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in reply to: L4 L5 S1 after surgery #5142
I first must ask what your symptoms were prior to back surgery? Two basic questions. Did you have back pain or leg pain (which includes buttocks pain)? Second, did the pain become worse with sitting or with standing?
You have new right leg numbness that was not there prior to surgery. This is uncommon but if the surgeon had to do signficant manipulation of the nerve root during surgery, the numbness can occur. It normally takes between 6 weeks and 6 months for the numbness to abate. I will assume you have no new onset of motor weakness. You can test this by lifting up your left leg, holding onto a counter only for balance and performing ten heel raises, ten toe raises and ten one legged squats. Your right leg should be just as strong as your left leg is.
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.The disc bulge itself is not compressing the S2-4 nerves so the possibility of nerve compression causing the pain doesn’t follow the MRI findings.
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.in reply to: Laminectomy #5134Please contact the office and we would be glad to help you with this project.
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.You report a disc prolapse at L5-S1 which causes effacement but not compression of the left S1 nerve. You report relatively new symptoms of anus and penis pain. We can look at these complaints two ways- what causes anus and penis pain and what compression of the S1 nerve would cause.
The perineum and penis are innervated (nerve supply) from the sacral plexus. That is S2,S3 and S4. These originate from the sacrum and are rarely compressed as there are no open discs in the sacrum. The L1 nerve can occasionally cause penis and testicle pain as there is sensory nerve supply to these structures from this nerve. There would be no anus pain generated from L1 as the anus is strictly an S2-4 nerve supply.
The S1 nerve, if irritated and symptomatic (and with a small bulge that is only effacing the nerve- this is less likely to cause significant symptoms) will cause posterior buttocks pain and pain radiating down the back of the leg to the foot. Therefore, this nerve will not cause anus or penis pain.
Don’t forget that there are local diseases that can cause this pain such as infections or neoplasms.
Normally- if caused by nerve origin, anus and penis pain would be caused by a sacral plexopathy.
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.in reply to: Herniated Disc #5132These symptoms indicate that your C6 nerve is compressed and malfunctioning. You need a consult with a spine surgeon.
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.You report your diagnosis of spondylolysis was made with a bone scan as the fractures could not be seen by standard X-ray. You apparently never had a confirmation by a CT scan.
Bone scans are designed to light up where bone metabolic activity is very high such as in a pars fracture that “is attempting” to heal. Bone scans will not light up at a pars fracture that has no metabolic potential (no “attempt” to heal).
The problem with using a bone scan by itself to diagnose a pars fracture is that one side may be “quiet” or non-reactive as it has already fractured and now the opposite side is in the process of fracturing and “lighting up” or reactive. A CT scan is necessary or at the minimum, an MRI to actually visualize the area to determine the integrity of the pars.
Good Luck!
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. -
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