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Scared after bilateral diskectomy/laminectomy L5-S1

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:30 AM in Back Surgery and Neck Surgery
Hi, there!

This is a great site! I'm so glad I found it & all of you fantastic folks! I think it's wonderful & inspiring that you all are taking time to help & comfort others even though you have your own pain & worries. You're a big bunch of sweetie pies & I wish you all the best.

Well, then...I've been scared & crying quite a bit lately, so I was hoping for some friendly support & guidance from others who know where I'm coming from. Here's my deal: I'm 23 days post bilateral diskectomy / full laminectomy @ L5-S1. When I woke up from surgery the back of my right thigh was really numb (no sensation), my heel felt like a block of wood, & my last 3 toes were numb & I still was unable to spread them apart. (I had these issues for about 3 weeks before surgery, but they seemed more pronounced after.)

Except for these 3 things, I felt that I was improving significantly the 1st week. However, sometime during the 2nd week I started to experience a slew of new symptoms: my calf, ankle, & achilles tendon became numb; sometimes the tendon feels cut; sometimes the ankle feels swollen, but it's not; the numb areas seem to be having a contest for who's numbest: one day it's the thigh, the next it's the heel, etc; I'm feeling this tingly/creepy crawly sensation up & down my leg (not constant); I have shooting pains behind my knee after walking for awhile; When I lift my knee, I feel what seems to be a tight knot in my butt; Hamstring is tight; Both my legs are stiff & tight (maybe a consequence of not using my body normally?) & in general I feel rickety & fragile; Worst of all, the bottom of my foot has become hyper-sensitive. I can only tolerate wearing socks & slippers. If I'm barefoot, it feels like a nerve mosh pit with every step I take.

After a few days of freaking out, I called the on-call NS @ the hospital (last Sunday). He said he couldn't really help me since he wasn't my NS, but offered that my symptoms could be indicative that the nerves are waking up...OR that I've reherniated. Great, right? I talked to the PA the next day (last Monday), & she told me not to worry, that it's probably just the nerves coming back to life. She said she'd talk to the NS about it, but never called me back.

Like many of you post-ops, I'm worried that I've reherniated & will need a MILF or what have you to make things right. Is it possible to reherniate without a sudden onset of severe pain? Based on what I've read here, it seems like I'd KNOW if I did, but I just can't shake the feeling that something's wrong, especially in light of the new numbness & the fact the I'm not improving noticeably as the days go by.

There are a few glimmers of hope, though. I can sleep through the night; I feel pretty good when lying on my side; Lortab is helpful(I take 4 a day + flexeril + ibuprofen); My toes & calf are still numb, but I can now feel sensation in them, like cold/hot/scratching; heel is a little less wood-like.

Some questions: Is what I'm experiencing nerve pain? What's the difference between pre-op sciatic pain & post-op nerve pain? For those of you who've overcome post-op numbness, how long did it take & what did it feel like?

I know that you can't diagnose me & that everyone is different, but I'd still like to hear from you (especially if you have psychic abilities!)

Sorry to complain,

Best wishes,


34, married, ex-librarian, mommy to almost 2 year old boy genius, smoker, eBay shopper, 25 lbs overweight, coffee lover



  • I just wanted to welcome you to the forum. I guess you have to see your Dr for a exam whether you've reherniated. I hope you haven't and it's just your nerves waking up. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Welcome to the board. I am sorry for the reasons you found us.

    Just to clarify a couple things: Sciatica is just a generalized "catch-all" term for nerve pain. Laymen use the term to describe any pain that originates in the cauda equina area of the spine that results in pain that travels down through the buttocks, thigh, calf and into the foot, or along parts of those areas. It can result in a variety of sensations, tingling and numbness. I don't believe there is any reliable way to separate pre-surgery nerve pain from what you experience post surgery, except anecdotally...what you report to your surgeon or others.

    As the PA told you, you could be experiencing some "seriously pissed-off" nerves, as my surgeon surprised me by saying. I'm pretty sure it's a medical term. Sometimes the surgeon has to handle the nerve quite a bit during surgery. They can be stretched or otherwise traumatized and it can result in new sensations. Or, you could have a new herniation or other disc issue. Or, I would add, you may now have some instability from the lamina being removed. When more than one level is removed without fusion being performed, there is always the risk of instability. In this case, something may have shifted which is resulting in a new nerve compression. These are the things I can think of that could be causing your pain. Of course, inflammation from the surgery itself can take a long time to resolve and that could account for the pain, too.

