PDA

View Full Version : laminectomy and removal of a synovial cyst


freefashion
06-02-2016, 03:49 AM
Hello,
I'm new on this board. On October 1st 2015 I had decompression surgery (L2-L4), a laminectomy and removal of a synovial cyst that was very high up on the spine (L2)- it was compressing the cauda equina in a bad way. Since then I have had a lot of nerve pain in my groin (both sides), hamstrings, plus sciatica down my right leg from the hip to the toes (according to the neuro surgeon, this is a 'small hernia' due to stenosis and a trapped nerve on S1/L5/L4 that he will operate on when the pain gets too much for me). Not sure if the sciatica is related to the cauda equina syndrome, but imo the cause of both is spinal stenosis. The nerve pain got less throughout the months (except for the sciatica) but the last weeks it's returning again more, on both sides. I had an MRI done two months ago for the sciatic pain and the doctor saw 'something' on the L2 facet joint that could be a new synovial cyst, or else it's scar tissue, he wasn't sure. My gut feeling is that the cyst is growing back and pressing on the cauda equina again- or could it be that i'm still recovering from the first surgery (now 6 months ago)? I sure hope it's the latter, as it was a big operation and the surgeon said that fusion may be next, as the facet joints move too much and in this way the liquid will keep forming new cysts. Ugh. Mid August I will have a new MRI to see whether the synovial cyst is back or not. Advice is very much appreciated, thank you!

teteri66
06-04-2016, 07:25 PM
Welcome to the board. I'm not quite clear about whether you had sciatic pain prior to the surgery to remove the cyst. Is that a new symptom since surgery?

True sciatic pain generally or often is caused by nerve compression of the L5 and/or S1 nerves. Since you know there is stenosis at these levels, I would attribute your pain to that issue. If there is scar tissue or a reforming cyst at L2, it should not be causing pain that runs down the back of your leg, or into the groin. You can look online for a dermatome map which will show you which area of the body is innervated by which spinal nerve.

One thing to watch out for with nerve compression in the lower lumbar area are a sudden change in bladder or bowel, as in sudden incontinence, or sudden muscle weakness like a drop foot. If you suddenly experience any of these symptoms, call your doctor immediately. If the nerves are not decompressed fairly quickly, there is a real danger of permanent nerve damage.

freefashion
06-05-2016, 02:00 AM
Welcome to the board. I'm not quite clear about whether you had sciatic pain prior to the surgery to remove the cyst. Is that a new symptom since surgery?

True sciatic pain generally or often is caused by nerve compression of the L5 and/or S1 nerves. Since you know there is stenosis at these levels, I would attribute your pain to that issue. If there is scar tissue or a reforming cyst at L2, it should not be causing pain that runs down the back of your leg, or into the groin. You can look online for a dermatome map which will show you which area of the body is innervated by which spinal nerve.

One thing to watch out for with nerve compression in the lower lumbar area are a sudden change in bladder or bowel, as in sudden incontinence, or sudden muscle weakness like a drop foot. If you suddenly experience any of these symptoms, call your doctor immediately. If the nerves are not decompressed fairly quickly, there is a real danger of permanent nerve damage.

Thank you so much for the reply! I had sciatic pain for over a year already before the cyst started to press on the cauda equina- I went to ER when I lost feeling in my saddle area, they diagnosed cauda equina syndrome and I had the surgery straight away. I think you're right and the two issues are not related. My neuro surgeon says the sciatic pain is a 'small hernia' due to spinal stenosis on L4, L5, S1 and he can free that nerve with a laminectomy, as leg pain is easier to heal than back pain. But he suggests I wait as long as possible, so that the time between the two back surgeries is longer. He also advised that revalidation will take quite some time, more than with a 'normal' laminectomy. My worry is that the synovial cyst is growing back, as that might mean a fusion (a big no in my book, as I'm allergic to opiods) and also, I guess they can't do the two in one surgery as it's quite a bit apart. Or maybe they can and I just end up with a long 'zipper' on my back ;-)
The last few days I also have a lot of cramps in my calves, ankles and feet, not sure if this is also due to the spinal stenosis. And it's a bit silly to call my surgeon with every complaint I have, isn't it? Thank heavens for this health board! Have a nice Sunday.

teteri66
06-06-2016, 03:33 PM
Sometimes cramps are caused by the body compensating for pain in a particular area. The body's natural defense is for opposing muscles to guard the injured area. Also your gait may be thrown off which can cause tight muscles or spasms, cramps.

