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Iklepickle wrote:

The sole purpose of the surgical procedure I undewas told needed and elected to have done after discussions with my consultant, husband and I a few months before my day surgery admission in March 2017 as a day case patient”Left Sided L5 S1 Microdiscectomy” spinal surgery I was listed for by my clinician in March 2017, was to decompress the s1 nerve root by removing the impinging pathology impinging my L5 – S1 nerve root via what my family and I were informed as being straight forward day surgery ‘microdisectamy spinal surgery ‘

Having sustained sudden onset of pain to my lower back with radiating left leg pain in 2015 while lifting a patient during a manual handling monouver, further exacerbated with weight loading on back, twisting, pulling pushing, exacerbated ++ fall/falling left sided, short durations of leg numbness, exhausting all Conservative options made available to me:
Physiotherapy
Facet injection
Intravascular Bursa injection
Trial tens machine
Medication changes which due to the medication side effects, butrans, baclofen, or a morph etc, risk of qc prolongation I was reffered to a consultant Neurosurgeon for further management

MRI Lumbosacral Spine

Magnetic resonance imaging of lumbar spine abnormal
History
worsening symptoms and pain
Reduced power throughout lower extremity
Intermittent parathesia
Radiating pain down the back of left thigh missing the knee, down the calf and under ball of left foot
Positive straight leg test
Several episodes loss of bowel and bladder control also continued pins and kneedles patients hands, last two fingers having to shake to wake up, do cervical issues found on the mri only small disc bulge.
Under pain clinic. Not responding to injections or analgesia

MRI lumbar report pre surgery :

Normal appearance of piriformia and pectineus muscles. Normal appearance of the ischial tuberosities. There was no evidence of ischinl bursitis. No evidence of inguinal hernia or Anterior abdominal wall hernia as far as could be seen on this MRI.

Reported by: xxx

Feb-2016 MRI Lumbar

level. Marrow signal was preserved. Normal conus and cauda equina roots.

L5 – S1 shows a small broadbased central disc protrusion. This encroached bilateral recesses, more on the left side impinging left s1 nerve root.
But there was also contact of the right s1 nerve root

**please note, I am unsure if the information posted above re right s1, contact has any relevance to the surgical procedure or my symptoms, diagnosis,or the excruciating pain I was in upon waking in recovery after my original surgery thought to have been a microdisectamy ***

Conserns:

The primary procedure I was listed for by my consultant, told i needed. Further told was confirmed by my most up-to-date MRI and Consistent with my symptoms was a ” Left Sided L5-S1 Microdiscectomy”

Within my medical records
My Patient Care Plan records – Procedure also as ” Left Sided L5 S1 Microdiscectomy”. As does
The Anaesthetic Record, and the recovery Kardex and several other pertinent medical records.

However the consent form I signed on the morning of my admission. Minutes before being taken to theatre and whilst being gowned up due to a last minute patient surgery listing change (of which I wasn’t provided with a copy at the time) signed whilst my family were present. Now shows “Left Sided L5 S1 Microdiscectomy & decompression”

The operation record, records operation as
“Left sided L5 S1 Microdiscectomy & Decompression”

The surgeon is recorded as being my allocated clinician – consultant on several records. But then on another records the surgeon as a specialist trainee Neorosurgeon

Their is also two identical records “operation record” one barely ledgable and the other directly under my clinician whom I relied on to perform my procedure as being “in scrubbed”!

When I first asked you a question a few years ago I had no idea about what actually happened. All I nee was that I had been struggling for nearly two years with lower back pain and left leg pain that started deep in my left buttock and back following lifting a client as a carer and then after falling became increasingly worse and radiated down the back of my left thigh, missing my knee, down my calf to occasionally the sole of my foot. I was on alot of pain relief which was causing constipation and I also had some worsining of bladder leaking but I did suffer with a stressed bladder.

Prior to the first surgery around 6 months I was sent for an S1 diagnostic nerve root block ” and this worked for just over 3.5 days and honestly felt like a new woman as I got my legs back. I think I over did too things and the symptoms returned quite quickly.

It was sometime before I was seen again and following examination by a nurse practitioner, I was reffered for a follow up MRI to plan for surgery. This was November 16.
Examination showed a positive straight leg test, evidence of left leg weakness. Noted as being unsure if pain related or not. Reflexes right leg 5/5 all and left leg hipflex & ext 3/5 knee flex & ext 3/5 Ankle/planter 4/5 toe flex ext 4/5
Sensation normal right leg
Left leg L1 L2 L4 L5 S1

Tone all the 5s

MRI confirmed Moderate broadbased disc protrusion impinging nerve root with little fat between

Prior to my procedure I stopped smoking and was wearing a nicotine patch in theatre

Because of nausea and struggling to take the level of pain relief and discussions with the pain clinic I had reduced butrans patch from 20 mg to 5 mg and on the day of my surgery was wearing a 5mg butrans patch

I had athsma as a child but since my children were born over 18 years ago when had primary surgery I had no problems or required any use of inhalers or anything or treatment.

I was over weight which was due reduction on my previous mobility due to pain

As I explained in my initial contact with you. When I woke up in recovery from the procedure I was on oxogen, coughing my guts up and initially couldn’t feel my legs at all. Thankfully this was only brief as I then started to get pins and needles, prickly sensation in both my legs and then all of a sudden an Acute unrelenting stabbing pain deep in my left and right groin and into the side of the very top of my thies and middle of my lower back.
I remember being asked if the least pain was 1 and worst 10 what would I say the pain I was experiencing was right now.

I said 12 and on a par with the pain I felt when I had internal bleeding with placenta abruption. I have experienced placenta abruption three times and yes horrendous.
I was given intravenous pain relief.
My records show I received 200m in total on top of diamorphine, paracetamol and others.

I was then taken with oxogen tank to a side room on inpatient ward

I was a mess . I was unable to complete all the physio exercises, when shown how to bedroll the bed rail gave way and I nearly fell off the bed.

My pain score was 7/10
Reflexes 3/5 & ,2/5 all
Pain left calf and lower back at operation site and groin. Last two fingers hand numb
My thigh was bright red and sore
I wet myself again as couldn’t find the call bell
At home prior to surgery I had oramorph which I took for breakthrough pain and would take 5ml I was now being given oramoph 10 mil ever 2 to 4 hours plus paracetamol
I had been given a sabutamol inhaler and stayed in as was to poorly but my records show that I was safe for DK with help and my husband would contact social services and ide use mothering laws wet room as I only had a bath.
However I actually went home the following morning, I wasn’t examined, my clinician saw me really early around 6.30 7am and pressed the sole’s of my feet and said I could go home

I was discharged unaware that my operation was prolonged 3.5 hours
My recovery 1 5 hours
I had bronchospasm X3 on intubation and experation plugging, yellow secretions, help called, upproned aspirations and sabutanol given. On 100 % oxygen. Temp35 ketamin propofol and more bone lamina removed than planned. Disc bulge palpated and not compressing so not entered removed

Discharged on opiates, no medication review, on pain and no discectomy!

