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L5/S1 herniation connected to right leg and foot symptoms?

Large L5/S1 herniation July 2001.  April 2003 right leg hamstring swelling and pain.  MRI April 2003 showing nerve compression.  Increasing hamstring swelling and pain plus pain/tightness in right calf muscle.  Laminectomy August 2003. Post-surgery; no low back pain and sciatic pain much less but lost feeling under my right foot (especially along the outside, under the ball and the last three toes of my foot).  Could not flex right ankle properly. Later, right calf muscle even more painful/tight, slowly enlarged (now much larger than left calf muscle), and right hamstring also still quite sore and enlarged.

Sciatic pain returns December 2003. MRI January 2002 showing re-herniation with nerve compression.

2004 spent waiting to see another Ortho surgeon (2 appointments). Laminectomy recommended.  Not gone ahead because he reported to g.p. that he could not find any relationship between re-herniation and right leg problems. My logic; I only suffer from minor back pain very occasionally (mostly when lying flat or when standing/walking for long periods of time), I don't suffer from any sciatic pain, but I do suffer terribly from  pain that my enlarged/tight right leg calf muscle causes (especially in the mornings when I can hardly walk) ... so why should I have surgery that won't fix the latter.

Also bladder and bowel problems; increased urination and diarrohea.  Unable to hold back and sometimes control both/either.

Neurologist cannot find relationship between reherniation and right leg problems.  Ignored request for nerve study/EMG.
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Avatar universal
A related discussion, L5, S1 nerve, extra vertebre was started.
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Avatar universal
Hello,
I am hoping that one of the doctors can give me a bit of guidance with my question.

On December 17th of 2004 I had the charite artificial disk implanted at L5/S1 at Florida Spine Institute by Dr. Scott Webb. I know he has done a marvelous job with the procedure but what my question involves is the post-surgical pain.

I am having "uncontrollable" muscle spasms and I live in utterly horrible 7 out of 10 pain almost everyday. When I have ample pain mediation onboard I can deal with the pain but since Dr. Webb is a surgeon he does not provide much to me in the way of pain management and to date will not refer me to pain management. He said in a couple months if I am still in pain they will try botox injection into the area spasming to help with the pain.

I am wondering if we are missing something that could have developed in the interm. I just recently heard about clonus and I am curious if it is possible to get this and have it be undiagnosed for such a long time because I also had a positive disc problem that had to be diagnosed by 2 seperate discograms. I had nucleoplasty in may of 2004 and then in december I had the full blown surgery.

Please help as I am at the edge of disaster with this pain and I am really worried because since the surgery my ability to manage the pain is gone. Thanks for your help.
Brian
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Avatar universal
I agree with Craig's Post...bowel/bladder problems along with your other symptoms indicates Cauda Equina Syndrome (CES) and is indeed a medical emergency.  Make sure you tell the Dr. and or N/S about your back, legs, feet and BOWEL and BLADDER...I have had CES and trust me when I say you can perm. lose sexual function, bladder, bowel, end up with slap foot...which is what it sound slike Kiwi has...dragging your foot and then "slapping" it, was wht I was told would happen (I already had foot drop at time of surgery) but PLEASE get treated....Craig did you have CES also?

Celine
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Avatar universal
Sorry to hear about your problems!
Our problems sound very similar. I ruptured the L4-5 and L5-S1 in 2001 on the job. Due to a workers comp claim I was jerked around intil I finally put the surgery on my cobra insurance in Oct. of 2003. I had the 2 discs removed and 3 vertibrae fused with rods and screws. In the hospital I was overdosed on morphine and returned to the hospital 2 weeks later with 2 strains of staph infection. I took about a year to start making good progress in my recovery! About the time I was doing good and trimming off the weight I started going backwards. About the last 5 months have been a downward spriral so I had an MRI done a few months ago and the found an abundant amount of scar tissue and a bone spur hitting a nerv where they put in a screw. The surgeon wouldn't come out and say if this was the problem but did hint a little when I asked him if it was causing my regression. I'm having the same problems as you but with both legs and feet! Have they adressed possible scar tissue problems? did you have infection?
I really feel my problems are from the Staph! I still have Sciatica down both legs along with the other symptoms. SAIF, workers comp carrier, is sending me to a milti-disiplinary rehab for 8 hours a dy for 4 weeks....I about laughed, with my limitations it seems really extreme. Most therapy I've been to has ruined me in 30 minutes! Sorry for the long reply but I feel what you're going through!!!
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Avatar universal
It will be 2 years in August since I had the laminectomy.  I did not have any problem with flexing my ankle prior to this surgery, and no-one that I've seen has been able to explain why I am unable to properly flex my right ankle (walking uphill, even with a slight gradient, is very difficult, and I sometimes have to walk sideways like a crab).

I don't think I have 'foot drop' ... from what I've read about this condition, however, my right leg feels very heavy in the mornings when I first awake and I find it difficult moving my leg and foot forward (feels like I'm dragging a weight attached to my right leg).

I am very nervous about re-doing back surgery and have lost confidence in the medical fraternity as a whole.  I no longer get low back pain as badly as I did before the surgery, however, I find it very uncomfortable standing for long periods of time and I cannot lie flat on my back for any length of time (the muscles that seem to run across my lower back feel increasingly tight and pain, and the hamstring and calf muscles in my right leg also tighten and pull up).  

Disc fragments were detected on the MRI done about 4 months after the laminectomy, and the radiologist reported that there is nerve compression.  

I take pain killers every day (8 tabs) and also something to sleep at night when the pain is extreme.  I've had months of physiotherapy, involving deep massage of the calf muscle, but this hasn't worked.  

I feel as if I'm stuck in a nightmare where everyone I speak to cannot help me.  A medical freak!
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Avatar universal
Its hard for me to answer your question comprehensively without seeing you or your scans

Your problems are complicated by the fact that you have had surgery already. Remember, surgery to relieve compression will only halt any worsening - any damage done already may or may not recover, and then may take months.
Sensation along the sole of the foot is from the medial and lateral plantar nerves, sensory branches of the tibial nerve, which itself is a branch of the sciatic nerve. Foot drop (or foot flexion weakness) is a common problem seen in compression of a nerve in the leg (but can be compression anywhere from the root near the spinal cord to the peripheral nerve)
Unfortunatly re-do back surgery can be more complicated due to the first surgery and you need a good spine neurosurgeon - the outcome depends on whether the recurrent pain is directly due to the disc reherniation and how much is due to other causes/soft tissue pain or injury. Its hard to tell for sure. There are some obvious reasons to go back in surgically like severe cord compression or floating disc fragments - I'm not sure if this is correct for your case
Try treatment for the spasm in your right leg ie muscle relaxants, massage then see what is left - that may be more related to the nerve compression
An EMG might be useful but a lot of the time in this situation just shows chronic nerve changes or nonspecific changes that do not add to the decision making process for surgery.
Good luck
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Avatar universal
Have visited my g.p. countless times. Have had to ask him each time for the various radiology tests I've had, and have had to ask him to refer me to the various specialists I've seen (orthopaedic surgeons x 2, and neurologist).

Seems to me that anything that isn't to be found in a textbook baffles the medical fraternity and I feel as my case has been put in the 'too hard to solve' basket.

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Avatar universal
Inability to control your bowel/bladder is a medical emergency. See a doctor immediately.
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