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  • randrews
    Post count: 1

    Thank you so much for this forum! I feel so much more informed after reading through many of the other questions and reviewing your educational resources.

    I am a very athletic 36 year old mom of 3 with a desk job. I have always had back pain here and there but nothing that could not be taken care of with a visit to the chiropractor. This started with a running injury when I was 16 or 17 and seemed to resolve itself with a few weeks of visits to the chiropractor.

    Approx three weeks ago I irritated my back doing double unders (jump roping) and a couple of days later had severe pain 10 of 10 that started in my left buttocks and ran all the way down through my calf which was bad enough to send me to the er. I started oral steroids and pain control and the pain reduced but certain movements would cause the pain to increase.

    I had an lumbar spine xray five views. Impression was 1. Lumbosacral spondylosis 2. 4mm left retroperitoneal calcification.

    I then had an MRI that said Sigittal images show loss of the normal bright signal in this pulposus at the l4-5 and l5 S1 level measuring 1.2×1.8×1.2 and transverse AP and cranial caudal dimension. This contacts and displaces the nerve roots posteriorly vertically the S1 nerve root on the left side. No compression fracture or subluxation is seen. Axial images through the L5 S1 level reveals a large extruded disc fragment extending to the posterior portion of the left side the canal and displacing the nerve roots posteriorly. The foramen appear patent bilaterally At the L4-5 level of the canal and foramen are widely patent L3-4 and L2-3 the canal and foramen are patent.

    A week ago I went in for a epidural cortisone injection. That morning prior to I was again having severe (8 of 10) pain in left leg more so focused in the lower leg and calf. After the epidural injection it was unbearable (10 of 10) and they admitted me overnight for pain management. The pain subsided after about 48 hours but my foot is still numb, has pins and needles and significant weakness in my left leg. It is also a struggle to fully empty my bladder.

    When I wake up in the morning the pins and needles and numbness is less severe but as I get up and start the day it gets more and more irritated as the day goes on.

    Do you think based on my symptoms that the nerve is damaged?

    I have an appointment with a neurosurgeon tomorrow to discuss surgery options. I would really appreciate any direction or suggestions that you can provide.

    I would really like to continue to be very active for a long time.

    Thanks so much!

    Donald Corenman, MD, DC
    Post count: 8455

    You have developed a disc hernation at L5-S1 with significant compression of the S1 nerve root. Unfortunately, it sounds like you had a volume phenomenon from the epidural injection. There was precious little root for the nerve and the volume of the injection compressed the nerve root even more.

    You have failed an injection and have extreme pain. This is enough to indicate a microdiscectomy (see website for description of this surgery). Even more, you have motor weakness. In my opinion, this is a significant indication for surgery sooner than later as these motor nerves do not recover completely in many cases. Surgery allows a much better chance for recovery (see section under nerve injury and recovery).

    Surgery will allow you to return to your normal activity in most cases (see “recovery information by surgery”-“microdiscectomy” under “Pre and Post Op”)

    Dr. Corenman

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