Len61MemberNovember 5, 2011 at 1:45 amPost count: 2
Hi Doctor.. Do you think a S1 nerve that has been compressed for nearly two years would recover if decompressed now ?
My Doctors in England say that the herniation will shrink over time…And leave it alone also because I already had a back surgery in 2005 now it’s it’s more complicated and dangerous to do another surgery in that area..
I have had little to no improvement of my numbness and weakness in left leg and foot since Dec 2009.. I now walk with a limp…
I now live in California..I did see a Nuerosurgeon here, a very aggressive man who scared the life out of me with tales of Paralasis sand Meningitis..so I wasn’t very keen on him..Your ipinion would be very much valued
Aged 61Donald Corenman, MD, DCModeratorNovember 5, 2011 at 3:14 amPost count: 8507
The first question I have is what are the symptoms? Numbness, pain and weakness are the typical symptoms that can occur with nerve compression. Surgery for a compressed nerve can still yield some relief after two years but the results will not be as good as if the surgery was performed within the first six months. Also, if there is weakness present after two years, the chance of return of strength after surgery is minimal.
The limp can be caused by pain inhibition of the muscles or frank weakness. If the limp is caused by pain, surgery can possibly help to relieve pain and reduce the limp. If the weakness is the cause of the limp- do not expect surgery to help this problem.
If you have the disc herniation in the same area as the previous surgery, this is not unexpected. There is about a 10% chance of recurrent herniation in the same area. The surgeon is somewhat correct that surgery in the same area of the prior surgery is somewhat more complex but this is a surgery that is performed commonly in the USA.
Any time a spine surgery is performed, there is the small risk of complications but in the case of a recurrent disc hernation, the risk is very small. I can tell you I have never seen a case of paralysis or of meningitis with this type of surgery.
Dr. CorenmanLen61MemberNovember 5, 2011 at 9:09 amPost count: 2
Thank you for your candid reply Doctor Corenman.
My present problem is a 16mm L5-S1 herniation ( Dec 2009 ) and although, somewhat strangely, apart from normal aches and pains I do not have any significant back pain to speak of. Just the numbness and weakness in my left foot and side of lower leg (can’t go on tip toes for more than a few seconds , squeezing sensation and nerve discomfort in foot ) my limp is minimal unless I have been walking a long distance.
Also strangely when I pass water and go to the toilet I can feel it in my foot..weird. !
My prior surgery in 2005 was at L4-5 with compression, after surgery I made a complete recovery and my right foot regained it’s strength and normal sensation.
Thank you again for your very helpful and insightful advice.Donald Corenman, MD, DCModeratorNovember 5, 2011 at 9:58 amPost count: 8507
This is good news. First, the disc herniation is at a different level so there is no problem with any scar formation. Even though prior surgery at the same level is not really a problem for future surgery at the same level, this new herniation is at a different level making surgery somewhat easier.
The fact that you have no back pain is also good news. The herniation is only compressing the nerve root and the disc itself is not registering pain. The numbness and pain has a reasonable chance of being relieved with surgery.
The weakness is from the gastrocnemius- soleus group of muscles (the calf muscles). These are innervated by the S1 nerve- the one that is most likely currently compressed. This weakness most probably will not recover because of the long time period of nerve compression.
The MRI is too old to make a current surgical determination. You need a new MRI to allow the surgeon to make a reasonable decision.
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