pain in opposite leg after laminectomy

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RAVI
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September 3, 2014 at 5:50 pm

Post count: 9

#11375

i was having a huge disc prolapse at L4-L5 vertebrate level. the width of spinal cord was reduced to 4 mm at the point of herniation as compared to 13 mm at other points . the nerve compression was more marked on left side and there was a shooting pain and numbness in the left leg . i underwent Laminectomy and Discectomy 2 weeks ago . after the surgery my left leg is completely free with no pain . there was occasional numbness till a week after the opearation but that also went away .
But one that is concerning me that whenever i walk, travel by car or a slightly long sitting i have pain in my right leg and very minute pain in right side of back (right side was completely ok before surgery) . the pain is not shooting pain or numbness but its not muscular pain too . its a kind of internal pain in my leg . previously when i travelled 6 hours by car the pain was for 2 days then went away now again when i travelled it is there from the last 2 days , and still not gone .
is it because i started too much movement very early after surgery .

Donald Corenman, MD, DC
Moderator

September 3, 2014 at 10:42 pm

Post count: 8660

#11376

One question is whether the microdiscectomy approach was only from the left side? If there was some remaining disc material left as can occasionally be the case, it could have been inadvertently pushed over toward the right side. This would explain your new symptoms.

A hematoma (a small collection of blood) could also occur to cause these symptoms.

As long as there is no motor weakness (you can walk on your heels to check this) give these symptoms some time to abate. Even if there might be residual disc material in the canal, the nerve can adapt and symptoms could calm down. If in six weeks, the pain continues, as your surgeon if a new MRI might be ordered to check on these above two possibilities.

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.

RAVI
Member

September 4, 2014 at 5:28 pm

Post count: 9

#11381

thank you doctor for your time ..

after taking rest the pain is reduced by 50% , actually i had a quite of travelling after 10 days of surgery because i was feeling better (that was a mistake )during that travelling the surgical wound got swelled and then i came back and the swelling went away with rest but the wound area is very much stiff and the leg pain also came with that.
the stiffness that went away in 10 days came back after the travelling , is it a concern ?
i was thinking to continue my software engineer job from this monday , but now i am confused .

i want your advice , can i continue my job after 3 days of rest as its been more than 2 weeks after the surgery .
or starting the job will affect my healing ? ( the job is 8 hours of sitting )

Donald Corenman, MD, DC
Moderator

September 5, 2014 at 12:07 am

Post count: 8660

#11382

Travelling after 10 days post-operative is not necessarily a problem. Extensive travelling can cause a flair reaction and even a hematoma.

I think that you can go back to work, but part time. Ease back into your schedule and allow your body time to adapt to the healing of the incision and root.

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.

RAVI
Member

September 5, 2014 at 11:22 am

Post count: 9

#11384

if it is a hematoma , then can it cure by itself or it needs a treatment ?. the surgical site is clean(no redness , swelling etc) and the wound has healed completely from outside but i feel a lot of stiffness from inside which is only after travelling and the associated mild and constant pain in the opposite(right) leg .
i talked to the doctor he said the pain will go away by itself .
The painkiller has no effect , yesterday i didnt take the painkiller and there wasn’t any more pain and even with the painkiller the pain doesnt reduce .
but the pain is bearable , means i am able to sleep properly but still it bothers .
is there any way to check if this pain is due to hematoma or due to some residual disc material ?

symptoms :
constant and mild pain in right leg (bearable pain) mainly below the thighs .
no motor weakness
pain is less in morning
pain in the evening is more than morning
no numbness or shooting pain
surgical site quite stiffed

Donald Corenman, MD, DC
Moderator

September 5, 2014 at 10:41 pm

Post count: 8660

#11386

Hematomas will generally absorb after time. The only way to determine if a hematoma is present is to have a new MRI. However, if the symptoms are tolerable, give this some time to resolve.

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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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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