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Old 01-19-2008, 03:01 AM   #1
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Laminectomy/Discectomy Update - left leg pain after surgery

I posted on here before and many asked for updates because they had a similar situation where they had no left leg pain until after surgery and didn't know what may be the cause. I went to a second opinion and was given COMPLETELY DIFFERENT information compared to what my neurosurgeon was telling me. I have totally renewed hope and so I think it is important I share this with others that may be in the same boat.

Background: Severe herniation of L4/L5 just from bending over for newspaper. Caused by degenerative disc. I had severe right leg pain, numb right foot. Since the herniation was so severe, my neurosurgeon told me I must have lam/discectomy on my right side, so I had the surgery right off. Two weeks after surgery I started having left leg psyiatic pain for first time all the way to the foot. It has slowly gotten worse - both legs and back pain. Had another MRI and went to neurosurgeon at 8 weeks, he said he didn't know why left leg pain, maybe the disc is so compressed that the left nerve root is being pinched. Go home, there is nothing I can do for you.

Currently: I am sleeping only a few hours a night for months now and it is getting to me. I can't stand for more than 15 minutes at a time without pain. I can't really do my job, my boss is just putting up with me. This past week I finally got into another neurosurgeon for a second opinion. I asked him the following questions and got the following answers:

Q1: Why pain getting progressively worse? I never had left leg pain before the surgery, why now?

A1a: Mostly likely it's inflammation. Nerves can actually become inflammed similar to muscle. When your surgeon did your right side discectomy, he had to lift up on your right side nerve root (which is connected to your spinal cord, which is connected to your left nerve root) in order to remove the disc material. So he pulled your left nerve root over to such an extent he "damaged" or "irritated" it and caused it to become inflammed. He said he has seen this happen to some patients.

THIS IS COMPLTELY DIFFERENT THAN WHAT MY NEUROSURGEON HAD TOLD ME: I don't know why you have left leg pain. Maybe your left nerve root is being pinched. There is absolutely nothing you can do about it. You may have permanent nerve damage. Go home.

Q2: If it is inflammation causing the pain, is there anything I can do about it?

A2: Yes, I will give a prescription for a steroid dose pack (Methypred) to reduce inflammation. Come back in 6 weeks. If it hasn't improved, then we can start looking at whether your nerve is pinched with a mylogram (?), which may help us detect a pinching we are not seeing in your MRI.

THIS IS COMPLTELY DIFFERENT THAN WHAT MY NEUROSURGEON HAD TOLD ME: He didn't explain that the nerves themselves can become inflammed. He certainly didn't say there was anything we could do about it like prescribe steroids or take shots to reduce the inflammation. He literally said there is nothing you can do about it. Both my neurosurgeon and my internal medicine doctor said the same thing.

Q3: Why is my pain worse at night?

A3: Your body produces pheromones (or hormones?) while it sleeps, which can actually increase inflammation.

Q4: If it isn't a nerve pinching problem, then why is my pain worse when I stand?

A4: When you use your leg muscles, it puts a demand on the nerves. Inflammed nerves under increased demand cause more pain.

Q5: Given how badly my disc herniated and now weakened, will I ever "heal" and be able to lead a normal life again, or am I doomed to have a fusion surgery?

A5: It takes about 6 weeks for the outer annulus of the disc to heal. After it is healed, you have just as much chance of herniating it again as you did before your major herniation occurred. You have degenerative disc disease, so you have a higher probability than most people, but no more than you did before. So yes, 6 months from now you should be able to lift 100 pounds or dig in your yard, etc. And no, I would not expect that you will ever likely need a fusion surgery.

THIS IS COMPLTELY DIFFERENT THAN WHAT MY NEUROSURGEON HAD TOLD ME: He said my disc is permanently weakened. He said discs do not heal or regenerate. I could basically live my life as best I could, but the next time he wouldn't do a discomectomy, he would do a fusion surgery.

RESULT: I have been taking the steroid dose pack for two days now and I am already much better. Hopefully this improvement will continue. I will never go see my original neurosurgeon again. Unfortunately, my new doctor who is helping me is a 2 1/2 hour drive one way!

 
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Old 01-19-2008, 05:36 AM   #2
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Re: Laminectomy/Discectomy Update - left leg pain after surgery

Hi Klwass,
Good news! That all sounds very promising.
You and I had actually communicated at one time I think because I also am having nerve pain on the left and surgery was on the right. I actually went to have another EMG on the left leg because they were thinking I had permanent nerve damage there as well as my right leg. It was normal just shows "irritation". THIS doctor said that it will take up to a year for the left to heal....unfortunately the right has permanant damage. So I at least have one good leg
I'm very happy that you got good news. Just reinforces that a second opinion is always a good idea!
Keep us posted on your progress.

Deb

 
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