Unable to sit like down stand. Put weight through big toe left leg seen by GP as coughing chest bad pain unbearable readmitted 9 days later
MRI showed L5 S1 moderate broadbased central disc extrusion impinging nerve root
Told needed further surgery so underwent a second surgery 9 days after initial primary surgery to have redo open discectomy and foramen decompression woke pain free

Since diagnosed with neorogenic bowel and bladder
Very weak left leg and moderate right. Bending forward hurts stiff . My ddimer went through roof
Had abscess legs face stomach
Multiple vitamin deficiencys X3 repeat admission suspected stroke. Started pins and needles left leg which moved up to my arm couldn’t find side if putting mug down loss of spacial awareness, the pins and needles moved up the left side of my face and tongue couldn’t talk. It was thought last admission within 3 week period it was a infective episode and I was treated with anti viral s for encephalitis
I was then told hemiplegic migraines but no admission since snti virals

I have lost muscle both legs and bum. Straight up and down. My lower back is flat. My legs weak especially on walking or slight incline reduced flextion twist
Lost weight and doing better but legs get weaker walking and discomfort lower back into cocdix. Off all opiates doing better but have to self catheterise and have bowel washes possible stoma. What has gone wrong

Told surgery always meant to be a decompression with or without a discectomy. I don’t get this or understand why a Microdiscectomy wasn’t done but 9 days later showed similar to Pre-Op MRI and needed doing

I wish ide never had done and to not be told until over a week later and five years later that the surgeon you thought operated hadnt

The Theatre Anaesthetic record, records under the side heading “operation” as “L5 S1 Microdiscectomy”

The consent form I signed on the morning of my surgery – witnessed by family. Signed whilst being gowned up for theatre due a last minute patient theatre listing change was “Left Sided L5 S1 Microdiscectomy” and now following receipt of my medical records, records “left sided L5 S1 Microdiscectomy & Decompression”?! And the operation note also records the same.

Signed consent taken on my Clinician /consultants behalf (informed Clinician waiting my arrival in theatre) taken by the Clinician extended scope practitioner, whom I was first scene by within the spinal outpatient clinic and by the theatre anethasist in the presence of my family

I was told if my back pain was worse than my leg pain then this surgery wasn’t for me, which only 40, previously athletic, my leg pain then was the main problem.

I was asked did I no what the surgery I was having done? This was repeated at the Clinician team request twice before my arrival in surgery and I stated the following:

I was having an L5-s1 microdisectamy. My Clinician will make a small Incision in my lower back, pull my muscles etc a side before then removing the part of disc impinging my nerve, sucking any debry as I called it before sewing me back up.

Obviously I’m aware that the surgery was slightly more complicated than that but that was my interpretation.

My Clinician told me in my first and only appointment with him in January, 2017 that the surgery would be performed as a day case

Reletivly straight forward and has up to an 80% success rate.

Further stated as I had been in pain for a long time it was possible that although the nerve would no longer be impinged, I could still struggle with pain as my brain may continue to send the signals as before, however this was only a small possibility and in all was very positive

On waking from surgery, I awoke on oxygen, sweating, having pain to my chest, coughing Fleming up and struggling with my breathing, this continued for some time after surgery and on my return to the ward and coming home for which I was given a sabutamol inhaler on the ward and given an oxygen mask for a short time on oxygen for a short time. This information was advised to me by my anethasist on returning to the ward. Further noted that during theatre my airway tube became blocked so I had to be re-tubed.

I had no feeling in my legs to start, this soon resolved and I had excruciating pain bilateral in my groin. The pain was unbearable and the recovery team gave me a significant amount of pain relief to try and make me more comfortable.

On my return to the ward the anethasist advised that they had issues with my breathing tube and that more bone than planned was removed.
Not being quite with it, my back in agony, the pain deep in my groin now radiating down my left leg was significantly distressing especially as I lost control of my bladder from coughing and couldn’t walk to the buzzer to get assistance. Thankfully my family soon came to assist as I was in tears

Supposed to be going home, distressed, sweat pouring off me I could not understand why I was in so much pain

Scene by the physio, the physio showed me how to do a bed role and you really could not write it, I took hold of the bed rail and it gave way leaving me hanging half way off the bed.

I was advised that I should stay overnight in which I agreed, I didn’t see my Clinician the surgeon until around 6.30 am the following morning who checked my legs and power and other than that said I could go home.
.
Discharged on the same level of pain relief, my level of pain increased. I didn’t no if this was normal, in my head or what. By the end of the week the pain was so bad I could not put any weight threw my left leg at all and just putting my big toe to the ground was very painful. I tried to see my gp and I just couldn’t wait to be scene as I could not sit or stand and just sobbed

Having spoken with the hospital ward registrar I was re, – admitted to the hospital and an mri was performed which revealed that my disc was still intact and compressing my nerve and I now needed re-do surgery, the surgery I should have had from the start performed.

By this stage I had to push to wee but strangely my pain had eased all of a sudden. Following my second surgery I awoke pain free to much relief but I now have problems which I would like some advice on as the thought of further surgery scares me to death.

Symptoms

Unable to walk up an incline or stairs without difficulty
Short walks cause my legs to become heavier and heavier making every step hard work
Ots as though I have concrete in front of me and I get slower and slower.
My biggest issue is bending or twisting and power in my legs and agonising back pain. I also when I try to walk just to my local shop pain deep in the right side of my groin and my back pain is no longer focused just low down, it goes to the centre of my back
I fell asleep last week and some how ended up on my front my arms had gone numb and I didn’t have the strength to roll back to my front. I have also had heat at the front of both my legs after walking knees down and a central pain in the middle at the back of my calf all though this has only happened twice.
I’ve had a repeat mri which shows the following :

The are are 5 lumbar type vertebrae
With loss of the normal lumbar lordosis but otherwise normal alignment,

preservation of vertebral body
Height and normal marrow signal. The conus terminates at L1 and is of normal signal intensity.

At L3/L4 there is a mild central disc bulge without canal stenosis or
neural compromise.

At L4/L5 there is a broad-based central disc bulge with early facet joint arthropathy but no canal stenosis or neural compromise.

At L5/Sl there is evidence of a left-sided microdiscectomy and residual
Degenerative disc without canal stenosis.

There appears to be
Oedema/fibrous scar tissue at the site or the original surgery
The exiting nerve root does appear to be marginally thickened compared with
the right

All the remaining visualised intervertebral discs are wellhydrated without evidence of significant degeneration, canal stenosis or nerve root compromise.

Having raised questions relating to my original surgery, I have been told that on inspection during surgery the Clinician removed bone and ligament and on inspection of the disc which was enclosed there was no evidence of compression and that a microdisectamy is also called a micro-decompression and the sole reason for my surgery was to adequately decompress the nerve root which was successfully performed.

Please can you help me make sense of this entire horrible situation that has left me not only with what I believe more issues than I started with, but also having had mrsa, I’m still struggling with repeating infections, vitamin D deficiency and foliate difficiency, my inflammatory markers are continuing raised etc. Any help on your professional opinion on how I move forward given my latest mri results would be eternally appreciated x

n

Iklepickle wrote:

The sole purpose of the elected spinal surgery performed by my Clinician in March 2017, was to successfully decompress the s1 nerve root by removing the portion of disc impinging my L5 – S1 nerve root via what my family and I were informed as being straight forward day surgery ‘microdisectamy spinal surgery ‘

Having sustained sudden onset of pain to my lower back with radiating left leg pain in 2015 while lifting a patient during a manual handling monouver, further exacerbated with weight loading on back, twisting, pulling pushing, exacerbated ++ fall/falling left sided, short durations of leg numbness, exhausting all Conservative options made available to me:
Physiotherapy
Facet injection
Intravascular Bursa injection
Trial tens machine
Medication changes which due to the medication side effects, butrans, baclofen, or a morph etc, risk of qc prolongation I was reffered to a consultant Neurosurgeon for further management

MRI Lumbosacral Spine

Magnetic resonance imaging of lumbar spine abnormal
History
worsening symptoms and pain
Reduced power throughout lower extremity
Intermittent parathesia
Radiating pain down the back of left thigh missing the knee, down the calf and under ball of left foot
Positive straight leg test
Several episodes loss of bowel and bladder control also continued pins and kneedles patients hands, last two fingers having to shake to wake up, do cervical issues found on the mri only small disc bulge.
Under pain clinic. Not responding to injections or analgesia

MRI lumbar report pre surgery :

Normal appearance of piriformia and pectineus muscles. Normal appearance of the ischial tuberosities. There was no evidence of ischinl bursitis. No evidence of inguinal hernia or Anterior abdominal wall hernia as far as could be seen on this MRI.

