramen. The exiting dorsal root ganglia are surrounded by fat. The spinal canal is normal in caliber centrally.

    I had a microdiscetomy on April 15 and have had no pain until this past Monday when I went back to work. I have been taking 150 MG 2X daily of Lyrica but have been wining off. I also take 25 MG of Zoloft, 500 MG of Naproxen and 800 MG of Metaxalone. Why has my sciatic nerve pain come back since I started work again? What can I do about it. I’m going to get another MRI tomorrow to see what’s up.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6707

    Was this MRI performed after or before the surgery? What level and side was the surgery performed?

    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.
    AvatarQrkr0730
    Participant
    Post count: 4

    This was before the surgery.

    This is after:

    L1/L2: No evidence of disc disease or protrusion, central canal stenosis, or neural foraminal narrowing.

    L2/L3: No evidence of disc disease or protrusion, central canal stenosis, or neural foraminal narrowing.

    L3/L4: Status post left hemilaminotomy with microdiscetomy. Posterior left subsarticular 2.0 mm disc protrusion-subligamentous disc herniation exnatnds into epidural fat and indents the thecal sac. Bilateral facet arthropathy with mild left neural foraminal stenosis. Central canal is patent.

    L4/L5: Status post left hemilaminotomy with microdiscetomy. Grade1 (2 mm) anterolisthesis with uncovering of the interveteral disc. Posterior central 2.0 mm disc protrusion-subligamentous discherniation extends into the epidural fat and indents the thecal sac. Billateral facet arthropathy with mild left neural foraminal stenosis. Central canal is patent.

    L5/S1: Status post left hemilaminotomy with microdiscetomy. Posterior left subsarticular 2.0 mm disc protrusion-subligamentous disc herniation exnatnds into epidural fat and indents the thecal sac. Bilateral facet arthropathy with mild left neural foraminal stenosis. Central canal is patent.

    What is going on? Is this inflammation or a re herniation? What should I do?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6707

    The radiological MRI report does not note any significant compression as 2mm protrusions are generally not too compressive (as long as the reading is accurate). There is a question of a degenerative spondylolisthesis at L4-5 (“Bilateral facet arthropathy with mild left neural foraminal stenosis) as degenerative facet disease can lead to a slip and a slip with foraminal stenosis can look less compressive than it really is. Have you had prior flexion/extension X-rays?

    You are about 2 months out so things should be improving. Maybe ask for a course of oral steroid to take. Make sure you are not on NSAIDs (500 MG of Naproxen and 800 MG of Metaxalone).

    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.
    AvatarQrkr0730
    Participant
    Post count: 4

    I am confused. I am taking 500 MG if Naproxen and 800 MG of Metaxalone. Is this bad?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6707

    Not right now but if you take an oral steroid, you should not take Naproxen which is an NSAID while you are taking the steroid. I cut and pasted Metaxalone by error (Skelaxin). This is a muscle relaxant and not an issue while taking a corticosteroid.

    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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