Fefe15
06-08-2016, 09:49 AM
Hello,
I'm new on this board. On October 1st 2015 I had decompression surgery (L2-L4), a laminectomy and removal of a synovial cyst that was very high up on the spine (L2)- it was compressing the cauda equina in a bad way. Since then I have had a lot of nerve pain in my groin (both sides), hamstrings, plus sciatica down my right leg from the hip to the toes (according to the neuro surgeon, this is a 'small hernia' due to stenosis and a trapped nerve on S1/L5/L4 that he will operate on when the pain gets too much for me). Not sure if the sciatica is related to the cauda equina syndrome, but imo the cause of both is spinal stenosis. The nerve pain got less throughout the months (except for the sciatica) but the last weeks it's returning again more, on both sides. I had an MRI done two months ago for the sciatic pain and the doctor saw 'something' on the L2 facet joint that could be a new synovial cyst, or else it's scar tissue, he wasn't sure. My gut feeling is that the cyst is growing back and pressing on the cauda equina again- or could it be that i'm still recovering from the first surgery (now 6 months ago)? I sure hope it's the latter, as it was a big operation and the surgeon said that fusion may be next, as the facet joints move too much and in this way the liquid will keep forming new cysts. Ugh. Mid August I will have a new MRI to see whether the synovial cyst is back or not. Advice is very much appreciated, thank you!
Hi , I have just had my second op just 4. Weeks ago ,to remove a second synovial cyst, I had surgery last September,and have had chronic sciatic for over 2years. I also have degenerated disks l4 l5 And osteoarthritis and osteoporosis of spine , ny surgeon was shocked when my cyst came back,but it was twice the size , and I also have stenosis of spine .He said this was causing my leg pain , so hence the second op . But unfortunately there were complications,and I now have a dropped foot , I have managed to get a little bit of movement,but nothing more since surgery . They don't know if its going to be permanent . And I still have chronic sciatica,it's actually a bit worse . So I feel for you .I go back to see surgeons in two weeks ,and am so unhappy. I start physio on the 5th July,I will then find out a bit more on how they will treat my foot . I'm desperate to find out if anyone is back driving ,with a dropped foot . I would ask for another mri if I was you , hopefully you get a bit of release soon , fefe

freefashion
06-08-2016, 10:32 AM
Thank you so much for your feedback and sorry to hear about your experiences, it sounds a lot like mine and I'm hesitating to have the second surgery (for the sciatic pain), as it's not nice but I can keep the pain in check with over the counter painkillers so far. And I'm not at all sure what the outcome would be from the next surgery- I might end up in a worse condition. I'm seeing my specialist on August 17th and will have another MRI then as well, to see if the 'white spot' near L2 has grown or not- could be another cyst, but also a result of the removal of the first one- that wasn't clear last time I visited him. I was supposed to go into hospital today and have the second op tomorrow, but i'm kind of glad I didn't yet. Wishing you all the best and a good recovery!

Fefe15
06-08-2016, 01:43 PM
Hi I know how you feel , I don't think all my pain is caused with the cyst , I'm sure it from my back , you said you are not on prescription meds for your pain , I'm lucky as I have been under the pain clinic for years , I'm on a few meds , one being morphine,but when my foot dropped ,the pain specialists came straight to me , they gave me lidocaine infusions , I had two , I don't feel its helped much,but they did say it can take up to the 4th before I will notice if I'm going to get relief. If I don't by then .they would just stop giving me more . I can't sleep with this chronic pain,and also back pain . But if you go for more surgery , don't be afraid to ask everything that worries you , and even take notes ,,just so you are well read up on anything they plan to do . I don't know if I could go through more surgery after what happened to me . But at the same time , I don't think I can live with this pain . I hope it works out for you , good luck fee