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#36198

Hi Dr. Corenman,

Can you please shed some light on this what might have happened during microdiscectomy & I know you cannot tell for sure but in your valuable experience is this temporary nerve damage or of kind of permanent?

I had L5/S1 microdiscectomy around 8 weeks before. Now my leg pain/numbness is lot worse than before.
The worst part is that I had only 2/10 leg pain/numbness before surgery, but it was always there, and I waited for 3years before I jumped into surgery. I was fully active before surgery, only a little pain.
Now shooting pain travel from lower back to the foot & my outer 60% of the foot is numb. (if I cut my leg vertically in half, most of the pain is on the outer side) looks like S1 nerve. No motor issues.
I would like to share some of the notes of the surgery “we carried out a small diskectomy & freed up some apparent scar tissue that was quite adherent to the lateral aspect of the nerve root shoulder.”
if these notes can give you some clue. I don’t know where these scar tissues come from as I had no surgery prior to this one in my life.

Dr, please if you help me out in this & waiting for your reply!

[Donald Corenman, MD, DC]

#36199

The possible causes of increased leg pain after a period of relief post-microdiscectomy surgery are inflammation of the nerve, seroma, recurrent herniation and infection with much more rare conditions like facet fracture.

Inflammation is common after decompression of the root. A compressed structure that was injured will “swell” and become congested. Oral steroids and time are the best treatment.

Seroma is a common condition. Fluid exudes from surgical sites and can build up and congest and compresses the nerve root. Seromas typically resorb after some time but occasionally need to be aspirated by needle. This is diagnosed by MRI and treated by needle aspiration.

Recurrent herniation occurs in 15% of patients and normally increase pain significantly. Recurrent weakness and a “tighter” leg (SLR) are common. If the recurrence is not too large, sometimes an epidural injection can be helpful. A redo microdiscectomy is not uncommon in the face of a recurrent herniation.

Infection should be rare at less than 1% of all surgeries. Interestingly, many patients do not have fevers or chills but have increased back pain that translates to leg pain eventually. Lab tests are the beginning for diagnosis. Diagnosis is by lab tests and patient symptoms.

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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