Question: After years of chronic nerve pain in my upper right leg that had me get multiple x-rays, mri's, epidural steroid injections, 2 disc decompression surgeries, implanted neurostimulator and L3, L4 and L5 hemi laminectomy surgery in November 2013, the same severe right leg pain has returned. My doctor has increased my gabapentin from 1200mg to 1800mg, but based on the below x-ray report from early April 2014, is there anything else I can do from a surgery perspective, or do I manage and live with this through tweaks with medication. I am also waiting for my disability hearing sometime late in 2014.

Diagnostic report text

History: Peripheral neuropathy. Low back pain. History of laminectomy from L3-L5.

Comparison: CT lumbar spine 9/27/2013.

Technique: AP, lateral, bilateral oblique, and flexion and extension views of the lumbosacral spine.

Findings: There are 5 nonrib-bearing lumbar type vertebrae. L5 is transitional. Larninectomy changes are noted from L3-L5. Mild dextroscoliosis of the lumbar spine, apex at Tl 2-Ll is noted. The alignment is near-anatomic and the lumbar lordosis is maintained. There is no evidence of instability on the flexion and extension views. No acute fracture, spondylolisthesis, or spondylolysis.
Multilevel anterior spurring is noted with osteophytic ridging at L2-3. Disc spaces are preserved. Multilevel facet sclerosis are noted, worse at L3-4 to L5-S 1. Bone mineralization is within normal limits. There is atherosclerotic calcificatio•n within the abdominal aorta. A nerve stimulator is partially visualized with leads entering the spinal canal at Tl 2-L l posteriorly.

Impression:

Multilevel spondylotic changes of the lumbar spine as described above, status post laminectomy at L3-L5 levels. No evidence of instability.

Thank you!

Dr Tayal,

I appreciate your review, but I do have nerve damage, I had a nerve test a year ago which 2-3 nerves showed mild to moderate damage. After a CT mylogram in September, my Neurologist found that I needed a hemi-laminectomy on the right side to alleviate nerve compression radiating to the right thigh causing severe stabbing pain and numbness. That right thigh severe stabbing pain and numbness has returned again, in which maybe the nerve damage which resulted in me needing surgery has not healed and/or I still have some nerve compression in L2-3 to L5-S1. Since I have the neurostimulator implant I cannot get a MRI, so I am not going through a CT mylogram again. Maybe you see mild degenerative disc now, but it was mild to moderate last year that is why I had 2 disc decompressions before the laminectomy surgery last November. Please comment.

Thank you!