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  • AvatarSailormoon
    Participant
    Post count: 7

    Hi Doctor

    I have 2 microdiscectomy for L5S1, suspect cauda equina. Before 1st surgery the red flag is only saddle anaesthesia on my right buttock and bottom calf. I have pain in the right buttock radiating to my bottom calf. No numbness at all.

    After 1st microdiscectomy, wake up from surgery i feel pin n needles in the bottom of my feet,right leg. But the surgeon told me it will heal within 6 months. Is it normal that i have pin n needles while i dont have it before surgery?

    Then a week after surgery, i woke up feeling sharp pain at the same place just like before surgery. But this time no radiating pain. It lasts for 3 days then disappear. But i’m afraid it recurrent disc. Therefore 3 weeks later, i had MRI that stated:
    – Bone defect at Lamina posterior L5 right side with edema and subcutaneous fluid collection
    – L4-L5 protrusio
    – L5-S1 compare to previous MRI (before surgery) decreasing extrusio right and left.
    – Lesion 6-8mm at the right canalis spinalis suspect arachnoid cyst post op dd inflamasi.

    Then the surgeon told me there is recurrent, then 4 weeks after 1st surgery, i had the 2nd one.

    Woke up from 2nd surgery, i have pin n needles at my bottom leg, this time at my left leg. And also tingling sensation on left leg. I confused, because i never had problem with my left. And also my left hip and buttock was hurt until now. And if i lay flat, some minutes later i feel stabbing pain not far from incision site.

    The doctor told me, he perform exploration on surgery and found no arachnoid cyst, only wound/scar. No fluid when opening incision site.

    For reherniation, he said, he do manouver and took the disc from left side because its too risky to take the disc from right side because of narrowing spinal canal. Then i ask, the reherniation happen in left or right side? He said in the middle. He also perform curettage because degenerated disc and he said he make space for the right side

    My question is, can the disc goes to the middle? Why i have stabbing pain? Im almost 3 weeks after 2nd surgery is possible i have dura tears?

    Now im afraid to lay flat because of stabbing pain.

    Thank you for your answer

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7684

    Paresthesias (“pins and needles”) are not uncommon after microdiscectomies. Many individuals have “numbness” and paresthesias that are present but unnoticed prior to surgery due to pain covering up those symptoms. The microdiscectomy relieves the pain, uncovering the previously unnoticed numbness. However, manipulation of the nerve root (required to perform a surgery) can stimulate these symptoms too.

    I am a little confused as your surgeon surgically approached the opposite side. “For reherniation, he said, he do manouver and took the disc from left side because its too risky to take the disc from right side because of narrowing spinal canal”. Maybe due to the prior operation on the right, he was afraid of scar tissue and approached from the left side.

    If you had a dural tear, you would have a headache when upright that would less with lying down and your incision would be “puffy”.

    It takes some time (6 weeks-3 months) for the disc to “settle down” before your back will feel better. Try some physical therapy if see if this improves your discomfort.

    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.
    AvatarSailormoon
    Participant
    Post count: 7

    Hi Dr Corenman,

    Thank you for your reply.
    It help alot.

    I dont have postural headache and my incision site looks good after 1st op and until now. Just corious why there is fluid collection seen on MRI around 3 weeks after 1st surgery?

    Thank you.

    • This reply was modified 3 weeks ago by AvatarSailormoon.
    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7684

    Fluid collection pockets (seromas) are quite common and might take as long as 6 months to absorb over time. Occasionally, there can remain but most cause no problem.

    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.
    AvatarSailormoon
    Participant
    Post count: 7

    Hi Dr Corenman.

    Thank you for your explanation.
    During surgery, the doctor told me to prevent reherniation again, he took all the disc so probably my back left with an empty disc for L5S1 and in the future i will have fusion.

    Lately my back hurt so much when i try to sit and walk. My back feels like broken and unable to hold my leg. I know it needs 3 months for back to settle. But this pain is worst i barely able to walk and sit.
    Does it because empty disc?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7684

    Removing most of the nucleus will probably increase the chance of back pain. I would assume that he or she left the cartilaginous endplate intact which affords some shock absorption. You must give your back some time to accommodate. If no improvement in 3 months, reimaging would be helpful.

    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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