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  • dgarz
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    Post count: 1

    Hello Dr. Corenman,
    I had bilateral L5 laminectomy, foraminotomy, and microdiscectomy in June 2019 to address sciatica, mild pins & needles in feet, and pelvic/perineal pain. I just had a repeat MRI (impinged L5 nerve root) and EMG (radiculopathy in both feet [moderate pins & needles, often no feeling/dead feeling, sometimes almost normal feeling]). The pelvic/perineal pain continues unabated but is somewhat muted with Gabapentin 300 MG, 2-3x day. My surgeon said pre-surgery there was only a 50% chance that the surgery would help the pelvic/perineal pain which is most severe while sitting (like sitting on a lump that is at times writhing/pulsating, taut, knife-like). My questions are these 1) could the pain still be related to the L5 nerve impingement, 2) do I need to just give it more time to heal, and 3) what specialist would you recommend I see for the pelvic/perineal pain? I’ve already seen a urogynecoloist who said it was a spine problem, a neurosurgeon who said it wasn’t a spine problem, a physiatrist who did two epidural steroid injections pre-surgery (the 1st helped 50%; the 2nd minimally), and the orthopedic surgeon who did my surgery.
    Many thanks!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    You leave out information that the neurological consultation and EMG/NCV provided. Do you have peripheral neuropathy? See https://neckandback.com/conditions/peripheral-neuropathy/

    Pelvic/perineal pain can originate from the spine but other sources are more likely such as pudendal neuropathy. There are no specific specialists for pudendal neuropathy that I know about. Some neurologists (not neurosurgeons) can be helpful.

    Dr. Corenman

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