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  • Bikingenjo
    Participant
    Post count: 21

    I posted a while back about my MD a few months ago with recurrent symptoms (lower back pain that was exacerbated when leaning backwards or sitting, radiating glute). I had an MRI done and it shows stenosis around where my post microdiscectomy bulge is. This seems to be the source of my pain. But I was wondering, what is this stuff between my bulge and my canal?

    https://i.redd.it/l0d2h37gnifa1.jpg

    Is there a surgery that can help clear up the space and decompress my s1 nerve?

    Thank you

    Bikingenjo
    Participant
    Post count: 21

    IMPRESSION: MRI of the lumbar spine demonstrates:

    Previous left laminectomy at L5-S1. Unchanged left-eccentric disc bulge and posterior annular fissuring, with left lateral recess narrowing and disc contact on the descending left S1 nerve root. Moderate left facet arthropathy. Mild-moderate left and mild right foraminal narrowing. No thecal sac compression.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    By the radiologist’s description, “left lateral recess narrowing and disc contact on the descending left S1 nerve root”, it sounds like a redo surgery at this level could be helpful. I must remind you that radiologists can describe things differently than a spine surgeon so collaboration with a spine surgeon should be taken.

    A selective nerve root block would be helpful to insure the root is the cause of your symptoms. See:

    https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic/
    https://neckandback.com/treatments/diagnostic-vs-therapeutic-injections/
    https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections/

    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.
    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    By the radiologist’s description, “left lateral recess narrowing and disc contact on the descending left S1 nerve root”, it sounds like a redo surgery at this level could be helpful. I must remind you that radiologists can describe things differently than a spine surgeon so collaboration with a spine surgeon should be taken.

    A selective nerve root block would be helpful to insure the root is the cause of your symptoms. See:

    https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic/
    https://neckandback.com/treatments/diagnostic-vs-therapeutic-injections/
    https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections/

    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.
    Bikingenjo
    Participant
    Post count: 21

    Thank you so much for your reply as always. It is a big help. I saw my surgeon today and we are going to do another surgery – microdiscectomy, laminectomy, and foraminectomy to decompress the nerve in 2 weeks. He also mentioned he would try to clean up the scar tissue around S1.

    The only thing I am worried about is removing so much bone matter. I’m 26 years old, is there real risk to my health/spine stability etc after doing those 3 procedures at l5s1?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    I did not understand this is your third decompression. Generally, I would do a TLIF fusion of L5-S1 as third time decompression surgeries at the same level have a greater chance of failure (up to 50%) and fusions are a “one and done” type of procedure which prevents the disc from being a problem again.

    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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