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Post Laminectomy (L3/L4) leg pain
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Post Laminectomy (L3/L4) leg pain

Hello...back in August I was getting out of a chair..felt pain in my left hip which eventually radiated over to my groin and into my leg & foot. After 3 days of this pain...my doctor ordered an MRI which showed a rupture disk (L3/L4). I was sent to a neruosurgeon who recommended surgery to repair the rupture. At that time I had no reflex in my left leg, and it was very weak. I had the surgery on Aug. 15...and had immediate pain relief and eventually gained back 90% of the strength in my leg & foot. My problem is that during the last couple of months I have began to feel some tingling in my foot as well as pain that radiates from my buttock down into my left leg and foot...especially when sitting in a car or lying on my side in bed. I have done some swimming (per order of the doctor) to help gain strength back. I dont know weather to contact my doctor to describe this pain...I am afraid to hear that there may be more damage. Please advise. Thank very much.
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Avatar_n_tn
May be a new problem lower down in the back or could be related to the prior surgery depending on how extensive it was, hardware placed, etc...  I certainly would let your doctors know about the new symptoms and let them check you out.  You may need a repeat MRI and possibly an EMG.  In the meantime, take it easy for a while.  No heavy lifting. And would stop swimming until you get the ok from your doctors. I can understand that you're reluctant to hear about potential disc problems or nerve damage, but it's important to nip this in the bud.  Best of luck.
18 Comments
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Avatar_n_tn
Yes, contact your doctor.  He is best able to diagnose whatever is happening to you.
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Avatar_n_tn
just had surgery in june for a ruptured disk(l-5,s-1),3 weeks later my hip started hurting and started shooting down my leg.
went to my doctor and he said it was the nerves coming back to life.it got unbearable by november,went and got an mri and the same disk had blown completly out the left side and was jammed against the siatic (sciatic)(poor spelling)nerve, doctor couldn't believe it.they removed the disk on dec.20 and replaced it with a cage.hip and leg pain is gone but back still hurts(fourth surgery)you described the same problems,get an mri.hope this will lead you in the right direction,don't put it off,when it blows your gunna know it.
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Avatar_n_tn
I had the same surgery in december of 2001 around the L4-L5 L5-S1 area. I am having the same problems as you so I went and had a MRI on my lower back.  The doctor told  me that it is scar tissue and recommended all sorts of options.  He told me that surgery to remove the scar tissue is an ignorant move because you will just get more.  Or I could get surgery and then get radiation after to keep the scar tissue from coming back.  That was not anything he thought I should get because of my young age.  I just thought I would let you know what I think it may be.  Good luck!!!
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Avatar_n_tn
Thank you for your comments..I finally spoke to my surgeon yesterday and he feels it is scar tissue that has formed and is pressing on the affected nerve, thus causing the pain in my leg and has put my on Neurontin...to help ease the pain. he said it is a progressive medicine and it may take a couple of weeks to feel any improvement..the next step, should this not work...will be a new MRI and perhaps a round of steroids..I am very nervous about this..I am afraid that more damage has been done..but I am willing to go thru this course of medicine and see if it works..thanks again for all your support. Sassagirl
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14051_tn?1238255332
I can't seem to post a question without having to go to another site and pay 14.95 per response from three medical opinions. Is this a normal fee with the Forum?

Anyway...my symtons are much like yours. The neurosurgeon went back in to remove a bit more disc and scar tissue, then put a GelFoam (silicone like gel) on the nerve to keep the scar tissue from reforming on the nerves. I know how you feel! Years later though I am having problems so if anyone can answer my question, I would deeply appreciate it. I had a laminectomy at L5-S1 (75% removal of disc and foraminotomy on  the right-1983), laminectomy at L4-5 (85% removal of disc-1991) and 3 discectomies at L4 and L5-S1 (Fragment/Scar tissue removal-1992-93-94). Six months ago, the sciatic nerve problem has returned after I re-injured myself at what I think is L5-S1, but could be wrong; reguardless, sciatic nerve pain on the left buttock, pelvic area, leg ankle, side and top of my foot, and around my knee, accompanied with tingling in the side of my foot and toes. Went through PT and taking neurontin with no help. I recently had an MRI with contrast and the here is the results of the FINDINGS:
I am arbitrarily calling the last full disc L5-S1.
There is marked loss of disc height at L4-L5, as well as disc signal intensity. There are Modic type 1 degenerative endplate chages at L4-L5. There is also loss of disc signal and height at L5-S1. The vertebral body heights are maintained. The spinal cord terminates at L1-L2. No spondylolisthesis.
IMPRESSION:
1. Advanced degerative disc changes at L4-L5
2. Moderate degenerative disc changes at L5-S1. I do not see evidence of a significant disc bulge or herniation, nor significant scar formation. On the axial images there is narrowing of the inferior aspect of the left L5-S1 neural foramen.
I am having a EMG next Wednesday on the left leg to determine what and how many nerves are affected. I saw the MRI films and it shows very little space at L4-L5 which means that it is probably trying to fuse on its own; and straight I may add, but L5-S1 is far different. The vertebra are not aligned with L5 to the right and S1 off to the left. I know the worst senario; double fusion as I was told this after the last discetomy in 94.
MY QUESTION IS:
With not much disc left and and not in alignment and all information in mind; do you think that a double fusion is the only answer and inevitable?
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Avatar_n_tn
RE: Hip Pain