Reported by: xxx

Feb-2016 MRI PELVIS

level. Marrow signal was preserved. Normal conus and cauda equina roots.

L5 – S1 shows a small broadbased central disc protrusion. This encroached bilateral recesses, more on the left side impinging left s1 nerve root.
But there was also contact of the right s1 nerve root

**please note, I am unsure if the information posted above re right s1, contact has any relevance to the surgical procedure or my symptoms, diagnosis,or the excruciating pain I was in upon waking in recovery after my original surgery thought to have been a microdisectamy ***

Conserns:

Following signing patient consent to an “L5-S1 Microdiscectomy” and decompression?”

Signed consent taken on my Clinician /consultants behalf (informed Clinician waiting my arrival in theatre) taken by the Clinician extended scope practitioner, whom I was first scene by within the spinal outpatient clinic and by the theatre anethasist in the presence of my family

I was told if my back pain was worse than my leg pain then this surgery wasn’t for me, which only 40, previously athletic, my leg pain then was the main problem.

I was asked did I no what the surgery I was having done? This was repeated at the Clinician team request twice before my arrival in surgery and I stated the following:

I was having an L5-s1 microdisectamy. My Clinician will make a small Incision in my lower back, pull my muscles etc a side before then removing the part of disc impinging my nerve, sucking any debry as I called it before sewing me back up.

Obviously I’m aware that the surgery was slightly more complicated than that but that was my interpretation.

My Clinician told me in my first and only appointment with him in January, 2017 that the surgery would be performed as a day case

Reletivly straight forward and has up to an 80% success rate.

Further stated as I had been in pain for a long time it was possible that although the nerve would no longer be impinged, I could still struggle with pain as my brain may continue to send the signals as before, however this was only a small possibility and in all was very positive

On waking from surgery, I awoke on oxygen, sweating, having pain to my chest, coughing Fleming up and struggling with my breathing, this continued for some time after surgery and on my return to the ward and coming home for which I was given a sabutamol inhaler on the ward and given an oxygen mask for a short time on oxygen for a short time. This information was advised to me by my anethasist on returning to the ward. Further noted that during theatre my airway tube became blocked so I had to be re-tubed.

I had no feeling in my legs to start, this soon resolved and I had excruciating pain bilateral in my groin. The pain was unbearable and the recovery team gave me a significant amount of pain relief to try and make me more comfortable.

On my return to the ward the anethasist advised that they had issues with my breathing tube and that more bone than planned was removed.
Not being quite with it, my back in agony, the pain deep in my groin now radiating down my left leg was significantly distressing especially as I lost control of my bladder from coughing and couldn’t walk to the buzzer to get assistance. Thankfully my family soon came to assist as I was in tears

Supposed to be going home, distressed, sweat pouring off me I could not understand why I was in so much pain

Scene by the physio, the physio showed me how to do a bed role and you really could not write it, I took hold of the bed rail and it gave way leaving me hanging half way off the bed.

I was advised that I should stay overnight in which I agreed, I didn’t see my Clinician the surgeon until around 6.30 am the following morning who checked my legs and power and other than that said I could go home.
.
Discharged on the same level of pain relief, my level of pain increased. I didn’t no if this was normal, in my head or what. By the end of the week the pain was so bad I could not put any weight threw my left leg at all and just putting my big toe to the ground was very painful. I tried to see my gp and I just couldn’t wait to be scene as I could not sit or stand and just sobbed

Having spoken with the hospital ward registrar I was re, – admitted to the hospital and an mri was performed which revealed that my disc was still intact and compressing my nerve and I now needed re-do surgery, the surgery I should have had from the start performed.

By this stage I had to push to wee but strangely my pain had eased all of a sudden. Following my second surgery I awoke pain free to much relief but I now have problems which I would like some advice on as the thought of further surgery scares me to death.

Symptoms

Unable to walk up an incline or stairs without difficulty
Short walks cause my legs to become heavier and heavier making every step hard work
Ots as though I have concrete in front of me and I get slower and slower.
My biggest issue is bending or twisting and power in my legs and agonising back pain. I also when I try to walk just to my local shop pain deep in the right side of my groin and my back pain is no longer focused just low down, it goes to the centre of my back
I fell asleep last week and some how ended up on my front my arms had gone numb and I didn’t have the strength to roll back to my front. I have also had heat at the front of both my legs after walking knees down and a central pain in the middle at the back of my calf all though this has only happened twice.
I’ve had a repeat mri which shows the following :

The are are 5 lumbar type vertebrae
With loss of the normal lumbar lordosis but otherwise normal alignment,

preservation of vertebral body
Height and normal marrow signal. The conus terminates at L1 and is of normal signal intensity.

At L3/L4 there is a mild central disc bulge without canal stenosis or
neural compromise.

At L4/L5 there is a broad-based central disc bulge with early facet joint arthropathy but no canal stenosis or neural compromise.

At L5/Sl there is evidence of a left-sided microdiscectomy and residual
Degenerative disc without canal stenosis.

There appears to be
Oedema/fibrous scar tissue at the site or the original surgery
The exiting nerve root does appear to be marginally thickened compared with
the right

All the remaining visualised intervertebral discs are wellhydrated without evidence of significant degeneration, canal stenosis or nerve root compromise.

Having raised questions relating to my original surgery, I have been told that on inspection during surgery the Clinician removed bone and ligament and on inspection of the disc which was enclosed there was no evidence of compression and that a microdisectamy is also called a micro-decompression and the sole reason for my surgery was to adequately decompress the nerve root which was successfully performed.

Please can you help me make sense of this entire horrible situation that has left me not only with what I believe more issues than I started with, but also having had mrsa, I’m still struggling with repeating infections, vitamin D deficiency and foliate difficiency, my inflammatory markers are continuing raised etc. Any help on your professional opinion on how I move forward given my latest mri results would be eternally appreciated x

n

Iklepickle wrote:

The sole purpose of the elected spinal surgery performed by my Clinician in March 2017, was to successfully decompress the s1 nerve root by removing the portion of disc impinging my L5 – S1 nerve root via what my family and I were informed as being straight forward day surgery ‘microdisectamy spinal surgery ‘

Having sustained sudden onset of pain to my lower back with radiating left leg pain in 2015 while lifting a patient during a manual handling monouver, further exacerbated with weight loading on back, twisting, pulling pushing, exacerbated ++ fall/falling left sided, short durations of leg numbness, exhausting all Conservative options made available to me:
Physiotherapy
Facet injection
Intravascular Bursa injection
Trial tens machine
Medication changes which due to the medication side effects, butrans, baclofen, or a morph etc, risk of qc prolongation I was reffered to a consultant Neurosurgeon for further management

MRI Lumbosacral Spine

Magnetic resonance imaging of lumbar spine abnormal
History
worsening symptoms and pain
Reduced power throughout lower extremity
Intermittent parathesia
Radiating pain down the back of left thigh missing the knee, down the calf and under ball of left foot
Positive straight leg test
Several episodes loss of bowel and bladder control also continued pins and kneedles patients hands, last two fingers having to shake to wake up, do cervical issues found on the mri only small disc bulge.
Under pain clinic. Not responding to injections or analgesia

MRI lumbar report pre surgery :

Normal appearance of piriformia and pectineus muscles. Normal appearance of the ischial tuberosities. There was no evidence of ischinl bursitis. No evidence of inguinal hernia or Anterior abdominal wall hernia as far as could be seen on this MRI.

Reported by: xxx

Feb-2016 MRI PELVIS

level. Marrow signal was preserved. Normal conus and cauda equina roots.

