[purplepain]

#21671

I’m 38 I woke up one morning and had a pinched sciatica… The next thing I know I need spinal fusion because of spinal stenosis and disc pinching nerve, bulging disc. It’s been a year since the surgery and I am 100% worse. I have no strength in leg, falling often cuz my leg just goes numb. Pain is unreal. My hip feels broken and this is new and RLS is new. Injections don’t help, PT was impossible due to pain. Well I just had another MRI.. I would love for some help understanding what it says… I have to wait month+ before I see doctor.
The MRI says: EXAMINATION:
CLINICAL HISTORY: ; LOW BACK PAIN, PRIOR LUMBAR SURGERY

FINDINGS:
The marrow signal, vertebral body heights, and bony alignment are
normal throughout. Patient has had prior right laminectomy at L5-S1
with discectomy, the placement of an interbody fusion device, and
posterior pedicle screw fusion.

The conus is in normal position and demonstrates normal signal
intensity. The visualized abdominal and pelvic soft tissues are
unremarkable.

At L3-4 there are small bilateral foraminal disc protrusions larger on
the right which are causing no mass effect upon the adjacent nerve
roots or central canal narrowing.

At L4-5 there is mild diffuse broad-based disc bulging with inferior
foraminal narrowing on the right greater the left but no exiting nerve
root compression or central canal stenosis.

At L5-S1 there has been prior laminectomy and discectomy, with a
widely patent central canal. There is minimal granulation tissue
within the right lateral recess, surrounding the proximal descending
right S1 nerve root which otherwise appears unremarkable. There is
posterior osteophytic ridging at the disc space producing mild right
greater than left foraminal narrowing but no exiting nerve root
compression.

IMPRESSION:
Postsurgical and degenerative changes within the lumbar spine as
described above. No central canal stenosis, no descending or exiting
nerve root compression. Granulation tissue surrounding the descending
right S1 nerve root.

Thank you so much in advance. Sorry for this being so long!! Thank you and bless you.

[Donald Corenman, MD, DC]

#21763

The first questions are what was your disorder that needed a fusion and what were your symptoms? How did the symptoms change after surgery? What are your symptoms now? What did the surgeon say the cause was with your current symptoms?
See the section https://neckandback.com/conditions/how-to-describe-your-history-and-symptoms-of-lower-back-and-leg-pain/ to help describe your current symptoms.

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.

[purplepain]

#21766

Thanks for the reply!!
PREOPERATIVE DIAGNOSES WAS::::
1. Lumbar recurrent disc hernaition and Stenosis, DDD and radiculopathy L5-S1
2. Chronic low back pain and radiculopathy
My symptoms before surgery was: lower back pain 70% that radiated down my buttock 15% & my leg 15%.. Weakness in leg was bad as well the pain stayed about a 6-7

Symptoms did not change after surgery
Actually got worse and are the same now just slowly getting more and more severe. The pain stays about a 8-9 now… The pain is lower back & hip pain are together the hip pain can even go around to pelvic and its about 75%, leg outter and inner thigh now 25%.. My hip & back feels broke. My leg is so weak and just goes numb or limp causing me to fall.. After surgery I ended up with RLS and its bad if I’m lucky I’ll sleep 20hrs a week… A month ago that RLS feeling I started having in my back.. Lower to middle of spine… Weirdest feeling ever… If I walk more than 15mins the pain goes to a high 9 in my lower back and hip… If I sit the pain in back goes all the way to my neck now and my leg starts hurting so bad and the RLS starts..

As of now I’ve been told the inflammation is really bad in back to the point injection had to be done from another position(?)and the rest of pain cause is currently unknown. The MRI posted above was just done a week ago.

[Donald Corenman, MD, DC]

#21769

There are many questions to be answered. First-did you have a work-up prior to the surgery that identified what the source of your lower back was? You note lower back pain much greater than leg pain. What actions caused the lower back pain to become worse (again-see that section I referred to you above to determine symptoms and provocation)?

I am unclear of the initials RLS. Is this regional leg syndrome. right lateral recess (stenosis) or RSD (reflex sympathetic dystrophy now known as CRPS)?

Do you have a solid fusion? Have you had a CT scan or X-rays with flexion-extension views? What muscles in your leg are weak? See the section https://neckandback.com/conditions/home-testing-for-leg-weakness/ to understand how to test these muscles.

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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