Summary: I have had terrible hip pain since Oct 00, diagnosed & treated as bursitis. One year later after two laminotomys at L5-S1, I still have severe back spasms, and numbness in right leg. Final diagnosis- degenerative disk at L5-S1, L5 nerve root compression, causing the hip pain and inflamed bursae.  Selective Nerve Root block in Nov 02 and today, 5 March 03 have substantially diminished the hip pain.  I may not be able to clean the house, but I can still scuba dive!

The Long story:  
I am 40 yr old female, working full time, and a scuba diver since 1989.  I had back pain growing worse since 1993 and diagnosed in about 1995 with a bulging disk.  In October 2000, I began having  terrible hip pain which become so bad at night, I could not roll over without my husband's assistance.  I cried many nights from the pain.  Doctor's diagnosed bursitis and I endured cortisone shots in left & right thighs every 3 months.
Finally, in December 2001, I could not stand the pain and was referred to Rheumatoid arthritis specialist and underwent all kind of tests - all negative.  

In January 31, 2002, my right leg gave out and I could not stand upright or have my left leg touch the ground without severe pain. A visit to Urgent Care and I was in the hospital that night.  I had immediate surgery (laminotomy) on L5-S1 in on 3 Feb 02.  Three weeks post-op, I was doing better although I had lost most of the feeling in my right leg. Suddenly, I developed excruciating pain where I could not move without screaming.  I was rehospitalized and another surgery was performed - I had re-herniated L5-S1.  The hip pain subsided but then returned with a vengeance after I returned to work in May 02.  I kept after my DR insisting that this was not just "bursitis", especially after an unbelievably painful cortisone shot in the left thigh that I felt go crunching into the bursae.  Finally, in October 02, my Ortho doctor speculated that my L5 nerve root was still compressed due to the degenerative state of my L5-S1.  He referred to me for a Selective Nerve Root block.  The Pain Spec. injects lidocaine in the back area and then under the guidance of a flouroscope, kind of an X-ray, finds the affected nerve with a needle, and injects the medication, thereby blocking the pain signal. When he hit L5, I felt a "tapping" on the nerve running from my hip to left calf.  I could clearly see on the Flouroscope the small and flat size of L5, as compared to L4 and higher.  Within a day or two, my hip pain should dissolve again.  I have been told that I am a candidate for fusion which I am refusing at this point.  I am steadfastly planning to hold out until FDA approves Prodisc.  The bottom line is that we are the steward of our own health.  I believe if I had not been adamant (but polite), I would still be treated for bursitis - a symptom but not the cause of my pain.        
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Avatar_n_tn
Oh my goodness...it is nice to see that I am not alone..however, I feel for everyone of you...all of our stories are so much alike...but some of you have been dealing with this stuff for much longer than I. I have been lucky, in that I have a surgeon and primary care doctor...that right from the start knew it was disc problems and took the right measures. I fear that after having gone thru the surgery (Aug. 02 for L3/L4) that  I have now developed and will have trouble with scar tissue. I have been on the Neurontin for 3 days...am taking Vicodin when necessary. The surgeon has asked that I give the medicine a month..to see if I get any relief. I am nervous and scared...I cant go thru another surgery..however, from what I am reading...they may have to go back in and remove the scar tissue...anyone have a thought or comment on this???? thanks.
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14051_tn?1238255332
As I said previously...I had 5 low back surgeries and the last 3 were fragment removal/scar tissue (back to back-about t months after each other) but the last one which was 9 years ago and worked as far as the scar tissue reforming. Scar tissue attaches itself to the nerves and causes the same pain with the sciatic nerve in the buttock, back of leg, down the side or top of the foot and into the toes. On my last scar tissue removal, the neurosurgeon went back in to remove a bit more disc and scar tissue, then put a GelFoam (silicone like gel) on the nerve to keep the scar tissue from reforming on the nerves. I have had no scar tissue form on the nerves since and that was 9 years ago. I know how you feel! Sad though, with age, by body is giving up the ghost again! It was so good to me for 9 years though! If you go back for surgery, ask about the Gelfoam! Good luck!
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Avatar_n_tn
Sassagirl:  Yes - you are not alone. But don't despair yet and don't have surgery until you ask all the questions.  Unless your pain is debilitating, I would wait.  Here's why:  

