Need a new search?
If you didn't find what you were looking for, try a new search!
-
AuthorSearch Results
-
#33633 In reply to: buttock nerve pain post microdiscectomy |
You didn’t mention how many weeks have past since you had the microdiscectomy.
As you said you might still have symptoms from the first herniation and the surgery.
Maybe is too soon for PT as your surgeon told you.
Iniitially my doctor recommended to start PT two weeks after the surgery, but then telling him that I still have bottock pain and leg pain he told me to wait, then when it was one month after the surgery and I made the MRI he saw the new herniation and he told me that I can start PT if I don’t have intense pain, because I’m not at risk…
Same as you, I have doubts about how PT could help in this kind of situations, I always had then even before the surgery especially because for me it didn’t work before the surgery…
I never had an epidural, have you? As dr Corenman said, it might help.#33581Topic: Arm pain 10 months after ACDF in forum NECK PAIN |Dear Dr Corenman,
I am a 33 years old male who underwent a C6/C7 ACDF 10 months ago.
Before the surgery, symptoms were a loss of strength in the left tricep and burning pain in the left tricep and forearm. Pain improved a little bit after 2 months of conservative therapy (oral steroids and physical therapy), but the loss of strength did not, so the spine surgeon suggested an ACDF surgery.
After the surgery, the tricep’s strength improved very quickly and, according to the surgeon and my own feeling, is now back to normal. However, I had only a slight improvement in arm pain.
The last x-ray shows that the fusion is solid and there is no sign of non-union or pseudoarthrosis.
Since the pain did not improve substantially, after 6 months the surgeon prescribed me an MRI and a CT scan. Both show that there is no residual compression on the nerve. However, there are small C5/C6 and T1/T2 herniations, without nerve or spinal cord compression. These herniations were already there before the surgery. The surgeon said that they were nothing serious but that I have arthrosis at the C5/C6 left facet joint. Therefore, he prescribed a 3 months therapy of NSAIDs (Etoricoxib).
During the first week of therapy, the pain improved a little bit, but then it remained stationary.
I also saw a pain specialist, who prescribed me Lyrica (75mg 3 times a day) and a low dose of Amitriptyline. With this therapy, in conjunction with NSAIDs, the pain almost completely disappeared and I could finally go back to my normal life! Nevertheless, when I stopped taking NSAIDs, the pain, although not as intense as before, went back.
A neurological examination shows that my reflexes are normal, my arm strength is normal and my sensations are normal (although sometimes I feel the left arm much colder than the right, without any apparent reason).
Now I feel pain almost only at the left forearm. Arm pain is sometimes associated with neck pain, but mostly not. The pain improves or even disappear if I do some kind of physical activity, however, it usually comes back when I stop.
Based on your experience, is having pain 10 months after an ACDF normal? Could it be that the nerve is still recovering from axonotmesis caused by the herniated disc? Shouldn’t I have some sort of neurological deficit if the nerve is still healing?Thanks a lot,
Simone#33572 In reply to: Reherniation after L5-S1 microdiscectomy after falling |This sounds like a slight aggravation of symptoms but not to the intensity or longevity you had prior to the fall; “I still had some light nerve pain coming and going, mostly translating in a tightness feeling on the back of my leg from the tight going down to my calf. Before the fall it was getting better but yesterday during the evening the pain went back to what it was 2 weeks after the surgery. It is not a strong pain (maybe 3 or 4 out of 10), it doesn’t prevent me from walking, sitting or laying and I do not think it is worse than it was pre or after the operation”.
There is no doubt that a fall in the early postoperative period can induce a recurrent disc herniation but symptoms can vary from nothing (the herniation is in a location that does not compress the root) to severe preoperative pain return. Slight increase in symptoms can still be treated by the same postoperative course you are on.
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.#33570 In reply to: buttock nerve pain post microdiscectomy |Hello Dr.Corenman,
The pain is tolerable and it doesn’t prevent me from walking, however 4 days ago I’ve started to exercise(kinetotherapy) and the pain intensified a little bit , especially when I’m sitting.Is this normal?
If I may, I want to ask you another thing , is it possible for the herniated fragment to dehydrate, so it may shrink over time, as my surgen told me?
Have you encountered this in your career?Thank you for all your answers.
#33568Topic: Direct Pars Repair – Grade I Spondylolisthesis L5/S1 in forum BACK PAIN |Dearest Dr. Corenman,
I am a 19 y/o who has always led an extremely athletic life (junior pro tennis, soccer, basketball). I started having back pain 8 months ago. I got an X-Ray of LS-Spine in Flexion & Extension (Aug-20), an MRI of the LS Spine (Aug-20) and a CT Scan of the Lumbar spine (Dec-20). I have a bilateral pars defect at L5 and minimal Grade I Spondylolisthesis of L5/S1. We also found Spina Bifida Oculta.
I haven’t played sports for 8 months, let alone jog or run. I’ve been doing aggressive strengthening of the core and surrounding muscles in physiotherapy for the last 6 months. I hope to one day be able to get back to tennis and soccer. I have had to take a year off from college after high school because of my condition.
With the way conservative treatment has been going, I’m not confident I will be able to do that and get back to sports without fixing the defect. So I’m considering a direct pars repair surgery.
My questions are:
1. In your opinion, am I eligible for a direct pars repair? I really do not want to get a spinal fusion. The MRI shows healthy discs (only minimal disc height reduction and bulging), I have minimal Grade I slippage, my spine is stable, and I am 19 years old.
2. How long do you think recovery from a potential pars repair surgery would take? I have to attend college by August/September 2021, so when should I plan for an operation?
3. Since Pars Repairs are more likely to be successful in younger patients (adolescents), would it be better if I did it sooner than later? I am 19, would you suggest I wait longer to see if conservative treatment can get me back to sports or that I go ahead with a repair soon? For example, if I did the surgery between my Freshman and Sophomore year (May-August 2022), would that be worse/better/the same in terms of likely outcome?Thank you very much
#33566 In reply to: Post OP Cervical Artificial Disc Replacement C5/C6 |The differential here is a decompressed nerve that is still healing, a chronic nerve injury, a question of the original diagnosis or an incomplete decompression. Normally, a healing nerve will show some improvement either in intensity of pain or less time of pain (or both) so that particular diagnosis might be down the list.If the nerve was not decompressed well or wrong diagnosis, then eventually a selective nerve root block of the root with diagnostic relief will give the correct diagnosis and possibly some long-term relief. Maybe start with an oral steroid treatment.
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. -
AuthorSearch Results
