Dear Dr. Corenman,
I had a lumbar foraminotomy on June 14, 2013 to release the compressed sciatic nerve root. Since the procedure, I walk 1 mile a day per instructions from my doctor. I went back for post op visit on June 28 and told him the pain in my left leg was the same, if not worse. He told me to give it 6 more weeks to see if the pain goes away and if not, a spinal fusion would be next step. He gave me more oxycodone for the pain but I cannot work taking that drug. My question is, since the spine doctor doesn’t give me more than a minute of his time and seems annoyed when I try to ask a question, does it sound typical that I would have no relief from the sciatic pain 19 days after the procedure? I don’t know how much more of this pain I can take. I called and asked for a pain med that doesn’t make me impaired so I can work but no response yet.
Foraminal stenosis can be caused by a stable or unstable vertebral segment. If the stenosis occurs from a stable vertebra, the success rate for decompression is about 80%. If there is instability (there is an angular collapse of one vertebra on the one below), the foraminotomy has a much lower chance of relief of pain.
With an angular collapse, you need to restore the height of the collapsed side. This is typically performed with a TLIF fusion (see website for full understanding).