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  • Avatarseb_nied
    Participant
    Post count: 12

    Hello Dr. Corenman,

    many thanks for providing your feedback and for this great service you are doing for the community.

    I had a microdiscectomy exactly 26 days ago and had an unfortunate accident yesterday during one of my walks. I did not notice an icy patch on the sidewalk and slipped on it. My feet slipped forward and I found myself on a horizontal position with my hands on the ground and my back facing downwards. The fall was very controlled, I managed to land on my hands and did not hit any part of my back on the ground.

    I did not feel any aggravated pain in my back or leg right after the fall and managed to normally walk without issues.

    My situation after the operation was that I still had some light nerve pain coming and going, mostly translating in a tightness feeling on the back of my leg from the tight going down to my calf. Before the fall it was getting better but yesterday during the evening the pain went back to what it was 2 weeks after the surgery. It is not a strong pain (maybe 3 or 4 out of 10), it doesn’t prevent me from walking, sitting or laying and I do not think it is worse than it was pre or after the operation. But i have to admit it increased since the day before the fall even though not very much.

    Of course I’m worried that the fall caused a reherniation, however reading around the net I discovered that reherniation usually happens independendtly from how fast we go back to normal activities and usually ‘just happens’ due to factors are not within our control. I didn’t find any information about an unforseen event like a fall. I’m planning to have an MRI soon but I’m going crazy about this and was looking to have an feeback in the meantime.
    I’d immensely aprreciate having an opinion from you.

    Sincererly,
    Sebastian

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7849

    This sounds like a slight aggravation of symptoms but not to the intensity or longevity you had prior to the fall; “I still had some light nerve pain coming and going, mostly translating in a tightness feeling on the back of my leg from the tight going down to my calf. Before the fall it was getting better but yesterday during the evening the pain went back to what it was 2 weeks after the surgery. It is not a strong pain (maybe 3 or 4 out of 10), it doesn’t prevent me from walking, sitting or laying and I do not think it is worse than it was pre or after the operation”.

    There is no doubt that a fall in the early postoperative period can induce a recurrent disc herniation but symptoms can vary from nothing (the herniation is in a location that does not compress the root) to severe preoperative pain return. Slight increase in symptoms can still be treated by the same postoperative course you are on.

    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.
    Avatarseb_nied
    Participant
    Post count: 12

    Thank you very much Doctor for your answer.
    A quick update on the development of my symptoms. After 48 hours from the accident my back muscles located in the lumbar zone started to feel soar, mostly when standing and sitting, a similar feeling of tiredness as I’ve been standing or bending for several hours. Usually this feeling is less severe when walking or laying.
    The front thigh muscles of my original herniated side started to heat up and feel tired and muscles in my calf became stiff, similar to a feeling of a cramp. The power in my calf and leg is comparable to how it was before, it is reduced comparing to the good leg (I can do several repetitions pushing up on my toes but I feel less strength than on the other leg).
    I have an MRI tomorrow to check what happened even though my symptoms suggest that something happened in my back.
    I will report the results tomorrow.
    Regards,
    Sebastian

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7849

    You note:”48 hours from the accident my back muscles located in the lumbar zone started to feel” sore. This is normal for a fall post surgery even without a recurrent herniation. The new MRI will define your current situation. Paste the results here.

    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.
    Avatarseb_nied
    Participant
    Post count: 12

    Hello Dr. Coleman,

    the MRI showed indeed that there is a disc herniation, but much smaller than the previous one and more centrally localized. It was unclear for the doctor who examined the MRI whether the herniation might have been a residual from the surgery or perhaps a re-herniation after the accident, as it is central and in general hard to remove with a discectomy.
    Additionally to the herniation, there is a sign of facet joint effusion at the same level (L5/S1) visible on the MRI as white substance filling the facet joint. The doctor said that this is creating a swelling of the joint and the pressure applied from both sides (one side from the joint and the other side from the centrally herniating disc) is causing the sciatic pain.
    I was advised to treat this in a conservative way with cortisone injections in the facet joint. If this does not help, discuss about a revision surgery. 
    About my current symptoms, in addition to the lumbar back pain I was experiencing there is still a feeling of discomfort in my posterior and anterior thigh area and a warmth feeling in my anterior thigh very close to the knee. Calf and foot/toes feel relatively the same as after the surgery.
    Do you see a greater risk coming from the inflammation of the facet joint and a high chance that a discectomy/laminectomy will need to be performed?

    Best regards,
    Sebastian

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