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  • jonas
    Member
    Post count: 13

    I had my 3 hour Operation on 16th of July 2012 L5 S1 Microdescectomy removal of a Neural Arc and Left and Right Decompression but i now feel things didn’t go to good because i have very severe L5 back pain and alot of muscle spasms in my lowerback and walking is down to very tiny steps which get smaller and smaller until i am almost stopped
    i use 2 crutches to try to walk but mostly i use a wheelchair because walking is to painful on my back and legs, my surgeon said my left nerve was almost crushed at the L5 S1 this is probably why i still carnt walk
    my bowels and badder are fine thank god i was dreading anything happening to them when i had my operation
    Do you think the operation failed like i do or have i got to give it more time to see the results

    Donald Corenman, MD, DC
    Moderator
    Post count: 8468

    Please describe why you had surgery and what your initial symptoms were. Also, please describe the disorder that surgery was intended for and what the procedure was.

    Removal of the neural arch can have many connotations. Did you have a spondylolisthesis and the surgery was removal of the arch? Was there instability present? Was only a small portion of the arch removed as in a microdiscectomy?

    How has the surgery affected you? Were you unable to walk prior to surgery and still cannot walk or is the lack of walking ability new since the surgery? How has your life been affected since surgery?

    Dr. Corenman

    jonas
    Member
    Post count: 13

    Thank you Dr Corenman for your speedy response
    I had Surgery because my MRI Scans showed the L5/S1 Nerve was really compressed by a very Ugly looking herniated L5 Disc it was also pinching the right side as well
    The surgeon wanted to do a L5 Fusion but because i smoke and find it difficult to kick the habit she decided to remove the bulging parts of the disc and decompress both sides not sure what the neural arch removal was designed to do but these were written on the notes i think she said if she removes the neural arch then anymore herniation would not give me problems because it gives the herniation more space but im not really sure if that was linked to the nerual arch removal because when i was talking to my surgeon i was extremely nervous and it was all to much to take in at the time

    before surgery i did suffer from severe left side Foraminal Stenosis which you told me i had months ago you were the only one who ever explained foraminal Stenosis and how to detect it,
    before surgery my walking went down hill to the point my left leg was so weak and wouldn’t move very good when trying to walk so instead of trying to put up with the slow painful walking i mainly used a wheel chair to get out and about pain free
    it seemed silly to me trying to walk and in so much pain it was pointless but if i got in my wheelchair i could go anywhere pain free and faster than ever

    after my operation my surgeon did say it was a very busy 3 hour operation and she did alot of work on me and the L5/S1 Nerve was almost crushed
    i’m not sure if all of the neural arch was removed all i can say is i am due to see her in November so i will ask her and update you then
    My Surgery hasn’t really given me any better quality of life, my mobility is still the same if not worse my left leg pain and throbbing is still the same and my lower back pain is worse than before surgery
    the only thing i am happy with is the surgeon tried her best and i am not totally disabled from the waist down

    My life was affected about 6 weeks after surgery because i expected so much more mobility and pain relief from this surgery but now i have been put on anti depressants and been given pain relief which blocks a good majority of the pain and i have come to terms with the condition of my back and legs and i understand that there are people out there with worse conditions than me to put up with if i cannot walk then so be it i will carry on using a wheelchair and that solves that problem
    the back pain has taken up till now to sort out the best medication which suits me and does the job
    so thank you Dr Corenman for all your time and i hope my experience can help other people in some way or other
    i would highly recommend surgery even though it hasnt helped me yet
    because if i didnt have surgery my L5/S1 Nerve would of got that crushed it would of left my leg in a more worse state i’m sure
    i think my poor back and left nerve condition was hard for any surgery to correct but it was worth a try

    Regards
    and good luck to all future back sufferers

    Jonas

    Donald Corenman, MD, DC
    Moderator
    Post count: 8468

    If you had foraminal stenosis causing nerve compression, the type of surgery does matter for effectiveness. If the foraminal stenosis is due to a disc hernation, a simple microdiscectomy can be effective. If however, the foraminal stenosis is due to angular collapse of the vertebra, a foraminotomy can be effective. However, to be effective, significant amounts of bone have to be removed to free up the nerve.

    Unfortunately, most of the time, that bone originally grew into the foramen to stabilize the angular collapse. Removal of the bone to free the nerve root also destabilizes the vertebral segment and allows re-collapse and recurrence of the original symptoms after a time.

    If this is the case, a TLIF fusion (see website) may be necessary to stabilize the segments and free the nerve while realigning the vertebral bodies.

    Dr. Corenman

    jonas
    Member
    Post count: 13

    Thank you Dr Corenman for your valued advice i feel quite reluctant to have another op because i don’t feel confident that it will give me more mobility and less pain, i tried a test which i read in one of your forums where you heel and toe 10 times with each foot my right is very responsive to movement but my left is half the speed and it burns in my hip and buttock area when i heel and toe so i take it my motor nerves are damaged i went for a very short walk to a shop yesterday which was about 100 yards from the car using my 2 crutches to stabilize me but after that i am very much in pain and my walking is back to tiny painful steps around the house
    sometimes when im in the kitchen my lowerback and muscles and buttocks contract and both my legs start to shake and i feel my legs bending at the knees and my legs feel so weak i feel ive got to sit down quickly to relieve the pain and muscle contractions
    once i sit in my wheelchair the pain and spasms go within 2 to 5 mins and i just finish off whatever i was doing in my wheelchair
    i know im going on a bit but i just wanted you to have a clear picture of my symptoms

    if i turn down a offer of another operation where do you think my mobility will be in the future will my compressed left leg become worse
    over time and is it possible my lowerback could cause any bowl or bladder problems in the future

    or is there any hope my symptoms could get better instead of worse
    the only thing what really concerns me is bowel or bladder problems
    mobility is something i can learn to adapt to

    Kinds Regards
    Jonas

    Donald Corenman, MD, DC
    Moderator
    Post count: 8468

    Those tests I described for motor weakness have a caveat. If the pain prevents you from performing the tests, that may not indicate weakness as pain can inhibit the completion of the tests. A physical examination by a skilled examiner can reveal weakness that is nerve induced.

    Your description of your pain leaves me to believe that you are incapacitated due to your symptoms; “i went for a very short walk to a shop yesterday which was about 100 yards from the car using my 2 crutches to stabilize me but after that i am very much in pain and my walking is back to tiny painful steps around the house”.

    Bowel and bladder dysfunction due to nerve compression is very rare. The nerve that must be compressed for dysfunction is the Nervi Eregantes, a filamentous nerve in the center of the canal. It takes a very large disc herniation or severe spinal canal stenosis to injure the nerve. Foraminal stenosis should not cause this nerve injury.

    Can symptoms get better without surgery? I have seen cases where the unexpected does happen but that is not the typical result. By your symptom description, you most likely will need surgery.

    Dr. Corenman

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