L5 – S1 shows a small broadbased central disc protrusion. This encroached bilateral recesses, more on the left side impinging left s1 nerve root.
But there was also contact of the right s1 nerve root

**please note, I am unsure if the information posted above re right s1, contact has any relevance to the surgical procedure or my symptoms, diagnosis,or the excruciating pain I was in upon waking in recovery after my original surgery thought to have been a microdisectamy ***

Conserns:

Following signing patient consent to an “L5-S1 Microdiscectomy” and decompression?”

Signed consent taken on my Clinician /consultants behalf (informed Clinician waiting my arrival in theatre) taken by the Clinician extended scope practitioner, whom I was first scene by within the spinal outpatient clinic and by the theatre anethasist in the presence of my family

I was told if my back pain was worse than my leg pain then this surgery wasn’t for me, which only 40, previously athletic, my leg pain then was the main problem.

I was asked did I no what the surgery I was having done? This was repeated at the Clinician team request twice before my arrival in surgery and I stated the following:

I was having an L5-s1 microdisectamy. My Clinician will make a small Incision in my lower back, pull my muscles etc a side before then removing the part of disc impinging my nerve, sucking any debry as I called it before sewing me back up.

Obviously I’m aware that the surgery was slightly more complicated than that but that was my interpretation.

My Clinician told me in my first and only appointment with him in January, 2017 that the surgery would be performed as a day case

Reletivly straight forward and has up to an 80% success rate.

Further stated as I had been in pain for a long time it was possible that although the nerve would no longer be impinged, I could still struggle with pain as my brain may continue to send the signals as before, however this was only a small possibility and in all was very positive

On waking from surgery, I awoke on oxygen, sweating, having pain to my chest, coughing Fleming up and struggling with my breathing, this continued for some time after surgery and on my return to the ward and coming home for which I was given a sabutamol inhaler on the ward and given an oxygen mask for a short time on oxygen for a short time. This information was advised to me by my anethasist on returning to the ward. Further noted that during theatre my airway tube became blocked so I had to be re-tubed.

I had no feeling in my legs to start, this soon resolved and I had excruciating pain bilateral in my groin. The pain was unbearable and the recovery team gave me a significant amount of pain relief to try and make me more comfortable.

On my return to the ward the anethasist advised that they had issues with my breathing tube and that more bone than planned was removed.
Not being quite with it, my back in agony, the pain deep in my groin now radiating down my left leg was significantly distressing especially as I lost control of my bladder from coughing and couldn’t walk to the buzzer to get assistance. Thankfully my family soon came to assist as I was in tears

Supposed to be going home, distressed, sweat pouring off me I could not understand why I was in so much pain

Scene by the physio, the physio showed me how to do a bed role and you really could not write it, I took hold of the bed rail and it gave way leaving me hanging half way off the bed.

I was advised that I should stay overnight in which I agreed, I didn’t see my Clinician the surgeon until around 6.30 am the following morning who checked my legs and power and other than that said I could go home.
.
Discharged on the same level of pain relief, my level of pain increased. I didn’t no if this was normal, in my head or what. By the end of the week the pain was so bad I could not put any weight threw my left leg at all and just putting my big toe to the ground was very painful. I tried to see my gp and I just couldn’t wait to be scene as I could not sit or stand and just sobbed

Having spoken with the hospital ward registrar I was re, – admitted to the hospital and an mri was performed which revealed that my disc was still intact and compressing my nerve and I now needed re-do surgery, the surgery I should have had from the start performed.

By this stage I had to push to wee but strangely my pain had eased all of a sudden. Following my second surgery I awoke pain free to much relief but I now have problems which I would like some advice on as the thought of further surgery scares me to death.

Symptoms

Unable to walk up an incline or stairs without difficulty
Short walks cause my legs to become heavier and heavier making every step hard work
Ots as though I have concrete in front of me and I get slower and slower.
My biggest issue is bending or twisting and power in my legs and agonising back pain. I also when I try to walk just to my local shop pain deep in the right side of my groin and my back pain is no longer focused just low down, it goes to the centre of my back
I fell asleep last week and some how ended up on my front my arms had gone numb and I didn’t have the strength to roll back to my front. I have also had heat at the front of both my legs after walking knees down and a central pain in the middle at the back of my calf all though this has only happened twice.
I’ve had a repeat mri which shows the following :

The are are 5 lumbar type vertebrae
With loss of the normal lumbar lordosis but otherwise normal alignment,

preservation of vertebral body
Height and normal marrow signal. The conus terminates at L1 and is of normal signal intensity.

At L3/L4 there is a mild central disc bulge without canal stenosis or
neural compromise.

At L4/L5 there is a broad-based central disc bulge with early facet joint arthropathy but no canal stenosis or neural compromise.

At L5/Sl there is evidence of a left-sided microdiscectomy and residual
Degenerative disc without canal stenosis.

There appears to be
Oedema/fibrous scar tissue at the site or the original surgery
The exiting nerve root does appear to be marginally thickened compared with
the right

All the remaining visualised intervertebral discs are wellhydrated without evidence of significant degeneration, canal stenosis or nerve root compromise.

Having raised questions relating to my original surgery, I have been told that on inspection during surgery the Clinician removed bone and ligament and on inspection of the disc which was enclosed there was no evidence of compression and that a microdisectamy is also called a micro-decompression and the sole reason for my surgery was to adequately decompress the nerve root which was successfully performed.

Please can you help me make sense of this entire horrible situation that has left me not only with what I believe more issues than I started with, but also having had mrsa, I’m still struggling with repeating infections, vitamin D deficiency and foliate difficiency, my inflammatory markers are continuing raised etc. Any help on your professional opinion on how I move forward given my latest mri results would be eternally appreciated x

n

Iklepickle wrote:

The sole purpose of the elected spinal surgery performed by my Clinician in March 2017, was to successfully decompress the s1 nerve root by removing the portion of disc impinging my L5 – S1 nerve root via what my family and I were informed as being straight forward day surgery ‘microdisectamy spinal surgery ‘

Having sustained sudden onset of pain to my lower back with radiating left leg pain in 2015 while lifting a patient during a manual handling monouver, further exacerbated with weight loading on back, twisting, pulling pushing, exacerbated ++ fall/falling left sided, short durations of leg numbness, exhausting all Conservative options made available to me:
Physiotherapy
Facet injection
Intravascular Bursa injection
Trial tens machine
Medication changes which due to the medication side effects, butrans, baclofen, or a morph etc, risk of qc prolongation I was reffered to a consultant Neurosurgeon for further management

MRI Lumbosacral Spine

Magnetic resonance imaging of lumbar spine abnormal
History
worsening symptoms and pain
Reduced power throughout lower extremity
Intermittent parathesia
Radiating pain down the back of left thigh missing the knee, down the calf and under ball of left foot
Positive straight leg test
Several episodes loss of bowel and bladder control also continued pins and kneedles patients hands, last two fingers having to shake to wake up, do cervical issues found on the mri only small disc bulge.
Under pain clinic. Not responding to injections or analgesia

MRI lumbar report pre surgery :

Normal appearance of piriformia and pectineus muscles. Normal appearance of the ischial tuberosities. There was no evidence of ischinl bursitis. No evidence of inguinal hernia or Anterior abdominal wall hernia as far as could be seen on this MRI.

Reported by: xxx

Feb-2016 MRI PELVIS

level. Marrow signal was preserved. Normal conus and cauda equina roots.

L5 – S1 shows a small broadbased central disc protrusion. This encroached bilateral recesses, more on the left side impinging left s1 nerve root.
But there was also contact of the right s1 nerve root

**please note, I am unsure if the information posted above re right s1, contact has any relevance to the surgical procedure or my symptoms, diagnosis,or the excruciating pain I was in upon waking in recovery after my original surgery thought to have been a microdisectamy ***

Conserns:

Following signing patient consent to an “L5-S1 Microdiscectomy” and decompression?”

