Still having leg pain and is getting worse when I don't move.

Tagged: Chronic nerve/leg pain after 2 microdiscectomies

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ftkm92
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February 10, 2015 at 12:14 pm

Post count: 28

#12186

The 3rd Mri is done in 13/10/14
Lordosis abnormal lumbar may due to spasm
L4l5 minor Para central disc herniation indenting the theca. L5S1 Left paracentral disc herniation with annual tearnarrowwing thelateral recess and left neura foramen causing impingement of the left S1 nerve root. There is further scarring and granulation tissue inflammatory changes of the sit of surgery but no obvious abcess.

4th Mri with contrast
Recent surgery has been performed discectomy at L5S1 levelaminectomy. Signal abnormality and enhancement along the surgical tract and enhancement adjacent to the S1 nerve root. Granulation tissue.
Central buldge of the L4L5 disc.

Current symptoms. Leg pulling sensation and tightness while sitting , , laying on the bed and difficulty tip toes and pointing toes up. Walking I drag my leg and weakness and heavy.
Somwtimes muscle twitching during the night. Do not really have numbness.

Sorry for the repeat of the questions. I want to have a clear picture. Dr ask me to used crutches. I force my self not to depend on crutches.

Just want to know what is going on. I been to physiotherapy .

ftkm92
Participant

February 10, 2015 at 6:55 pm

Post count: 28

#12187

I am not sure. Base of my compression of the S1 nerve root is it true that I should have spastic gait?

But that why my surgeon , pain doctor current physiotherapy says I have foot drop. Is it possible I have foot drop and spastic gait? Does a with person with spastic gait and footdrop tend to drag their leg when they walk.

I remember when I was in hospital after surgery I went for physiotherapy session and there was one very senior and experience physiotherapist was check on me and she said I could have problem with L5 and S1 nerve root.

Every time I went for my follow up with my surgeon he ask me to push up and down using my toes. After the follow up he just gave me pain killers and told my parents that my left ankle is weak.

Base of the MRI I have only compression on S1 nerve root and both of my surgery is to decompress the S1 nerve. I am puzzle why pain management dr and physiotherapist says i am having footdrop. My surgeon says my ankle weak. and He did not mention what gait I am having.

I know I having problem to tip toes. The exercises I am doing now using a special string and put around all my 5 toes and pull the string using my hands.

Donald Corenman, MD, DC
Moderator

February 11, 2015 at 11:14 am

Post count: 8660

#12190

Your MRI reports do not note significant compression of the L5 nerve at either level. Muscle twitching can be from denervation (loss of continuity with the brain from nerve injury).

Spastic gait is something very different from foot drop. Foot drop develops from compressive injury to the L4 or L5 nerves, normally in the lower back spinal canal from a disc hernation. Spastic gait normally occurs from a spinal cord (or occasionally brain) injury. If you have a spastic gait, you need someone to do a careful examination and look at the thoracic and cervical spine for compression of the cord.

You might be mixing your foot weakness directions. Foot drop is the inability to walk on your heels (keeping the forefoot off of the ground). The foot might “slap” on the ground with walking and you would need to bend your leg like you are going up stairs (steppage gait) to keep the foot from catching on the ground.

Calf (gastroc) weakness is the inability to tiptoe (keeping your heel off the ground). This is the weakness that would be involved with exercises like “The exercises I am doing now using a special string and put around all my 5 toes and pull the string using my hands”.

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.

ftkm92
Participant

February 11, 2015 at 5:59 pm

Post count: 28

#12195

Actually I am not sure what walking problems i have now. I just drag my leg when I walk.

Base on my MRI report I should not have footdrop but why My pain management and physiotherapist saying I have footdrop. My surgeon says ankle weak.

I am not sure what’s going on.
current symptoms. Back of my left leg I feel pulling sensation. Both side left and right ankle of left leg feels tight too. My last 3 toes and first toes feels someone is pulling my toes.
Is granulation tissue and scar tissue the same?

Is about 4 months after my 2nd surgery and having those leg discomfort. I am not sure Is the granulation tissue on the L5S1 giving me those problem.

If is S1 nerve root giving problem what is the name of that gait?

Donald Corenman, MD, DC
Moderator

February 11, 2015 at 8:32 pm

Post count: 8660

#12196

To understand how the S1 nerve functions, see “walking (gait) disorders” and “symptoms of lumbar nerve injuries”. on the website.

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.

ftkm92
Participant

February 11, 2015 at 11:52 pm

Post count: 28

#12204

Thanks.

Base of my symptoms I am having chronic radiculopathy. The nerve test said normal and no nerve damage but i still having walking difficulties.
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Donald Corenman, MD, DC

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Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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