1.  You are only about 6 months post-op.  Maximum recovery is estimated to be about a year.

2.  Over the year, symptoms which have gone away for me:
limp, severe leg spasms/cramps in my right leg, heel pain, severe back pain upon sitting, fatigue. I can now sit for a short 3 hr airline flight, although blocks of 45 minutes seem to be my best fit. I still work 9-10 hours a day!  

3.  Ask your Dr. why he is recommending surgery to remove scar tissue.  We all have scar tissue as a result of the surgery.  Does the MRI show it to be very intense?  

4.  Ask for a copy of your post-operative surgery report to see what they did while they were in there!  As an Human Resources specialist, I routinely read other people's post-operative reports so I figured I should get to read mine! Dr. was surprised when I asked for it but readily gave it to me.  

5.  Ask your DR. about a Selective Nerve Root Block. This is a diagostic and pain relief tool.  It takes about 30 minutes, and would postpone or eliminate the need for your proposed second surgery. It would identify a problem nerve.

6.  The 2 surgeries I had cleared the herniated disc material, releasing the entrapped nerve.  After surgery, the disk space at L5-S1 is now so narrow, that it is basically bone on bone.  Therfore, the Dr. theorized that the hip/leg pain was caused by the nerve still being compressed by the narrowed space.  
The Dr. said if the Block works, then our theory is correct.  
If it did not, he would explore other problems (scar tissue).

7.  After another MRI in Nov 02, I was referred for the Block.
It was successful in Nov 02 and yesterday.  

8.  Bad news for me: we have proved disk degeneration affecting L5 nerve, so I am only buying time and pain relief right now before a third surgery. That is why I am waiting for Prodisc, the artificial disc to be approved by FDA.  It puts the space back in between the discs without the trauma of a spinal fusion, the current solution for my problem.  

9.  I have 2 very reputable doctors here in San Diego CA:
a. Ortho spine Surgeon at Scripps Hospital, in La Jolla, CA
b. Dr. Wagner, who specializes only in Pain injections.
He's excellent and precise with the needle!
     Even though both are excellent, I believe we have to help them with information to help them with our diagnosis.

