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  • KB32
    Participant
    Post count: 5

    Hi Dr. Corenman,

    Back in April I had an emergency microdiscectomy on my L4/L5. The emergency was due to the L5 nerve root being severely displaced and my left foot was experiencing paralysis. Could hardly walk and stand. Couldn’t move my toes in the left foot and was experiencing severe sciatica pain. Anyways, my recovery was going great after surgery up until a few weeks ago. Received a ct scan at the ER and it shows the l4/l5 reherniated and the protrusion is pressing on the l5 nerve root again.
    What are your suggestions for conservative treatment? And at what point would you suggest another surgery? Would you suggest another microdiscectomy or would you suggest a fusion? I’m a young mid-30s athletic female and really want to get back to doing the things i love to be doing.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8140

    Generally if symptoms are of similar intensity to your prior herniation with a new herniation, a redo microdiscectomy is in order. If symptoms are less and there is no progressive motor weakness, an epidural steroid injection can be considered. Fusion would not be necessary unless there was even another HNP (3rd HNP) as the reherniation rate after a second microdiscectomy is only from 10-20%.

    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.
    KB32
    Participant
    Post count: 5

    Thanks for the quick reply!

    After a week of rest, massage therapy, and acupuncture my sciatica pain went away and so did my lower back pain. The only symptom I am currently feeling is pins and needles in both of my legs. The last time I had a herniated disc only one of my legs was affected. Is it possible to have pins and needles all over both legs with a L4/L5 herniated disc?

    KB32
    Participant
    Post count: 5

    I should clarify that the majority of my lower back went away. Still get some pain in lower back when I sit for too long.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8140

    You have progressed well. Normally, paresthesias bilaterally in the lower extremities is due to root irritation but it is unusual to have bilateral presentation with a unilateral HNP. Nonetheless, pain is mostly gone and function sounds acceptable so give this some time to improve. Paresthesias typically will fade away over time

    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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