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in reply to: Large Centrally Herniated Disc at L5-S1 #5642
rkassam post=1273 wrote: I have no motor weakness of the foot dorsiflexors and plantar flexors that I have noticed. I seem to be able to walk on my heels and toes for some distances.
I realize that surgery is not a 100% cure all as there is always a risk of re-herniation. So if pain is tolerable why go for surgery.
However, I am confused about this whole large centrally herniated disc situation. As this type of herniation is not as frequent it is not as easy finding information on it.
From my research in scientific journals, I have found that a central prolapse is apt to increase in size, which may develop rapidly. Since this type of prolapse can lead to nerve damage that may not be fully recoverable even after surgery, it maybe advisable to perform surgery in order to prevent progression. That is it’s better to do the surgery in a non emergency situation were there is no risk of irreversible nerve damage than in an emergency situation.
As I am not from a medical background, I might just be reading to much into this. What do you think?
Thank you for your input.
Thank you for posting your last question. Is it better to go ahead with surgery when the current situation is non emergent or wait till you can no longer tolerate the pain and the situation is emergent.
in reply to: Numbness and motor weakness post-op #5640Dr. Corenman post=1175 wrote: Unfortunately, nerves heal in their own due time. Nerve healing is very slow. There is not much that can be done to speed up nerve healing. There are some studies that might indicate using an electrical muscle stimulator is detrimental so if offered, stay away from that machine. You might need a custom orthosis for the weakness. That is a plastic device that fits over your ankle to stabilize your foot when walking and standing. I assume that your therapist has offered that to you.
Dr. Corenman
Dear Dr. Corenman,
When you state electrical muscle stimulator, are you referring to a TENS unit? If so, whats the risk?
in reply to: Numbness and motor weakness post-op #5639jbsangus post=1168 wrote: Hi doc, I am 48 have had long history of leg pain finally had surgery 8 weeks ago. surgeon said worst stenosis ever in 25 years doing this surgery. Laminectomy 4levels from L2 to S1 both sides, right side was really bad, said nerve root at L5 down to size of pencil. Now after surgery i can stand straight and tip head back with no pain, but now back side of right leg and whole foot is numb right after surgery, also dural tear repair layed flat for 2 days. Motor weakness right buttocks,back of leg and ankle, can’t push down on toes. Been doing physical therapy and walking on treadmill everyday. I am walking with help of cane and severe limp. Doc says should come back in time. I was a very active person, how long should i wait before i get another opinion? What are your thoughts on this? Also, I still have bladder and bowel weakness and numbness. Thank You
I too have lumbar stenosis. If you are open to share, did your doc stated that your stenosis should have been addressed sooner than later. I was diagnosed in August 2011 and my spine surgeon is recommending surgery. I have muscle twitching all the time and numbness at my feet. I have sciatic pain and lower back sharp pain with activity. I wonder whats the risk of waiting longer. My symptoms were apparent about July, and the EMG and MRI confirmed the symptoms I’ve been experiencing.
in reply to: Left Hand Tremor #5361Thank you so much again. So the appropriate procedure is a posterior foraminotomy for my neck issues. Its a bit concerning my doc said microdiscectomy, unless I misunderstood him. I will review the video on your site.
Also, is it common to have soooooooo many follow up visits. The spine specialists did suggest conservative measures first but also recommended surgery in the very beginning. I saw him for the first time late August / early September.
It took me about a month to even consider the epidural steroid injections for my neck and back radiculopathy.
As you stated before since post foraminotomy cannot be done concurrently with a shoulder arthroscopic surgery. He recommends f/u with him 4 wks after my shoulder surgery. I would have thought that he would have discharged me from his care since I’ve been so hesitant to surgery.
My neck pain remains at a steady 3-4. And my neck is stiff constantly. But I’m still able to perform my ADLs. As with my back pain it has remained at a steady 4-5. I’ve been able to manage both neck and back discomforts with Relafen 1000mg per day.
I’ve been offered narcs but I refused. I don’t have addictive tendencies, but worry the long term treatment would bring me to that point.
I think I would consider surgery if my neck pain increased beyond 6 and back beyond 7. I feel surgery is such a major risk with my current pain level. And lastly, at every visit I am asked how is my pain level. Its been the same. What response does my doctor expect. I can only say I’m better if I’m 100% normal.
in reply to: Left Hand Tremor #5349I just saw the spine surgeon today and he still recommends surgery, more so the neck than the lower back.
He thinks the mild tremor could be a result from the baclofen and told me to stop.
I understand the risk of infection, but I would rather just do the shoulder and neck and get it out of the way.
If I agree to the microdiscectomy in the neck, what type of scarring will I have to deal with?
in reply to: Left Hand Tremor #5346Thanks Dr. Corenman. Your explanation is very helpful.
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