Sorry so long but there is so much you can do before having another surgery.  Don't forget to read all the latest at www.spineuniverse.com
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Avatar_n_tn
I also had a laminectomy L4/5 and a discectomy L4/5 in 1991. Since my original operation i have had alot of complications my wounddidnt heal and i kept getting severe wound infections. But now the wound has finally nearly healed almost 2 years. I have a problem with the scar, as it is pulling too much and as reduced in size too much, this is causing alot more pain and i still cant bend due to increased pain in the scar. I am having a skin graft to remove all the scar tissue as my neurosurgeon as said that is the main problem now so he reffered me to a plastic surgeon who is going to do the skin graft in june. So i would say if it is affecting your quality of life then do what ever you can to relieve the pain so your life can be better, as i havent worked since the orginial operation i am looking forawrd to the operation as they have said that i should be able to work about 6 months after this operation as the scar wont be affecting my working ability anymore.
So to anyone who has had spinal surgery and have had scar problem eg increased pain and pulling of the scar due to skrinkage. Do your research on the surgeons and get a few opinions of what it better for you situation.
I would like to talk to anyonewho has had scar problems, could anyone please email me at ***@****
Sassagirl can you please email me as i can discuss this with you better as my situation is almost the same as yours.
Lindy
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Avatar_n_tn
Thanks Scuba Girl and everyone else...all this info is so good for me....I do not intend to have more surgery..unless it is the absolute last effort. My doctor HAS NOT said surgery yet...we are goin to try this Neurotin medicine for a month or more...as I said I am only 6 months post surgery...sooo I have to live with this and hope for the best...you have all been so supportive...I would really like to get a support group goin...somewhere...any ideas??????? Karen
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Avatar_n_tn
Hello everyone...I just wanted to give an update to my situation...one week ago...i was suffering with leg,calf & foot pain...called my neurosurgeon and he put me on Neurontin..it has now been 8 days and I have slept the past two nights pain FREE. During the day I have been good (2 days now) he said it would take a good week to get into my system...I wont say that is has 100% taken the pain away but it has atleast made it very tolerable. perhaps this medicine will work for me...I am keeping my fingers crossed. I would love to hear from anyone who has similar problems with post laminectomy pain...please feel free to email me at:  ***@****    thanks again for your support.
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Avatar_n_tn
Hi, I'm new to the board but understand your pain and concerns. In 12/02 I had a discectomy/laminectomy at L5-S1. The results were good. I was healing well and was ok'd to go to work 3/10 this year. The weekend before, 2/28 I was helping my wife around the house. I have since had the same symptoms reoccur and the doctors are telling me nothing is wrong. I can sympathize with you.  Hang in there.
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Avatar_n_tn
Thanks for your comment...its sounds as though you and I might have the same issue. I had a L3/L4 laminectomy on 8/16. Went back to work on 11/1. Surgery was unremarkable. Recup was normal. But then after Christmas I started to have similar pain in my leg (which was the affected leg) not as bad as when the disc ruptured...but bad enough that I was using my Vicodin and Advil. I lived with it until 3 weeks ago..when I could not stand it anymore...called my Dr. (neurosurgeon) and he thinks I have developed scar tissue around operative area...very common..but can create pain. I have been on Neurontin for the past three weeks..I have to call him next week to let him know how I am...I am about 80% better...still have episodes of bad pain..especially after driving the car (sitting at a 90 degree angle - the worst position for back trouble). So..he may do a MRI to see what we are dealing with. I am in limbo right now...It is so frustrating..I am a 44 year old mother of 2 teenagers and my life is hectic..I dont have time for pain. Please let me know what you story is...it helps so much to talk to other people that are goin thru this same thing...email me at ***@****    Good Luck.
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Avatar_n_tn
Today I just came upon this sight. I can relate to everyones problems. I have had four back surgeries. The first was to repair a ruptured disc at level L5-S1. Surgery went fine. But to make a long story short after many Doctor visits, mri's I reruptured that level and L4-L5. I had two more surgeries. But the pain and leg symptoms continued.  My doctor said there was nothing else that could be done. I did some research and found a wonderful doctor who does an amazing new technology fusion. I had a anterior laprascopic interbody fusion with posterior instruementation. What is amazing is that laprascopically thru your stomach they open the disc space and place small titanium cages within those spaces. The cages are then filled with a small sponge that has been soaked in a human protein that causes natural bone growth. The surgery was recently approved by the FDA and only specifically trained doctors can do it. There is lots of information out there about it. You can also find information by searching LT Cage. But after all that what I can tell is the results are amazing!!! Within a few days of surgery I could feel a difference already.
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Avatar_n_tn
I also had what I thought was a successful laminectomy with bi-lateral fusion 6 weeks ago. I was recovering well until week 3 when I was experiencing numbness in my foot. Numbness is now shooting pain, numbness, tingling.A lot of timesit feels like a bad sunburn. I had an MRI today and will be visiting the surgeon tomorrow. Hopefully its just to quick to heal properly and I won't be needing surgery.
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Avatar_n_tn
I had surgery on 5/19 for a slightly herniated disk L3/L4 . I was unable to stand without pain/numbeness in left leg that stopped at my knee (knee felt very tight). Ortho-surgeon said that disk was hitting my sciatic nerve. I decided to have the surgery and I still have the same symptoms. It has been a month now and I still cannot stand without back, buttocks,hip pain and the tingling down the sides of my left leg and the knee goes numb-I still have strength.
I had a second MRI of back -Ortho says it looks OK. I had Mri and x rays of knee - Mri came out clean and so did the Xrays.
I went to a neurologist and he is setting me up for an EMG.
The Ortho says the sciatic nerve needs to recover- the Neuro said that the disk off the sciatic should have brought immediate releive. My Physcial therpist- says that The sciatic nerve is not near l3/l4 and that it is a nother nerve.
Who do I beleive?
Do I have to wait for a pinched nerve to heal after a disk surgery? How long? Is it my Sciatic nerve or something else?
I need some direction- this is driving me nuts?

Can anyone offer some assistance?

Thanks;
Ken
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Avatar_f_tn
A related discussion, post laminectomy was started.
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Avatar_f_tn
Hi
I did a L5-S1microdisectomy about a month ago.  Since then, my left leg has been numb and heavy.  I am able to ambulate by dragging the left leg.  Sometimes I have to check if its there because I can't feel it.  The neurosurgeon thinks I need a psych eval cause my brain is telling my leg that I can't walk.  This is so frustrating.  I know I am not crazy.  Any advice?
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