Donald Corenman, MD, DC
Moderator
Post count: 8660

The back of legs pain and paresthesias (tingling) could be from the foraminal stenosis at L5-S1 (see foraminal collapse or foraminal stenosis on the website). Scar should not cause opposite sided symptoms unless there was a large hematoma with scar formation (very unlikely). The wide distribution of pain throughout the back and groin could be from a lower brain stem globalization syndrome (like a thalamus malfunction) but this is conjecture and cannot be proven.

I am glad that a thoracic spine MRI will be ordered. Lower thoracic herniations can cause your symptoms (but there would be long tract signs on your examination that would draw attention to this potential disorder).

Foraminal stenosis at L5-S1 can cause your back of leg pain (but not groin and perineal pain). Bilateral selective nerve root blocks at L5-S1 with a pain diary can help to answer that question.

I am unclear as to the origin of the groin and scrotal pain as the nerves from L5 and S1 do not travel to this area. This is L1-2 and S2-4 and there was no evidence of either of these nerve groups being affected by the lower lumbar herniations.

Your complaints of bowel and bladder function may be more pain or medication related than on any neurological basis. There was no severe caudal equina compression (by your record) which is necessary to cause caudal equina syndrome (see website for explanation).

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.