Microdiscectomy post OP problems

///Microdiscectomy post OP problems
Microdiscectomy post OP problems
Viewing 6 posts - 1 through 6 (of 6 total)
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  • AvatarRyan
    Participant
    Post count: 3

    Dear Dr Corenman,

    I’m writing in the hopes of receiving a second professional opinion regrading the pain and problems i’m dealing with right now 5 weeks after a surgery.

    I am a 35 years old Male and a year ago i was diagnosed with a sever disc herniation at L4-L5 level.
    Before the surgery i was not able to walk for more than 10 mins and i was not able to stand up for more than 5-10 mins, i was having this sever sharp sciatica pain and numbness in my left leg because of the disc herniation.

    I did a Microdiscectomy at L4-L5 level on August 11th, for the first 2-3 weeks my symptoms was significantly relieved, but all of a sudden the sciatica pain started to kick in and some new kind of pain started showing up in my my lower leg (Shin) and in my left hip, sitting in any form was very painful even for 10 mins.
    Although i was able to walk with very minimal pain in my leg. I followed up all the surgeons instructions such as the no lifting, twisting and bending rule and i walked everyday.

    I went to see my surgeon on 1st of November and he prescribed Pregabalin 75mg twice a day and Naproxen 500mg twice a day as well and told me to go see him in November again and if my pains is still there he would send me to do another MRI..

    As of i’m writing this email i still have problems with sitting down, i can sit on a chair for maybe 10-15 mins before the sciatica pain kicks in but i have almost no pain when walking even for 40-45 mins.. and also standing up is still a big struggle as it was before the surgery..

    I’m very worried that i have the disc re-herniated again for some reason and that i would have to do another surgery. I live alone and i have no family to take care of me really so a second surgery can be almost impossible for me to go through..

    I’m going to start physical therapy as of next Monday 21st of October. i would really appreciate it if you can give me your professional opinion. is there any chance that all this pains are just part of the nerve getting healed? after 5 weeks why i can’t sit on a chair or sofa or even in my car? is this normal?
    and why i still have problem with standing up?

    Thank you very much

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7069

    You certainly might have a recurrent disc herniation but the chance of a seroma (a post-operative collection of fluid) is equally possible. One might require a redo microdiscectomy but the other requires an aspiration and steroid injection.

    The inability to sit fits with a mass in front of the nerve causing compression when the hip is bent (flexed) which tensions the nerve root. This mass could be HNP but could be fluid too.

    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.
    AvatarRyan
    Participant
    Post count: 3

    Thank you very much for the reply Dr. Corenman. could doing another microdiscectomy weakens my spine and would require a Fusion?

    I also could walk for an hour yesterday with no pain, also i noticed the pain that comes with standing up slightly goes away when i keep standing up!! could any of these be a good sign that its not a re-herniation?
    and why the disc should re herniate when i followed all the doctor’s instruction?

    do you suggest physical therapy? its tomorrow the first session

    Thanks in advance

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7069

    Even if it is a re-herniation, if your symptoms are not impairing, you need therapy and possibly an oral or injectable steroid. If symptoms are impairing, you have a recurrent herniation and you fail conservative treatment, then another microdiscectomy could be in your future. A fusion is only required with three herniations that cause impairing symptoms that require three distinct surgeries.

    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.
    AvatarRyan
    Participant
    Post count: 3

    Thank you very much Dr. Corenman for taking the time and answering my questions..

    So yesterday i did my first session of PT. She did the SLR test and she made to bend and twist slowly.. i had no nerve pain at all, she bent my knee and pressed it towards my stomach i had no nerve pain at all.

    she said my muscles are very stiff and the fact that i had no pain while she was evaluating me is a good sign.. she said something about scar tissues and this could become the cause of nerve compression? i didnt understand it completely to be honest..

    could any of these be a good sign that my disc is not re-herniated?
    also the scar tissue problem. is that a big deal? does it need a surgery to have it fixed?

    Thank you in advance
    God bless you

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7069

    The bent knee relaxes the sciatic nerve root so even if the hip is flexed. this bent knee protects the root. Scar tissue forms at every surgery and generally scar is not a big problem. This is however why physical therapy is important to “floss” the nerve while healing to keep the nerve mobilized and prevent adhesions.

    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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