Signed consent taken on my Clinician /consultants behalf (informed Clinician waiting my arrival in theatre) taken by the Clinician extended scope practitioner, whom I was first scene by within the spinal outpatient clinic and by the theatre anethasist in the presence of my family

I was told if my back pain was worse than my leg pain then this surgery wasn’t for me, which only 40, previously athletic, my leg pain then was the main problem.

I was asked did I no what the surgery I was having done? This was repeated at the Clinician team request twice before my arrival in surgery and I stated the following:

I was having an L5-s1 microdisectamy. My Clinician will make a small Incision in my lower back, pull my muscles etc a side before then removing the part of disc impinging my nerve, sucking any debry as I called it before sewing me back up.

Obviously I’m aware that the surgery was slightly more complicated than that but that was my interpretation.

My Clinician told me in my first and only appointment with him in January, 2017 that the surgery would be performed as a day case

Reletivly straight forward and has up to an 80% success rate.

Further stated as I had been in pain for a long time it was possible that although the nerve would no longer be impinged, I could still struggle with pain as my brain may continue to send the signals as before, however this was only a small possibility and in all was very positive

On waking from surgery, I awoke on oxygen, sweating, having pain to my chest, coughing Fleming up and struggling with my breathing, this continued for some time after surgery and on my return to the ward and coming home for which I was given a sabutamol inhaler on the ward and given an oxygen mask for a short time on oxygen for a short time. This information was advised to me by my anethasist on returning to the ward. Further noted that during theatre my airway tube became blocked so I had to be re-tubed.

I had no feeling in my legs to start, this soon resolved and I had excruciating pain bilateral in my groin. The pain was unbearable and the recovery team gave me a significant amount of pain relief to try and make me more comfortable.

On my return to the ward the anethasist advised that they had issues with my breathing tube and that more bone than planned was removed.
Not being quite with it, my back in agony, the pain deep in my groin now radiating down my left leg was significantly distressing especially as I lost control of my bladder from coughing and couldn’t walk to the buzzer to get assistance. Thankfully my family soon came to assist as I was in tears

Supposed to be going home, distressed, sweat pouring off me I could not understand why I was in so much pain

Scene by the physio, the physio showed me how to do a bed role and you really could not write it, I took hold of the bed rail and it gave way leaving me hanging half way off the bed.

I was advised that I should stay overnight in which I agreed, I didn’t see my Clinician the surgeon until around 6.30 am the following morning who checked my legs and power and other than that said I could go home.
.
Discharged on the same level of pain relief, my level of pain increased. I didn’t no if this was normal, in my head or what. By the end of the week the pain was so bad I could not put any weight threw my left leg at all and just putting my big toe to the ground was very painful. I tried to see my gp and I just couldn’t wait to be scene as I could not sit or stand and just sobbed

Having spoken with the hospital ward registrar I was re, – admitted to the hospital and an mri was performed which revealed that my disc was still intact and compressing my nerve and I now needed re-do surgery, the surgery I should have had from the start performed.

By this stage I had to push to wee but strangely my pain had eased all of a sudden. Following my second surgery I awoke pain free to much relief but I now have problems which I would like some advice on as the thought of further surgery scares me to death.

Symptoms

Unable to walk up an incline or stairs without difficulty
Short walks cause my legs to become heavier and heavier making every step hard work
Ots as though I have concrete in front of me and I get slower and slower.
My biggest issue is bending or twisting and power in my legs and agonising back pain. I also when I try to walk just to my local shop pain deep in the right side of my groin and my back pain is no longer focused just low down, it goes to the centre of my back
I fell asleep last week and some how ended up on my front my arms had gone numb and I didn’t have the strength to roll back to my front. I have also had heat at the front of both my legs after walking knees down and a central pain in the middle at the back of my calf all though this has only happened twice.
I’ve had a repeat mri which shows the following :

The are are 5 lumbar type vertebrae
With loss of the normal lumbar lordosis but otherwise normal alignment,

preservation of vertebral body
Height and normal marrow signal. The conus terminates at L1 and is of normal signal intensity.

At L3/L4 there is a mild central disc bulge without canal stenosis or
neural compromise.

At L4/L5 there is a broad-based central disc bulge with early facet joint arthropathy but no canal stenosis or neural compromise.

At L5/Sl there is evidence of a left-sided microdiscectomy and residual
Degenerative disc without canal stenosis.

There appears to be
Oedema/fibrous scar tissue at the site or the original surgery
The exiting nerve root does appear to be marginally thickened compared with
the right

All the remaining visualised intervertebral discs are wellhydrated without evidence of significant degeneration, canal stenosis or nerve root compromise.

Having raised questions relating to my original surgery, I have been told that on inspection during surgery the Clinician removed bone and ligament and on inspection of the disc which was enclosed there was no evidence of compression and that a microdisectamy is also called a micro-decompression and the sole reason for my surgery was to adequately decompress the nerve root which was successfully performed.

Please can you help me make sense of this entire horrible situation that has left me not only with what I believe more issues than I started with, but also having had mrsa, I’m still struggling with repeating infections, vitamin D deficiency and foliate difficiency, my inflammatory markers are continuing raised etc. Any help on your professional opinion on how I move forward given my latest mri results would be eternally appreciated x

n

Iklepickle wrote:

The sole purpose of the elected spinal surgery performed by my Clinician in March 2017, was to successfully decompress the s1 nerve root by removing the portion of disc impinging my L5 – S1 nerve root via what my family and I were informed as being straight forward day surgery ‘microdisectamy spinal surgery ‘

Having sustained sudden onset of pain to my lower back with radiating left leg pain in 2015 while lifting a patient during a manual handling monouver, further exacerbated with weight loading on back, twisting, pulling pushing, exacerbated ++ fall/falling left sided, short durations of leg numbness, exhausting all Conservative options made available to me:
Physiotherapy
Facet injection
Intravascular Bursa injection
Trial tens machine
Medication changes which due to the medication side effects, butrans, baclofen, or a morph etc, risk of qc prolongation I was reffered to a consultant Neurosurgeon for further management

MRI Lumbosacral Spine

Magnetic resonance imaging of lumbar spine abnormal
History
worsening symptoms and pain
Reduced power throughout lower extremity
Intermittent parathesia
Radiating pain down the back of left thigh missing the knee, down the calf and under ball of left foot
Positive straight leg test
Several episodes loss of bowel and bladder control also continued pins and kneedles patients hands, last two fingers having to shake to wake up, do cervical issues found on the mri only small disc bulge.
Under pain clinic. Not responding to injections or analgesia

MRI lumbar report pre surgery :

Normal appearance of piriformia and pectineus muscles. Normal appearance of the ischial tuberosities. There was no evidence of ischinl bursitis. No evidence of inguinal hernia or Anterior abdominal wall hernia as far as could be seen on this MRI.

Reported by: xxx

Feb-2016 MRI PELVIS

level. Marrow signal was preserved. Normal conus and cauda equina roots.

L5 – S1 shows a small broadbased central disc protrusion. This encroached bilateral recesses, more on the left side impinging left s1 nerve root.
But there was also contact of the right s1 nerve root

**please note, I am unsure if the information posted above re right s1, contact has any relevance to the surgical procedure or my symptoms, diagnosis,or the excruciating pain I was in upon waking in recovery after my original surgery thought to have been a microdisectamy ***

Conserns:

Following signing patient consent to an “L5-S1 Microdiscectomy” and decompression?”

Signed consent taken on my Clinician /consultants behalf (informed Clinician waiting my arrival in theatre) taken by the Clinician extended scope practitioner, whom I was first scene by within the spinal outpatient clinic and by the theatre anethasist in the presence of my family

I was told if my back pain was worse than my leg pain then this surgery wasn’t for me, which only 40, previously athletic, my leg pain then was the main problem.

