L5,S1 and Fasciculations

[diana]

Thank you in advance for any help you may provide.

My husband (37 y/o) had neurosurgery two years ago for a badly herniated L5 S1 disc.  This provided relief from terrible muscle spasms in his back and left leg and foot, weakness in left leg and foot and reduced sensation.  Six months ago he started to have fasciculations in his left calf.  Over time the fasciculations spread to his entire leg and increased in severity and frequency to the point of creating fatigue in his leg.  He revisited the neuro group.  They put him on Tegretol which helped a little but not really significantly.  Neurontin was tried next which helped even less.  The neurologist had an MRI done just to check.  Sure enough the same disc was badly herniated on the same side.  He was also found to have a narrow spinal column (congenital).  The compression on the sciatic nerve definitely warranted surgery.

Surgery was completed two weeks ago. A gel was painted on his nerve to help with build up of nerve tissue.  The fasciculations have lessened a little in both severity and frequency.  His leg is still weak which doesn't surprise me and his back is too, but that seems part of the healing process from surgery.

My questions are:
1.  Is it probable that the fascicultions will continue to diminish over time?
2.  Will the nerve continue to heal and if so how long is typical in the healing process?
3.  I understand the gel has recently been approved by the FDA.  What is the buzz on the effectiveness of this gel?
4.  How likely is a disc to herniate a third time?  More likely or no more likely than an individual who has never had a herniated disc?

Thank you!

[Kamalraj]

A related discussion, post Micro lumbar disectomy pain was started.

[CCF Neuro[P] MD, RPS]

Dear Pat Gorman:

Yes a severely herniated disc could cause the symptoms you describe.

Sincerely,


CCF Neuro MD

[Pat Gorman]

Good morning
I just received the "total test results" of my myelogram
I am told that I have deg disc and facet lessions....can't this
condition be repair by surgery or am I stuck with this for life???In the last 4 months I have seen several doctors.. here are their findings
a...Ms... not proven yet... family doc
b...myofascial... not proven yet ...neuro doc
c...hurniated dics but... not proven yet ...neuro doc
d...deg disc and facet lessions (myeologram)proven... ortho doc
I am awaitting as previously mentioned for a MRI...I have had a nerve conduction study test it came out ok but could not do the EMG because it was causing to much pain the the neuro doc moved the needle around..she is the one that thinks that I may still have a hurniated disc...is it possible the facet lissions and deg disc are giving me the symtoms for hurniated disc...numbness weak legs vibrating feeling in my right groan and leg foot feeling could muscle spasms in my back etc all of the fun stuff a herniated disc would do to you?????
Thank you
Pat

[CCF Neuro[P] MD, RPS]

Dear Pat Gorman:

There is no really known etiological agent for your condition.  The pain can be intense and cause many problems with lifestyle.  There are many approaches to the control of pain and we usually try to use non-sedating and non-addicting medications first.  Most of our patient function well and are living active and productive lives.  There are always patients who do extremely well and some who do not seem to respond well.  

This is a free service and demands cannot be always meet on time. Sorry.

CCF Neuro MD

[Pat Gorman]

no comment on myofascial????

[Dee Nokes]

    Thank you for your response even though not quite what I wanted to hear. Here is a question, I know it may sound shocking to some (it did my family) but ...instead of all this pain management stuff and medications that will cause side effects, what if a surgeon went in and "killed off " the sciatic nerve,cut or whatever ? Wouldn't I just be paralized on my right leg side and then resume life better? I'd rather have a bumb leg than continued pain.  
    Second, I've heard of a clinic in Cal. that claims their natural medications work better and are safer. is the FDA/MDA looking into natural or are they against each other?
                 thank again,
                        Dee    

[Pat Gorman]

Good morning
I have just been told that I have Myofacial Pain syndrome .In October I had surgery for a hurniated S1L5 hurniated disc...I take 8 tylenol #3 a day for the pain...can you tell me what causes this syndrome and if it is reconized as a disability...and will I ever be able to return to work???What could have triggered this???
Pat

[CCF Neuro[P]MD, RPS]

Dear Dee Nokes:

No, head will not break down scar tissue.  Lazer is not a precise enough tool to remove scar tissue from the nerve.  It is either surgery (likely the scar tissue will return) or ?  Sometimes rehab helps, pain management helps some, but I am afraid there is not much other than surgery one the first two fail.

Sincerely,

CCF Neuro MD

[Dee Nokes on January 15 , 2000]

Hello,I have a couple of problems I would really like input on. In June 1999 I had "emergency" back surgery on a herniated disk. They took out 40% of L5. felt great!
  3 months later i felt worse than before surgery. MRI results have come back saying the same disk has herniated again but the scar tissue has grown into my sciatic nerve. I need not go into the amount of pain. My question is why can't laser surgery be done on the scar tissue? Is "pain management" the only thing left?
  In the "natural" books I have read claim that a lot of heat, especially saunas break down scar tissue. Do you think this is false hope for us who at this point are desperate for relief?
Final question, can the scar tissue eventually paralize me?

