michaelMemberMay 31, 2013 at 9:49 amPost count: 7
Dr. Corenman, I had a microdiscectomy with a hemi-laminectomy April 15th at L4/5. I had been battling for 2 years sciatic pain, aches in legs, hot/cold sensations, sensation of circulation being cut off to feet, etc. 70% of the pain in the left leg and 30% in right leg. My pain is/was almost always when I am sitting….standing and lying down I’m good. I am just about 7 weeks post op and all the surgery pain is gone, but I have little relief of my pre-surgery symptoms. I am an airline pilot and sitting is my lively hood. I do not have the ability to go lie down or stand up and walk around during my trips (obviously!) for relief. My question is this: How long after such a surgery do you determine it failed and that another procedure may be necessary?
I was pretty optimistic about this procedure but now I am mad at myself for not flying to Vail to see you for all this (you worked on another airline pilot I know). Any information would be greatly appreciated as I’d hate to be sidelined with my career over this. Thank you for your time.Donald Corenman, MD, DCModeratorJune 3, 2013 at 11:00 amPost count: 8455
Failure of spine surgery to relieve leg pain has multiple potential causes. I assume you do not have lower back pain.
First, leg pain with sitting is typically caused by a disc herniation or lateral recess stenosis (see website for description). Bilateral leg pain can also be caused by the forgoing conditions but has some other potential diagnoses.
A hemilaminectomy could be vertical or horizontal. A vertical hemilaminectomy would only decompress on one side and a horizontal hemilaminectomy would decompress across the canal.
Failure of relief with surgery can originate from the wrong diagnosis, incomplete decompression, unrecognized instability (rare), recurrent herniation or chronic radiculopathy.
A new MRI along with standing X-rays including flexion/extension views is necessary. If the diagnosis is not immediately recognizable, selective nerve blocks would be necessary. Finally, with the understanding of your pain generators, treatment which could include another surgery would be in order.
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