I was asked did I no what the surgery I was having done? This was repeated at the Clinician team request twice before my arrival in surgery and I stated the following:

I was having an L5-s1 microdisectamy. My Clinician will make a small Incision in my lower back, pull my muscles etc a side before then removing the part of disc impinging my nerve, sucking any debry as I called it before sewing me back up.

Obviously I’m aware that the surgery was slightly more complicated than that but that was my interpretation.

My Clinician told me in my first and only appointment with him in January, 2017 that the surgery would be performed as a day case

Reletivly straight forward and has up to an 80% success rate.

Further stated as I had been in pain for a long time it was possible that although the nerve would no longer be impinged, I could still struggle with pain as my brain may continue to send the signals as before, however this was only a small possibility and in all was very positive

On waking from surgery, I awoke on oxygen, sweating, having pain to my chest, coughing Fleming up and struggling with my breathing, this continued for some time after surgery and on my return to the ward and coming home for which I was given a sabutamol inhaler on the ward and given an oxygen mask for a short time on oxygen for a short time. This information was advised to me by my anethasist on returning to the ward. Further noted that during theatre my airway tube became blocked so I had to be re-tubed.

I had no feeling in my legs to start, this soon resolved and I had excruciating pain bilateral in my groin. The pain was unbearable and the recovery team gave me a significant amount of pain relief to try and make me more comfortable.

On my return to the ward the anethasist advised that they had issues with my breathing tube and that more bone than planned was removed.
Not being quite with it, my back in agony, the pain deep in my groin now radiating down my left leg was significantly distressing especially as I lost control of my bladder from coughing and couldn’t walk to the buzzer to get assistance. Thankfully my family soon came to assist as I was in tears

Supposed to be going home, distressed, sweat pouring off me I could not understand why I was in so much pain

Scene by the physio, the physio showed me how to do a bed role and you really could not write it, I took hold of the bed rail and it gave way leaving me hanging half way off the bed.

I was advised that I should stay overnight in which I agreed, I didn’t see my Clinician the surgeon until around 6.30 am the following morning who checked my legs and power and other than that said I could go home.
.
Discharged on the same level of pain relief, my level of pain increased. I didn’t no if this was normal, in my head or what. By the end of the week the pain was so bad I could not put any weight threw my left leg at all and just putting my big toe to the ground was very painful. I tried to see my gp and I just couldn’t wait to be scene as I could not sit or stand and just sobbed

Having spoken with the hospital ward registrar I was re, – admitted to the hospital and an mri was performed which revealed that my disc was still intact and compressing my nerve and I now needed re-do surgery, the surgery I should have had from the start performed.

By this stage I had to push to wee but strangely my pain had eased all of a sudden. Following my second surgery I awoke pain free to much relief but I now have problems which I would like some advice on as the thought of further surgery scares me to death.

Symptoms

Unable to walk up an incline or stairs without difficulty
Short walks cause my legs to become heavier and heavier making every step hard work
Ots as though I have concrete in front of me and I get slower and slower.
My biggest issue is bending or twisting and power in my legs and agonising back pain. I also when I try to walk just to my local shop pain deep in the right side of my groin and my back pain is no longer focused just low down, it goes to the centre of my back
I fell asleep last week and some how ended up on my front my arms had gone numb and I didn’t have the strength to roll back to my front. I have also had heat at the front of both my legs after walking knees down and a central pain in the middle at the back of my calf all though this has only happened twice.
I’ve had a repeat mri which shows the following :

The are are 5 lumbar type vertebrae
With loss of the normal lumbar lordosis but otherwise normal alignment,

preservation of vertebral body
Height and normal marrow signal. The conus terminates at L1 and is of normal signal intensity.

At L3/L4 there is a mild central disc bulge without canal stenosis or
neural compromise.

At L4/L5 there is a broad-based central disc bulge with early facet joint arthropathy but no canal stenosis or neural compromise.

At L5/Sl there is evidence of a left-sided microdiscectomy and residual
Degenerative disc without canal stenosis.

There appears to be
Oedema/fibrous scar tissue at the site or the original surgery
The exiting nerve root does appear to be marginally thickened compared with
the right

All the remaining visualised intervertebral discs are wellhydrated without evidence of significant degeneration, canal stenosis or nerve root compromise.

Having raised questions relating to my original surgery, I have been told that on inspection during surgery the Clinician removed bone and ligament and on inspection of the disc which was enclosed there was no evidence of compression and that a microdisectamy is also called a micro-decompression and the sole reason for my surgery was to adequately decompress the nerve root which was successfully performed.

Please can you help me make sense of this entire horrible situation that has left me not only with what I believe more issues than I started with, but also having had mrsa, I’m still struggling with repeating infections, vitamin D deficiency and foliate difficiency, my inflammatory markers are continuing raised etc. Any help on your professional opinion on how I move forward given my latest mri results would be eternally appreciated x

n

Iklepickle wrote:

The sole purpose of the elected spinal surgery performed by my Clinician in March 2017, was to successfully decompress the s1 nerve root by removing the portion of disc impinging my L5 – S1 nerve root via what my family and I were informed as being straight forward day surgery ‘microdisectamy spinal surgery ‘

Having sustained sudden onset of pain to my lower back with radiating left leg pain in 2015 while lifting a patient during a manual handling monouver, further exacerbated with weight loading on back, twisting, pulling pushing, exacerbated ++ fall/falling left sided, short durations of leg numbness, exhausting all Conservative options made available to me:
Physiotherapy
Facet injection
Intravascular Bursa injection
Trial tens machine
Medication changes which due to the medication side effects, butrans, baclofen, or a morph etc, risk of qc prolongation I was reffered to a consultant Neurosurgeon for further management

MRI Lumbosacral Spine

Magnetic resonance imaging of lumbar spine abnormal
History
worsening symptoms and pain
Reduced power throughout lower extremity
Intermittent parathesia
Radiating pain down the back of left thigh missing the knee, down the calf and under ball of left foot
Positive straight leg test
Several episodes loss of bowel and bladder control also continued pins and kneedles patients hands, last two fingers having to shake to wake up, do cervical issues found on the mri only small disc bulge.
Under pain clinic. Not responding to injections or analgesia

MRI lumbar report pre surgery :

Normal appearance of piriformia and pectineus muscles. Normal appearance of the ischial tuberosities. There was no evidence of ischinl bursitis. No evidence of inguinal hernia or Anterior abdominal wall hernia as far as could be seen on this MRI.

Reported by: xxx

Feb-2016 MRI PELVIS

level. Marrow signal was preserved. Normal conus and cauda equina roots.

L5 – S1 shows a small broadbased central disc protrusion. This encroached bilateral recesses, more on the left side impinging left s1 nerve root.
But there was also contact of the right s1 nerve root

**please note, I am unsure if the information posted above re right s1, contact has any relevance to the surgical procedure or my symptoms, diagnosis,or the excruciating pain I was in upon waking in recovery after my original surgery thought to have been a microdisectamy ***

Conserns:

Following signing patient consent to an “L5-S1 Microdiscectomy” and decompression?”

Signed consent taken on my Clinician /consultants behalf (informed Clinician waiting my arrival in theatre) taken by the Clinician extended scope practitioner, whom I was first scene by within the spinal outpatient clinic and by the theatre anethasist in the presence of my family

I was told if my back pain was worse than my leg pain then this surgery wasn’t for me, which only 40, previously athletic, my leg pain then was the main problem.

I was asked did I no what the surgery I was having done? This was repeated at the Clinician team request twice before my arrival in surgery and I stated the following:

I was having an L5-s1 microdisectamy. My Clinician will make a small Incision in my lower back, pull my muscles etc a side before then removing the part of disc impinging my nerve, sucking any debry as I called it before sewing me back up.

Obviously I’m aware that the surgery was slightly more complicated than that but that was my interpretation.

