Sailormoon

Hi Dr Corenman,

Hope you are doing well. It’s been almost 3 years since our last conversation.

Since our last conversation, my nerve inflammation still happening until 1 year post surgery. MRI showing large fluid near spinal canal where lamina removed but MRI every 3 months showing the size is smaller and then disappear. My nerve is calmer 1 year post surgery after i took arcoxia for 5 days and no longer put pillow under my knee when sleeping. I dont know its related or not, but the nerve symptom is ease after i did that.
I still have back pain occasionally, especially when i overdo. But it always ease after rest. So i thankful i have good days for 1.5years.

Lately, i feel left back pain. Usually when i over do i feel back pain in the middle, but now on the left. When sitting i tent to sit on right buttock to reduce the pain on left back. And now i feel uncomfortable on my left leg when lay down and straight my leg. Its like my left thigh feels tight on anterior (femoral near knee). I think the source of tight muscle coming from my left buttock. I did MRI, the result is my bulging disc at L4 L5 now already healed (go back in). My previous surgery was L5S1. I also have significant bilateral foraminal stenosis at L4-S1 but this stenosis already mentioned on my previous annual MRI, no changes. I also had L2L3 facet joint effusion. The radiolog and my doctor said all okay. No changes on MRI except L4-L5 that healed. But what i feel is otherwise. I feel new pain that previously never there. Now when i walk longer than 15 min, i feel shooting pain sometimes at my left hip, other times my left crotch. Sometimes when i sit i feel burning pain at my left hip and my left thigh. But all the pain is intermittent, trigger by moving. But what that always there is when laying down, my left leg cant relax. If i try to relax, the ankle will auto sleep to the side (it automatically find the most comfortable position) while the right ankle will relax without sleep to the side. So the position of my body is assymetrical when laying down.

The tightness of my thigh disappear when i put pillow only under my left knee. And it also disappear when i bring my knee close to my stomach or just simply fold my knee up or side.
I also sometimes feel localized pain on my anterior thigh when i squat to take something that fall (i avoid bending since surgery).

It already around 2 months, the pain increasing and my neuropathy that already eased since 1.5years ago suddenly comeback. I also hear the sound my back popped when i out from the car, or when i stand up twisting from dining chair (the sound like bone cracking with bone) I also often hear my left leg sound popped when i move. But it doesnt cause pain. Just weird because all of the symtomp happened within this last 2 months.

Do you have any idea what possibly causing my issue? My spine doctor suggest me to go to hip and knee doctor. But the hip and knee doctor said that all my issue doesnt match with one desease. He said it only muscle athrophy. Thank you before.

Dr,

I mean, the blood check is improve, the back pain is gone, but the black shadow on my spinal canal is wider.
And it aligned with my nerve deterioration symptoms.

If the infection is heals why the nerve deterioration become worst? Thats why i think i have other issue.

Hi Dr Corenman,

The previous MRI (before surgery for debridement) performed with contras and radiologist stated that:

– there is mass on corpus with infiltration to pre and paravertebral and especially invasion to intra spinal, infiltration to retrovertebral
– Spinal stenosis and compression to thecal sac, especially to S1 bilateral.

Do you know what it means? After surgery my doctor said there is so much pus near my dura, but not inside the spinal canal. On contrary with note from radiologist above right?

While he also said the nerve so sticky and cant differentiate between nerve and scar tissue, so he make them free from bone. I dont know which nerve mention by him, because he said he didnt enter spinal canal.

Is it too risky too perform debridement on spinal canal? If i have pus pocket there, does my CRP will high too?
If it is a phlegmon, does it will cause nerve deterioration? And how long it will cured?

My bowel movement now already full impacted. I cant sit here waiting for my bladder and motoric impacted too. I have gradual onset of cauda equina ????

I just go to other doctor to have other opinion and he said MRI after surgery doesnt represent real condition. He said its hard to differentiate between pus, scar tissue or else. So he suggest me to wait and heal the infection. I feel stuck.