[tres]

#10071

hi dr, on 9/4/13 mri finding l5/s1 extruded posterior central disc herniation /cephalad migration disc mat by deforming the thecal sac.possibility of associated sequestered disc fragment posterior to the l5 vertebra. on 9/24/12 EMG findings left l5 radiculopathy, lower extremities the test took 45min/to 1hr.on 1/2/14 EMG diagnosis:722.10 lumbar disc displacement also lower extremities test took 15-20 min when she probed with needle on outer calfs and top of foot she said negative only positive in the lumbar area, wich test is correct 9/12 or 1/14. my question is the 1/2/14 diagnose related to 9/4/13 mri finding in any way? can the nerve damage done by the DLIF approach in 2010 heal or not?thank you dr.

[Donald Corenman, MD, DC]

#10074

It is really hard to know based upon this internet discussion what is causing symptoms now, what the new disc herniation’s role it, what caused symptoms before your first surgery and what generated new symptoms based upon the failure of your spine surgery. This can be discerned but that would take a prolonged history, physical examination, evaluation of your previous surgical report and review of the old and new images.

You do have a disc herniation at L5-S1 and this can cause buttocks and leg pain. The EMG test is normally not helpful in your case as most nerves do not demonstrate motor weakness which is really what the test picks up on. If there were no EMG findings in your legs, this is what I would have expected as you have never talked about weakness in your legs. The EMG findings in the lumbar muscles are not helpful as everyone has these findings after a posterior spine surgery no matter what the problem.

I cannot determine what injury occurred after your spine surgery so I cannot tell you if these symptoms will resolve. I would assume that since the surgery was four years ago, the symptoms generated after the surgery will not heal but that assumes irreversable nerve injury. If something is still correctable, I might be wrong on that.

Your discussions have prompted me to write a new thread regarding failed spine surgery syndrome. This topic should be out in the next three weeks.

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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