My Clinician told me in my first and only appointment with him in January, 2017 that the surgery would be performed as a day case

Reletivly straight forward and has up to an 80% success rate.

Further stated as I had been in pain for a long time it was possible that although the nerve would no longer be impinged, I could still struggle with pain as my brain may continue to send the signals as before, however this was only a small possibility and in all was very positive

On waking from surgery, I awoke on oxygen, sweating, having pain to my chest, coughing Fleming up and struggling with my breathing, this continued for some time after surgery and on my return to the ward and coming home for which I was given a sabutamol inhaler on the ward and given an oxygen mask for a short time on oxygen for a short time. This information was advised to me by my anethasist on returning to the ward. Further noted that during theatre my airway tube became blocked so I had to be re-tubed.

I had no feeling in my legs to start, this soon resolved and I had excruciating pain bilateral in my groin. The pain was unbearable and the recovery team gave me a significant amount of pain relief to try and make me more comfortable.

On my return to the ward the anethasist advised that they had issues with my breathing tube and that more bone than planned was removed.
Not being quite with it, my back in agony, the pain deep in my groin now radiating down my left leg was significantly distressing especially as I lost control of my bladder from coughing and couldn’t walk to the buzzer to get assistance. Thankfully my family soon came to assist as I was in tears

Supposed to be going home, distressed, sweat pouring off me I could not understand why I was in so much pain

Scene by the physio, the physio showed me how to do a bed role and you really could not write it, I took hold of the bed rail and it gave way leaving me hanging half way off the bed.

I was advised that I should stay overnight in which I agreed, I didn’t see my Clinician the surgeon until around 6.30 am the following morning who checked my legs and power and other than that said I could go home.
.
Discharged on the same level of pain relief, my level of pain increased. I didn’t no if this was normal, in my head or what. By the end of the week the pain was so bad I could not put any weight threw my left leg at all and just putting my big toe to the ground was very painful. I tried to see my gp and I just couldn’t wait to be scene as I could not sit or stand and just sobbed

Having spoken with the hospital ward registrar I was re, – admitted to the hospital and an mri was performed which revealed that my disc was still intact and compressing my nerve and I now needed re-do surgery, the surgery I should have had from the start performed.

By this stage I had to push to wee but strangely my pain had eased all of a sudden. Following my second surgery I awoke pain free to much relief but I now have problems which I would like some advice on as the thought of further surgery scares me to death.

Symptoms

Unable to walk up an incline or stairs without difficulty
Short walks cause my legs to become heavier and heavier making every step hard work
Ots as though I have concrete in front of me and I get slower and slower.
My biggest issue is bending or twisting and power in my legs and agonising back pain. I also when I try to walk just to my local shop pain deep in the right side of my groin and my back pain is no longer focused just low down, it goes to the centre of my back
I fell asleep last week and some how ended up on my front my arms had gone numb and I didn’t have the strength to roll back to my front. I have also had heat at the front of both my legs after walking knees down and a central pain in the middle at the back of my calf all though this has only happened twice.
I’ve had a repeat mri which shows the following :

The are are 5 lumbar type vertebrae
With loss of the normal lumbar lordosis but otherwise normal alignment,

preservation of vertebral body
Height and normal marrow signal. The conus terminates at L1 and is of normal signal intensity.

At L3/L4 there is a mild central disc bulge without canal stenosis or
neural compromise.

At L4/L5 there is a broad-based central disc bulge with early facet joint arthropathy but no canal stenosis or neural compromise.

At L5/Sl there is evidence of a left-sided microdiscectomy and residual
Degenerative disc without canal stenosis.

There appears to be
Oedema/fibrous scar tissue at the site or the original surgery
The exiting nerve root does appear to be marginally thickened compared with
the right

All the remaining visualised intervertebral discs are wellhydrated without evidence of significant degeneration, canal stenosis or nerve root compromise.

Having raised questions relating to my original surgery, I have been told that on inspection during surgery the Clinician removed bone and ligament and on inspection of the disc which was enclosed there was no evidence of compression and that a microdisectamy is also called a micro-decompression and the sole reason for my surgery was to adequately decompress the nerve root which was successfully performed.

Please can you help me make sense of this entire horrible situation that has left me not only with what I believe more issues than I started with, but also having had mrsa, I’m still struggling with repeating infections, vitamin D deficiency and foliate difficiency, my inflammatory markers are continuing raised etc. Any help on your professional opinion on how I move forward given my latest mri results would be eternally appreciated x

n

Iklepickle wrote:

The sole purpose of the elected spinal surgery performed by my Clinician in March 2017, was to successfully decompress the s1 nerve root by removing the portion of disc impinging my L5 – S1 nerve root via what my family and I were informed as being straight forward day surgery ‘microdisectamy spinal surgery ‘

Having sustained sudden onset of pain to my lower back with radiating left leg pain in 2015 while lifting a patient during a manual handling monouver, further exacerbated with weight loading on back, twisting, pulling pushing, exacerbated ++ fall/falling left sided, short durations of leg numbness, exhausting all Conservative options made available to me:
Physiotherapy
Facet injection
Intravascular Bursa injection
Trial tens machine
Medication changes which due to the medication side effects, butrans, baclofen, or a morph etc, risk of qc prolongation I was reffered to a consultant Neurosurgeon for further management

MRI Lumbosacral Spine

Magnetic resonance imaging of lumbar spine abnormal
History
worsening symptoms and pain
Reduced power throughout lower extremity
Intermittent parathesia
Radiating pain down the back of left thigh missing the knee, down the calf and under ball of left foot
Positive straight leg test
Several episodes loss of bowel and bladder control also continued pins and kneedles patients hands, last two fingers having to shake to wake up, do cervical issues found on the mri only small disc bulge.
Under pain clinic. Not responding to injections or analgesia

MRI lumbar report pre surgery :

Normal appearance of piriformia and pectineus muscles. Normal appearance of the ischial tuberosities. There was no evidence of ischinl bursitis. No evidence of inguinal hernia or Anterior abdominal wall hernia as far as could be seen on this MRI.

Reported by: xxx

Feb-2016 MRI PELVIS

level. Marrow signal was preserved. Normal conus and cauda equina roots.

L5 – S1 shows a small broadbased central disc protrusion. This encroached bilateral recesses, more on the left side impinging left s1 nerve root.
But there was also contact of the right s1 nerve root

**please note, I am unsure if the information posted above re right s1, contact has any relevance to the surgical procedure or my symptoms, diagnosis,or the excruciating pain I was in upon waking in recovery after my original surgery thought to have been a microdisectamy ***

Conserns:

Following signing patient consent to an “L5-S1 Microdiscectomy” and decompression?”

Signed consent taken on my Clinician /consultants behalf (informed Clinician waiting my arrival in theatre) taken by the Clinician extended scope practitioner, whom I was first scene by within the spinal outpatient clinic and by the theatre anethasist in the presence of my family

I was told if my back pain was worse than my leg pain then this surgery wasn’t for me, which only 40, previously athletic, my leg pain then was the main problem.

I was asked did I no what the surgery I was having done? This was repeated at the Clinician team request twice before my arrival in surgery and I stated the following:

I was having an L5-s1 microdisectamy. My Clinician will make a small Incision in my lower back, pull my muscles etc a side before then removing the part of disc impinging my nerve, sucking any debry as I called it before sewing me back up.

Obviously I’m aware that the surgery was slightly more complicated than that but that was my interpretation.

My Clinician told me in my first and only appointment with him in January, 2017 that the surgery would be performed as a day case

Reletivly straight forward and has up to an 80% success rate.

