Pain post micro discectomy

Tagged: Sciatica nerve pain after micro discectomy

Viewing 5 posts - 1 through 5 (of 5 total)

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lmn1428
Participant

September 25, 2019 at 9:24 pm

Post count: 1

#31183

Hello, I would greatly appreciate some advice!

I had sciatic pain that slowly grew over time. It eventually reached a point when traveling in Peru that I couldn’t walk, stand, or sit and laying down was almost unbearable. After an MRI you could see the spinal nerve was almost completely compressed. It was deemed unsafe for me to travel and on July 11th I had to have an emergency micro discectomy in Peru.

I have had numbness in my foot and some pain in my hip but haven’t been too alarmed. However, recently I have been having nerve pain down my leg again. It’s mostly when I am laying down or sleeping. It is not constant and comes in and out and very very low on pain scale. When I’m up and active I do not feel this. If I stand for long periods I will have pain in my foot.

I am trying to join the military and I’m terrified that it will reherniate. I know they will not accept me if there’s any further issues. Are these pains normal parts of the healing process? Or should I be concerned that it’s slowly reherniating again?

Thank you for all your help!

Donald Corenman, MD, DC
Moderator

September 26, 2019 at 9:21 am

Post count: 8660

#31186

From the sounds of it (“I have had numbness in my foot and some pain in my hip but haven’t been too alarmed..recently I have been having nerve pain down my leg again..not constant and comes in and out and very very low on pain scale”) you have some root swelling which is common after a microdiscectomy. Be aware of the “rules of BLT” (see https://neckandback.com/treatments/conservative-treatment-mechanical-lower-back-disorders/). You have a 10-20% chance of recurrence but you can’t let that dissuade you in applying for the military. The numbness is expected and can take 6 months to resolve. The pain sounds tolerable so don’t be too concerned.

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.

microdisc
Participant

September 28, 2019 at 12:12 pm

Post count: 1

#31204

Hi,

I am 3 weeks out from L4-5 microdiscectomy for large herniation with right sided buttock and right calf and ankle pain as well as associated severe central stenosis from the herniation. The surgery went smoothly and my radicular pain was gone for the first 2 weeks. Over the past several days I have noted mild to moderate right top of the ankle and right buttock discomfort similar to to prior to surgery but less intense.

My surgeon recommended prednisone 20mg twice a day for 5 days and then 20 mg daily for 5 additional days. Does this seen like a reasonable dose if the cause if root inflammation? How will I know whether there is another cause (seroma, reherniation etc). They also recommended reducing walking to 10 minutes 3 times a day.

Donald Corenman, MD, DC
Moderator

September 29, 2019 at 6:30 am

Post count: 8660

#31207

I would agree with your surgeon’s plan. The pain is not to the same intensity as it was pre-op and the root is probably swollen from the severe compression to which it was subjected. Oral steroid now makes sense. Let’s see how you do after the course of steroids.

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.

LexMicro
Participant

September 29, 2019 at 7:23 pm

Post count: 2

#31212

Hello! I had an L5-S1 microdiscectomy on June 17th of this year. I’m 29 and fairly active. For the past few months, I’ve been pain-free in my right leg. Prior to surgery, I had pain radiating down my right leg. Starting Friday, similar pains have returned. They are amplified when I adjust my seating position, go from lying to standing, bend over, etc. They are in the same areas as prior to surgery. I am nervous that this is a recurrent disc herniation in the same spot. I am going to call my neurosurgeons office tomorrow. I’ve been reading other posts about similar situations on your forum. I see that this type of pain is typically treated as a new herniation if what I’ve read is correct? In your experience, what is the likelihood of getting another MRI before the year is over? Is it unusual to have symptoms totally resolve and then the pain reoccur spontaneously slightly over 3 months after surgery, or is this more indicative of a recurrent disc herniation? What are the odds of the nerve root being irritated due to activity or a hematoma this long after surgery? If I do need to have a secondary microdiscectomy, I’d like to have it done prior to the new year since I’ve already met my out of pocket maximum. I’m just not sure what I can do/if I can do anything to speed the diagnosis process along in order to get an MRI to have a definitive answer of what is going on.
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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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