[Pat Gorman]

Dr Doctor
Thank you very much for your info you have help me out and answer more questions than some of my own doctors and I truly am gratefull!!!
Can tylenol #3 cause a higher level of enzynes???and if so what
are the symtomes if any???

Pat

[CCF Neuro[P] MD, RPS]

Dear Pat Gorman:

I think you need to talk to your neurologist about pain management and what tests that need to be done.  Tylenol would not mask the symptoms nor give you the symptoms you have described.

Sincerely,

CCF Neuro MD

[Pat Gorman]

Good morning
As previously discust is it possible that the tylenol that I am taking causing all of my symtoms mimaking a herniated disc symtoms I know I am grasping at straws but realy must look at all possabilities!! I take 8 tylenol a day #3's for the last year for
my hurniated disc that I had surgery for in October 1999.
Pat thanks again

[Pat Gorman]

Hello
What kind of testing should I have???
Pat thanks again

[CCF Neuro[P]MD, RPS]

Dear Pat Gorman:

It depends on the extent of the disease.  No, an MRI will just show changes, you need to have various testing done to see if the etiology is due to the diseases mentioned.

CCF Neuro MD

[Pat Gorman]

ok if it is what can be done to make the nerves go back to normal???And can this be seen on a MRI??

Pat thanks again

[CCF Neuro[P] MD, RPS]

Dear Pat Gorman:

Inflammation can be due to systemic illness such as rheumatoid or osteo arthritis, lupus, collagen vascular disease etc.  It can also arise from surgery in the area.  It can be the result of irritation from long term misuse of the area such as a job where lifting occurs.  It can arise from trauma.  So the list is pretty long.

CCF Neuro MD

[Pat Gorman]

Thank you for answering my question.So what would be causing inflamation in the nerve area then???Would it still be the surgery I had and if not????Is this permanent??
Pat
happy new year
and thanks again

[CCF Neuro[P] MD, RPS]

Dear Pat Gorman:

I can not tell from what you have told me without seeing the films and doing a physical exam.  I would wait for the results of the MRI.  The sensitivity of the MRI is sometimes better and this might tell you something.  It may be that there is just inflammation in the spinal nerves, but a good neurological exam and the MRI will help matters.

CCF Neuro MD

[Pat Gorman]

Hello just got the results from my myelogram that I had 2 weeks ago and to my surprise there is no new hurniation!!!How can tha be???if I am experiencing the same type of pain muscles and nerve pain on the opposite side???And since that test I have been having problems with my bladder??My doc seems to think that I have MS Somehow I do not feel the same I think it has to do with the nerves the disc or something????I also have alot of trouble with the cold my nerve in my bum back leg and foot goes nuts in the cold it is so painfull feels like a tooth ache that is exposed to the cold but in the  area where the dics would be causing problems!!Would a mylogram show siatic nerve damage or spine damage???? I will be going for a MRI soon will that help??? I understand that the myelogram is the best test that shows everything better than a MRI?????My legs also are very weak feels like I am walking in water when I walk  and standing is very hard  to do as well it gives me alot of pain and weakness sitting is out of the question it just kills me when I do and getting up well the nerves in my bum back and legs don't like that at all hehehehehe they let me know real fast!!! I also get alot of burning in my foot and numness???SO confused and would appreciat you thouhgts
Thanks Pat Gorman

[Susan]

Hello,

I am a 41 year old female. In good shape. Never smoked, not
over weight. I had a laminectomy 7 years ago.

Last year I started having problems again. My neurologist
did an MRI and it showed the beginning of my disk
herniating.

Uptill now, I have been able to survive taking motrin.

But recently I've experienced the numbness in my left
buttocks and pain radiating down my back and buttocks.

These symptoms are all too familiar from what i had 7
years ago prior to surgery.

My question is::::::
Should I undergo more surgery? I've also tried cortisone
shots but they didn't last long.  

At this point, would more surgery be beneficial?

Looking forward to your reply.

Susan

[Susan]

Hello,

I am a 41 year old female. In good shape. Never smoked, not
over weight. I had a laminectomy 7 years ago.

Last year I started having problems again. My neurologist
did an MRI and it showed the beginning of my disk
herniating.

Uptill now, I have been able to survive taking motrin.

But recently I've experienced the numbness in my left
buttocks and pain radiating down my back and buttocks.

These symptoms are all too familiar from what i had 7
years ago prior to surgery.

My question is::::::
Should I undergo more surgery? I've also tried cortisone
shots but they didn't last long.  

At this point, would more surgery be beneficial?

Looking forward to your reply.

Susan

[CCF Neuro[P] MD, RPS]

Dear Pat Gorman:

I would contact the physician who performed the myelogram and let them know what is happening.  

Sincerely,

CCF Neuro MD

[Pat Gorman]

Why do myelograms make the injured area more painfull after they inject the dye in you!! I had one done a few days ago and since then I have had alot of pain "nerve" pain in the legs and back pain and starting to have bladder problem loosing control not alot just enough to notice???

[CCF Neuro[P] MD, RPS]

Dear Jamie:

Yes, there are many other conditions that can give you fasciculations.  Many of the polyneuropathies, Issac syndrome, infections, muscle disease other than ALS, etc.

Sincerely,

CCF Neuro MD