Further stated as I had been in pain for a long time it was possible that although the nerve would no longer be impinged, I could still struggle with pain as my brain may continue to send the signals as before, however this was only a small possibility and in all was very positive

On waking from surgery, I awoke on oxygen, sweating, having pain to my chest, coughing Fleming up and struggling with my breathing, this continued for some time after surgery and on my return to the ward and coming home for which I was given a sabutamol inhaler on the ward and given an oxygen mask for a short time on oxygen for a short time. This information was advised to me by my anethasist on returning to the ward. Further noted that during theatre my airway tube became blocked so I had to be re-tubed.

I had no feeling in my legs to start, this soon resolved and I had excruciating pain bilateral in my groin. The pain was unbearable and the recovery team gave me a significant amount of pain relief to try and make me more comfortable.

On my return to the ward the anethasist advised that they had issues with my breathing tube and that more bone than planned was removed.
Not being quite with it, my back in agony, the pain deep in my groin now radiating down my left leg was significantly distressing especially as I lost control of my bladder from coughing and couldn’t walk to the buzzer to get assistance. Thankfully my family soon came to assist as I was in tears

Supposed to be going home, distressed, sweat pouring off me I could not understand why I was in so much pain

Scene by the physio, the physio showed me how to do a bed role and you really could not write it, I took hold of the bed rail and it gave way leaving me hanging half way off the bed.

I was advised that I should stay overnight in which I agreed, I didn’t see my Clinician the surgeon until around 6.30 am the following morning who checked my legs and power and other than that said I could go home.
.
Discharged on the same level of pain relief, my level of pain increased. I didn’t no if this was normal, in my head or what. By the end of the week the pain was so bad I could not put any weight threw my left leg at all and just putting my big toe to the ground was very painful. I tried to see my gp and I just couldn’t wait to be scene as I could not sit or stand and just sobbed

Having spoken with the hospital ward registrar I was re, – admitted to the hospital and an mri was performed which revealed that my disc was still intact and compressing my nerve and I now needed re-do surgery, the surgery I should have had from the start performed.

By this stage I had to push to wee but strangely my pain had eased all of a sudden. Following my second surgery I awoke pain free to much relief but I now have problems which I would like some advice on as the thought of further surgery scares me to death.

Symptoms

Unable to walk up an incline or stairs without difficulty
Short walks cause my legs to become heavier and heavier making every step hard work
Ots as though I have concrete in front of me and I get slower and slower.
My biggest issue is bending or twisting and power in my legs and agonising back pain. I also when I try to walk just to my local shop pain deep in the right side of my groin and my back pain is no longer focused just low down, it goes to the centre of my back
I fell asleep last week and some how ended up on my front my arms had gone numb and I didn’t have the strength to roll back to my front. I have also had heat at the front of both my legs after walking knees down and a central pain in the middle at the back of my calf all though this has only happened twice.
I’ve had a repeat mri which shows the following :

The are are 5 lumbar type vertebrae
With loss of the normal lumbar lordosis but otherwise normal alignment,

preservation of vertebral body
Height and normal marrow signal. The conus terminates at L1 and is of normal signal intensity.

At L3/L4 there is a mild central disc bulge without canal stenosis or
neural compromise.

At L4/L5 there is a broad-based central disc bulge with early facet joint arthropathy but no canal stenosis or neural compromise.

At L5/Sl there is evidence of a left-sided microdiscectomy and residual
Degenerative disc without canal stenosis.

There appears to be
Oedema/fibrous scar tissue at the site or the original surgery
The exiting nerve root does appear to be marginally thickened compared with
the right

All the remaining visualised intervertebral discs are wellhydrated without evidence of significant degeneration, canal stenosis or nerve root compromise.

Having raised questions relating to my original surgery, I have been told that on inspection during surgery the Clinician removed bone and ligament and on inspection of the disc which was enclosed there was no evidence of compression and that a microdisectamy is also called a micro-decompression and the sole reason for my surgery was to adequately decompress the nerve root which was successfully performed.

Please can you help me make sense of this entire horrible situation that has left me not only with what I believe more issues than I started with, but also having had mrsa, I’m still struggling with repeating infections, vitamin D deficiency and foliate difficiency, my inflammatory markers are continuing raised etc. Any help on your professional opinion on how I move forward given my latest mri results would be eternally appreciated x

n

The surgery

Thank you for reply. Hopefully the following information answers your questions.

Did you have deep tendon reflex changes (DTR) on exam? Reflexes: Right/left biceps, brachioradialis, triceps absent/absent, patellar and Achilles 2/2.
Did you have sensory changes in your arms? Light touch intact bilaterally C5-T1.
Did you have any weakness of muscle groups upon examination? Right/left shoulder abduction, elbow flexion, extension, wrist extension, finger abduction and thumb opposition 5/5.
Did you have long tract signs (hyperreflexia, clonus, Hoffman’s sign) present? No

WHen you note levels for injections, are these medial branch blocks (MBB), facet injections, selective nerve root blocks or epidural injections.
Diagnostic C2,3,4 medial branch block, Left – Only 25% relief
Therapeutic C7-T1 interlaminar epidural steroid injection #1, Midline – good relief for 6 days
Therapeutic C7-T1 interlaminar epidural steroid injection #2, Midline– moderate relief for 4 weeks
Diagnostic #1 C4 and C5 and C6 medial branch blockade Left– 95% relief
Diagnostic #2 C4 and C5 and C6 medial branch blockade Left– 95% relief

When you developed “Arm pain – I do occasionally have upper arm pain but this is minimal. My arms are quick to fatigue which has prevented PT progression beyond basic arm exercises. I also have tingling in the forearm and into the hand as well as a decrease in grip strength”, what sides? Tingling in forearm/hand is on the left side. Upper arm fatigue occurs in both arms but worse on the left side.

I did have an EMG which indicated mild carpal tunnel.
There is a left, mild in degree median neuropathy at the wrist that may be associated with carpal tunnel syndrome. There is no electrophysiologic evidence for right or left cervical radiculopathies, brachial plexopathies or other evidence for neuromuscular disease.

The neurologist and 2 spine specialists did not feel the canal stenosis noted on MRI was significant enough to cause my symptoms.

Since the 2nd C4,5,6 MBB was successful I will be scheduling RFA. Do you feel this is the best approach and would you think surgery might be required in the future?

Thank you for reply. Hopefully the following information answers your questions.

Did you have deep tendon reflex changes (DTR) on exam? Reflexes: Right/left biceps, brachioradialis, triceps absent/absent, patellar and Achilles 2/2.
Did you have sensory changes in your arms? Light touch intact bilaterally C5-T1.
Did you have any weakness of muscle groups upon examination? Right/left shoulder abduction, elbow flexion, extension, wrist extension, finger abduction and thumb opposition 5/5.
Did you have long tract signs (hyperreflexia, clonus, Hoffman’s sign) present? No

WHen you note levels for injections, are these medial branch blocks (MBB), facet injections, selective nerve root blocks or epidural injections.
Diagnostic C2,3,4 medial branch block – Only 25% relief
Therapeutic C7-T1 interlaminar epidural steroid injection #1 – good relief for 6 days
Therapeutic C7-T1 interlaminar epidural steroid injection #2 – moderate relief for 4 weeks
Diagnostic C4 and C5 and C6 medial branch blockade – 95% relief – 2nd injection will be this week.

When you developed “Arm pain – I do occasionally have upper arm pain but this is minimal. My arms are quick to fatigue which has prevented PT progression beyond basic arm exercises. I also have tingling in the forearm and into the hand as well as a decrease in grip strength”, what sides? Tingling in forearm/hand is on the left side. Upper arm fatigue occurs in both arms but worse on the left side.

I did have an EMG which indicated mild carpal tunnel.
There is a left, mild in degree median neuropathy at the wrist that may be associated with carpal tunnel syndrome. There is no electrophysiologic evidence for right or left cervical radiculopathies, brachial plexopathies or other evidence for neuromuscular disease.

The neurologist and 2 spine specialists did not feel the canal stenosis noted on MRI was significant enough to cause my symptoms.