What could cause the same symptoms to return - post op Disectomy (no reherniation)?
Hi. I had a discectomy at the L4/L5 Jan 5. The initial month went well. Felt immediate relieve, but all the symptoms came back in Feb (sciatica - butt, outside thigh & calf), pain in lower back, tight muscle/spasms along the spine. Went in for a 2nd MRI this week, but it showed no renerniation of the disc (though there was a mild herniation at the L3/L4) compared to the original MRI in Dec. However, since I wasn't showing any symptoms the ortho surgeon ruled that out as a cause.
His advice was that these flare ups are common enough & since the L4/L5 disc seems healthy & normal, there's nothing that can be done at this point though if the pain/discomfort persists, he can recommend an epideral injection. He also prescribed me 50mg Voltaren (anti-inflammtory) to take twice a day.
Theefore, I'm wondering what anybody else thinks, anything else to consider, how others have dealt with it & what else I can do? Is a 2nd opinion needed? It's driving me nuts thinking something else might be wrong. I've been dealing with this for 3yrs managing it with injections, medication, therapy, acupuncture, etc. so was hoping for the surgery to finally resolve all that so am a little concerned & disappointed.
If anyone can share their experience, insight or recommendation, I would greatly appreciate it. Thank you.
Re: What could cause the same symptoms to return - post op Disectomy (no reherniation
You are still very early on in the healing process. Your surgeon is right that the nerves can take a while to settle down, and it isn't uncommon to have some recurrent symptoms for a while after surgery. I'm glad your surgeon did an MRI to rule out other issues.
If your symptoms are still in place around 6 months, you may want to ask your surgeon about having a discogram which could show if there is a tear in that disc. If you have a tear that goes through the entire disc, the chemicals inside the disc can leak out onto the nerve roots and cause sciatica symptoms. In that case usually a fusion is required to fix it. This happened to me. However, you should first give yourself some time to heal before getting worried that something is still wrong.
It's also possible you have had some scar tissue form which is causing your symptoms. Does your surgeon have you going to physical therapy? If not, please ask him/her about going as that can help prevent scar tissue from adhering to your nerve roots. Scar tissue typically forms between 6-12 weeks after surgery, so physical therapy during this time is important. Some exercises to do nerve root flossing (check with your surgeon first) are to sit on the edge of a chair with your feet on the floor. Raise one leg up (the lower leg) so it's straight out, then lower it back down again. Repeat 15 times, then do the other leg. Also, after you've done it on one leg 15 times, do ankle pumps 15 times (repeat on other leg). You can also do a variation of this while laying on your back.
Regarding getting a 2nd opinion, very few spine surgeons will look at you until at least 6-12 months post op as they want you to try working with the surgeon who did your surgery for a period of time. Also, surgeons make money by doing surgery, not by having office visits, so surgeons are most eager to see patients who need surgery instead of those who just need follow-up care.
Please focus on healing right now and don't worry about what could be wrong. Walk as much as you can as that is one of the best ways to help your body heal as it improves blood flow throughout your body. An epidural may very well help you also as it could reduce the inflammation in that area.
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