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Neurology (Expert Forum)
Laminectomy L5-S1 5 y. ago
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Laminectomy L5-S1 5 y. ago
by IGoR_2803, Apr 18, 2006 12:00AM
Hi! I had laminectomy 5 years ago at L5-S1 (i was 15 at the time, my neuro said i was the youngest of his patients wtih the condition ever)... anyway, everything was alright untill a month ago, when i started to feel the same kind of pain... lower back, left leg and foot... i visited a neurosurgeon (not the one who performed the surgery) and he said it was nothing, that there is no need for further neurosurgery activities and recommended physical therapy... to cut it short - i just wanted to know is it possible that nothing is really wrong with me (regarding the disc) or are these symptoms recurrent only when there's a serious problem. i'm scared so i just wanted to make sure... thanks
Doctor's Answer
by CCF-Neuro-M.D.-PW, Apr 23, 2006 12:00AM
Its difficult for me to comment specifically on your case, without knowing more details and results of MRI scans
In general, symptoms that occur after a lamainectomy should be evaluated in case there is instability of the joint, or the presence of a new problem, or a disc fragment still in the area of surgery. So long after surgery, it may be more likely to be instabilty of the joints around the area of surgery - surgery stabilises the site of surgery, but areas around it with similar (but milder) disease may still cause symptoms down the road depending on teh diagnosis.
It may be necessary to do an MRI to evaluate for this, but further surgery should be avoided unless there is evidence by the examination or EMG of progressive neuroloigcal function like muscle paralysis or there is a retained disc fragment. Conservative therapy is ideall recceomended unless this is the case, as in most cases it resolved on its own and surgery has the potential to make things worse
Good luck
In general, symptoms that occur after a lamainectomy should be evaluated in case there is instability of the joint, or the presence of a new problem, or a disc fragment still in the area of surgery. So long after surgery, it may be more likely to be instabilty of the joints around the area of surgery - surgery stabilises the site of surgery, but areas around it with similar (but milder) disease may still cause symptoms down the road depending on teh diagnosis.
It may be necessary to do an MRI to evaluate for this, but further surgery should be avoided unless there is evidence by the examination or EMG of progressive neuroloigcal function like muscle paralysis or there is a retained disc fragment. Conservative therapy is ideall recceomended unless this is the case, as in most cases it resolved on its own and surgery has the potential to make things worse
Good luck
Member Comments (10)
by cyndi57, Apr 19, 2006 12:00AM
To: IGoR_2803
To answer your question: I had my first lumbar surgery at the age of 22 in the same location as you have described. Ten years later, I had 4 more surgery, 6 months apart on the right side, then the left, then the next level up. My first surgery was by a Neurosurgeon, but the rest were done by an orthopedic spine specialist. My advice to you is to try the physical therapy, but also seek a second opinion by a ortho. Don't wait as I am now going in for my 7th, the 6th was a double fusion and in 4 weeks to have hardware removed. Techonology is better than it was when I had my first leminectomies/discectomies done in the 80s and early 90s so you should have a better outcome if you stay on top of it. I would also recommend a bone density scan to check for osteoperosis of the spine as I did and found that I have severe of the spine, but mild in the hip. Evidently, I have had it for years and didn't know it. Just a thought, but good luck and stay on top of it!
by IGoR_2803, Apr 19, 2006 12:00AM
huh, i don't like the idea of so much surgeries... i'm sorry for u... thanks though
by csue, Apr 22, 2006 12:00AM
Hello. I am new to the forum. I hope everything goes well with you. I would get a second opinion and maybe from an ortho. I slipped on some ice in dec. and hit my lower back on front steps. Now, i will be going for surgery on tuesday. I am having a laminotomy and micro disc. I hope it works and I do not have any more surgeries down the road.
by IGoR_2803, Apr 23, 2006 12:00AM
i wish u good luck! i went to another specialist and he said that it was probably nothing, but i should make a MRI just in case...
by cyndi57, Apr 23, 2006 12:00AM
I am glad that you are getting the MRI. You will then know for sure what, if anything, is going on! It may only be muscle/tissue issues, but at least you can rest knowing that its not something surgically wrong and that PT will help! Never give up as you have to push, push, and push, until you get satifactory answers! Good Luck!
by IGoR_2803, Apr 25, 2006 12:00AM
thanks very much...
by IGoR_2803, Apr 29, 2006 12:00AM
oh, one more thing: i've been having ailments with my left knee (the one on the side that was affected by the herniation)... it's not really pain but the instability... it feels as though my left knee is weaker than the other one... and it looks different, phisically i mean. it is not symmetric regarding the right one... so i've been wondering if it could be connected to above mentioned problems. tnx again...
by cyndi57, Apr 30, 2006 12:00AM
To: IGoR_2803
To answer your last question about your knee: Normally the nerves that were involved with L5-S1 is the sciatic nerve which runs from the buttock to the outer side of the leg, outer/backside of the knee and backside of the calf running down to the outer part of the heal, ankle, outer part of the foot and the 3 smaller toes. That doesn't mean that it is not effecting your knee as you could have an improper gait from your previous problems that can effect your walk, hip, knee and your foot. Your muscles may also be atrophied from all of your back problems, especially if you have more nerves that may be pinched off. Be sure to tell the ortho of these issues and anything that you can think of when you go back to see him after you get the MRI results. Remember, I am not a doctor, but I have had 7 spinal surgeries throughout the last 23 years, including shoulder and elbow surgeries, and I get the radiologist reports before I see the doctor so that I can do research online. It gives me a better idea and have learned to understand much of their reports throughout the years. Make sure that you ask all questions necessary to satisfy your suspicions and don't stop until you are satisfied. It may mean going for more than a second opinion, but thats okay as it is your body and you need to know what is going on! Good luck and hang in there!
by IGoR_2803, May 01, 2006 12:00AM
once again - thanks much! i about to go on that MRI so i guess i'll know than. regards