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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Lower Back Pain, Took Epidural Injection. Had Left L5-S1 Hemilaminotomy And Microdiskectomy, Numbness, Pain In Left Side Again. Solution ?

I was moving in mid September 2012 and while lifting a box felt immediate pain in lower back, finally went to doctor at the beginning of October and had a MRI done that showed I had a herniated disc (L5-S1). I had an epidural injection the following week and that only made it worse. I was having pain in lower back, left butt cheek down left leg along with numbness and tingling down the same leg. I ended up having a left L5-S1 hemilaminotomy and microdiskectomy on 10/24/12. Everything was feeling better regarding the numbness and pain for a couple weeks except for surgery pain of course. Then I started having pain again in the lumbar area again and just have dealt with for the lat 3 months. But then about a month ago I noticed the pain in left butt, hip and leg again and numbness down left leg. My pain specialist wanted me to go back to my neuro surgeon and he ordered a MRI again. I had it today and have the cd but no report yet. They will send that on Monday to surgeon. I opened up the cd and compared the original MRI and this one and it looks to me that the same disc is herniated again. I just can t wait until Monday to get an answer. From what I have told you and I can gladly send you the cd results of the MRI if you would like to view yourself but I want to know if I m right so I can plan what might be the next step and if surgery and what kind might be needed at this point. If you can help that would be greatly appreciated. I am going nuts and don t want to rely on what people who aren t doctors are telling me. Thanks in advance.
Fri, 3 May 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM. Generally, it is very unlikely to have a recurrent herniation of the disc at the same level within 3-4 months after a microdiscectomy (anticipating that adequate amount of prolapsed disc has been removed at the time of index surgery). Post operative epidural fibrosis will at times produces similar symptoms of disc herniation and is also difficult to differentiate between the two on MRI. In general, no surgeon will try a "redo" surgery at the same level within a short span of 3 months as redo surgeries will always have lower success rates along with high complication rates. I think you will be managed by conservative means only. Hope this helps
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Lower Back Pain, Took Epidural Injection. Had Left L5-S1 Hemilaminotomy And Microdiskectomy, Numbness, Pain In Left Side Again. Solution ?

Hi, thanks for writing to HCM. Generally, it is very unlikely to have a recurrent herniation of the disc at the same level within 3-4 months after a microdiscectomy (anticipating that adequate amount of prolapsed disc has been removed at the time of index surgery). Post operative epidural fibrosis will at times produces similar symptoms of disc herniation and is also difficult to differentiate between the two on MRI. In general, no surgeon will try a redo surgery at the same level within a short span of 3 months as redo surgeries will always have lower success rates along with high complication rates. I think you will be managed by conservative means only. Hope this helps