TypicalParticipantJanuary 22, 2020 at 5:15 pmPost 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.
“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
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?TypicalParticipantJanuary 23, 2020 at 4:50 amPost count: 6
Also, I can walk on my heels and toes fine.
I occasionally get a bit of a jolt in my right leg, not often.
Pain in left leg does feel indicative of L5-S1 nerve root compromise (pain focused on outer side amd rear of leg as well as on the bottom and outer side of foot.)TypicalParticipantJanuary 25, 2020 at 2:24 amPost count: 6
Also a “toothache” type of dull throbbing pain in the spine in what feels like the area just above the belly button.Donald Corenman, MD, DCModeratorJanuary 25, 2020 at 2:41 pmPost count: 8460
“My orthopedic surgeon is one of those “don’t want to know you” after surgery types. Can’t blame him”. I think that his behavior is inappropriate. He is your surgeon and should help you, not just be a technician.
You note “worsening radiculopathy in left glute/leg/foot 6 weeks post lumbar microdiscectomy…Original surgery: microdiscectomy: L4-L5”. How would you compare your current symptoms to your preop symptoms in location, intensity, activity restrictions. How much change has occurred and how have your symptoms evolved after surgery?
I will assume the MRI findings are presurgery; “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 upon reading this (through an unknown radiologist’s eyes), the L5_s1 level could have been left alone as you had severe changes only at L4-5. Did you have a bilateral procedure or just unilateral?
Dr. CorenmanTypicalParticipantJanuary 25, 2020 at 4:04 pmPost count: 6
The MRI findings are pre surgery, yes.
The surgeon didn’t really go ober the operation much with me. He just approached me in the recovery area and told.me there was a tremendous amount of pressure on the nerbe and I should have been in there sooner.
It leads me to believe it was a unilateral procedure.
How would you compare your current symptoms to your preop symptoms in location, intensity, activity restrictions. How much change has occurred and how have your symptoms evolved after surgery?
Worse. Much more pronounced post surgery.
preop, I barely ever felt discomfort in my feet, it was mostly in the glute and leg.
Intensity, maybe a 6/10. I could stand for maybe about 10 minutes before starting to “dance around” on one leg. Its pretty much the same, now.
How the symptoms evolved over time:
The first 2 weeks were fine, but I did feel tingling in my left foot toes that was not present preop. Right after the first 14 days, the morning of my follow up appt with my surgeon actually, I began to feel mild familiar “soreness” radiating down the left leg.
I informed my surgeon, we did a straight leg test and he was pleased. he told me to take Aleve once every 12 hours and double the dosage
week 3: Took double dosage NSAIDS for 1 week and aside from making my blood incredibly thin, it did nothing to aleviate the symptoms. I felt tingling in the left side of my body and face and my personal doctor was very alarmed by this. He instructed me to cease the double dosaging.
week 4: Feeling better! More stable. Not wearing back brace so mUch, doing some walking around the house.
week 5: woke up late at night, was very thirsty so I grabbed a bottle of water out of the refridgerator, bent low to do it and felt a bit of a “pop” in the lower back but that was nothing really out of the ordinary and wasn’t painful. Immediately went back to sleep.
Woke up with symptoms. 7/10, I can walk around, I can live life but I can feel it, too. Its been like that for a week.
The only real improvement is preop, getting out of bed, it felt like the bottom side of my left foot was burning or tearing, as I got out of bed. That is not the case, now. Also my posture is better, in the morning I would walk sort of hunched over and I dont have to do that, now.
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