Viewing 2 posts - 1 through 2 (of 2 total)
  • Author
    Posts
  • Typical
    Participant
    Post count: 6

    Dr.Corenman, I’ve been reading your posts for some time now and it has been very reassuring and supportive throughout my recovery time. I cannot thank you enough for “giving back” (as you’ve put it) as much as you have. You are clearly an expert in your field and your expertise and input is greatly valued. Thank you.
    I will try my best below to get straight to the point.

    Complaint: worsening radiculopathy in left glute/leg/foot 6 weeks post lumbar microdiscectomy.

    symptoms:
    “Soreness” radiating down left leg from glute.
    Tingling in left foot not present pre-surgery.

    straight leg raise from sitting position: I can do it, it just feels like im “over stretching” if that makes any sense.

    Original surgery: microdiscectomy: L4-L5

    MRI findings:
    L4-L5: 6mm broad-based disc extrusion contribute to several central canal stenosis and severely narrows both lateral recesses with mass effect on the cauda equina. Mild bilateral facet arthrosis. Patent neural foramen.

    L5-S1: The disc height is preserved. 2-3mm right paracentral disc protrusion moderately narrows the left lateral recess and may contact the descending S1 nerve root. Patent central canal noting the thecal sac relatively tapered at this point. The facet joints are maintained. The neural foramen are patent.

    From the MRI to the operating room was about 7 months with pain in left leg becoming more pronounced over time.

    Workers comp case.

    My orthopedic surgeon is one of those “don’t want to know you” after surgery types. Can’t blame him.

    I’m in my late 20’s and work a high impact and physically exhausting job on unever and unforgiving terrain.
    I am not used to “taking it easy” for 3 months.

    It is possible I may have over extended myself bending down to reach something in the refridgerator, putting on socks, walking up or down stairs or tossing and turning in my sleep. I do occasionally hear and feel “pops” and “cracks” not only in my spine but in my arms and legs as well. It is nothing out of the ordinary to adjust my upper back and here about four or five “cracks”. They are not painful.

    Resting on my back with my legs slightly bent above a pillow does not help anymore.
    Lying down with my legs straight does not help. Standing up for a matter of seconds can bring on symptoms.
    Pacing around does, however, help.

    I never asked but I am suspicious that my surgeon may have only addressed The L4-L5 situation and may have left the L5-S1 alone.

    As far as possible inflammation, I have consulted my private insurance HMO and they have given me prednisone and scheduled me for physical therapy and another MRI. I am now on day three of taking 4 prednisone tablets at a time.

    So far the prednisone is doing nothing.

    So given the information, what do you think?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    Your MRI report; “L4-L5: 6mm broad-based disc extrusion contribute to several central canal stenosis and severely narrows both lateral recesses with mass effect on the cauda equina…L5-S1:… 2-3mm right paracentral disc protrusion moderately narrows the left lateral recess and may contact the descending S1 nerve root”. Based on this report, it is unlikely that the L5-S1 level is causing pain as the L4-5 level was much more severe. The statement “may contact the descending S1 nerve root” means that the root is not compressed.

    You note “I never asked but I am suspicious that my surgeon may have only addressed The L4-L5 situation and may have left the L5-S1 alone”. Of course, I was not there but I assume your symptoms and examination pointed to the L5 root at the L4-5 level. The hypothetical proper surgery was an L4-5 decompression.

    You note “My orthopedic surgeon is one of those “don’t want to know you” after surgery types. Can’t blame him”. I can. This behavior is inappropriate. He should be taking care of you until these symptoms resolve or there is a good explanation of why there are current symptoms. Is there a seroma, recurrent herniation, discal collapse with foraminal stenosis or ??????

    “As far as possible inflammation, I have consulted my private insurance HMO and they have given me prednisone and scheduled me for physical therapy and another MRI”. Good. You need a new MRI with gadolinium.

    Dr. Corenman

Viewing 2 posts - 1 through 2 (of 2 total)
  • You must be logged in to reply to this topic.