Hoosemec

Hi Doctor,

It’s been a while since I last posted. Since my last post I had recovered fairly well and was managing my back with exercise and having very little if any sciatica. I had become quite active. The numbness feeling in my left foot had never recovered. However, about a month ago I strained my back I believe moving something. About a week after the sciatica returned to my left buttock and down into my left shin. There is also a lot of pain at the site where the nerve seems to be under pressure at the L5S1 level. It is quite painful. I have had an MRI done it shows scar tissue around the left S1S2 nerves and thecal sac and a posterior disc herniation that seems to not hit any nerves or cause any major stenosis. A pain doctor has told me my pain is caused by scar tissue. This seems over simplistic for scar tissue to suddenly cause this extreme amount of pain, and also I am 10 months removed from my surgery. I don’t have any issues with stability and my core is as strong as it has ever been. Please see my questions below.

Do you practice limiting scar tissue formation after discectomies with any nerve coverings? discectomies?

Can an attempt at a foraminal approach for discectomy/scar tissue removal be performed?

Adhesiolysis? I’ve read about this and it sounded interesting, but it seems it is practiced very little and without insurance compensation.

Fusion? Would this have any benefit if scar tissue is the issue and isn’t this more for stability? Can the nerve be decompressed again without serious damage? Wouldn’t this just cause more scar tissue?

Thank you.

Good Morning Doctor
I received my mri report post op 4 weeks. It read “recurrent left para central moderate size disc herniating extrusion at l5s1 which creates contact upon the nerve root traveling in the left lateral recess. Enhancing granulation tissue is also seen in the left lateral recess”. My doctor explained that mri’s will show large herniations that are not there at this early stage and would be surprised if this turns out to actually be a recurrent herniations. To my layman’s eyes, it almost looks like a fragment half in the disc half out 4 mm out when I measured it, ready to shoot out white one wrong misstep. I’ve been given no restrictions and have been cleared for work but boy do I feel unsure about this. Should I assume I have no extruded l5s1 disc and move forward? Or seek a second opinion. The last thing I want is to have this blow up in a month tying my shoes.

Hello Doctor

I have tried a 5 day pack of steroids which had reall no noticeable effects. I would say the sciatica I feel is mild and varies slightly located in the left buttock mostly and not below the knee. Im able to walk about 3 miles a day currently. I’m scheduled for an mri with contrast next week. Which will be about 4 weeks out from the surgery. No real conclusive straight leg test mostly muscle tightness. The mri probably won’t clearly differentiate between scar tissue and disc so early on I understand. My question is if a herniation is found, even if its small, would removing it sooner than later pose any issue ? That would be a third discectomy but perhaps that piece should have come out in the second surgery? I really want to get back to being active. If no herniation is found and its a resultant damaged nerve at least I would know that and could just work through the pain at that point and hope it gets better with time The thought of having another herniation just after an operation and leaving it there would seem like a massive setback. My Back so far has no stability issues.

Thank you.