    It's really hard to say. You might want to make an appointment and go back in to talk with your surgeon. Did you say you've taken prednisone since surgery? They will usually try one or two courses of an oral steroid to calm things down. And epidural or caudal injection might also be suggested for the same purpose. But at only 23 days post surgery, they will probably just tell you to hang in there unless you make a fuss.

    I guess if I were you I would be concerned too. It sounds like you are really quite a bit worse than immediately prior to surgery. Did the surgeon indicate he had to tug on the nerve to free it up or say anything about the surgical process? I guess I'd give it another week since you said in one of your last paragraphs that you were seeing slight signs of improvement, and then I would keep calling your surgeon until you get a response from him.

    Hope it's just taking your nerves a bit of time to calm down and that you will start feeling better soon. Keep walking. You want to get those nerves to stretch and walking is the best way for that to happen.
  • Hi, Charry! I like the spelling of your name! Thanks so much for the welcome. Your posts are always so friendly. Yes, I'll definitely have to speak with my NS. My follow-up is on 4-28-09, but I'm so out of my mind with worry that I'll probably have to call & pester the PA. I do have an "in," though. I just received an order for PT in the mail (???) with no instructions as to when I should begin or anything else. I can't even imagine going to PT at this point. I can't even imagine putting on my own socks! So maybe I'll call & start with questions about the PT order & move into questions I have regarding my numbness, etc. Sneaky, huh? I really hate to call because the PA always seems to be in a big hurry to get off the phone, which causes me to feel like a nuisance.


    Hope you're doing well...

    Hi, Gwennie! I really appreciate your clarifications & insights. Your posts are always informative, articulate, & honest. I hope my questions don't sound too ignorant. Even though I'm no stranger to back pain or surgery--I had a laminectomy/discectomy @ L4-L5 5 years ago--I'm only just now wading through all this neurology BS. Last time I didn't do too much research before surgery because medical stuff grosses me out & scares me (I haven't even looked at my current incision). And because I had no issues post-op, I had no need (or desire) to go poking around on the internet.

    I guess what I was really asking with my pre-op/post-op question was, "Based on my symptoms, you all don't think I have permanent nerve damage or another herniation, do ya?" But, of course, I know none of you can answer that.

    I like your speculations as to why I'm still suffering. You mentioned "instability" as a result of "more than one level being removed without fusion." I'm still learning, as I mentioned, but I thought I only had work done on one level: L5-S1. This may be a stupid question, but does that count as 2 levels?

    I think "seriously pissed off nerve" appears on page 471 of the PDR. :))) When the NS came to speak with me in my hospital room after the surgery, I expressed my concerns about the numbness. He told me that during the procedure the nerve (I assume he's referring to S1) "pretty much didn't do anything" when he [insert verb--I thought he said "cauterized it" ?!? Yikes!]. Even so, he remained ever-optimistic & told me not to worry. I don't know about any tugging or stretching, but the MRI report mentions that the 8 x 13 mm disc fragment was severely impinging the thecal sac & the nerve roots in that location, so maybe there was a lot of trauma during the surgery. It certainly didn't sound pretty.

    Other than "don't worry," I have been given no input regarding my post-op issues nor do I know anything else about the operation except that it went well. I didn't press him for information at that time (& he didn't offer any) because I was strung out & tired of the whole ordeal & wanted to get on with the healing & get back to my life. Since he didn't act like it was any big thing, neither did I. But as the numbness shows no real signs of going away, I am finding myself in tears more & more. I wish he'd have said something like, "Expect the numbness to continue for X length of time. Also expect to experience some strange new symptoms, like xyz. Signs of nerves waking up are these. Signs of a problem are those." Then I wouldn't feel so in the dark.

    No, I haven't had prednisone since my operation, but I have had it in the past & think it's good stuff. Why is it that steroids are typically the first line of defense in post-op issues. It seems to me that if you have another herniation you're going to be back to square 1 after you stop taking the drug, & maybe worse off for it? And what about this Neurontin everyone's talking about? Does it stop nerve parties? Like a bouncer?

    Finally, about walking. My discharge papers vaguely say "up walking frequently." I've found on this board that one person's frequently is 10 minutes every hour, while another's is 3 miles a day. The 1st week out, I walked around the house for about 2 to 3 hours after I first got up in the morning, then on & off all day. When I started having new symptoms, I backed off & rested way more. Now I'm walking more. What's a reasonable amount daily? And if I do in fact have anther herniation, is walking a lot a bad idea?

    Thanks to all,

    Hope you're well,

  • Thanks for the kind words.

    You are right that L5-S1 is referred to as one level, but you also had a lami at L4-5 earlier, right? That leaves you with two adjoining areas that are minus their "roof." So I just thought it might be providing enough wiggle room to make that segment a tad unstable.

    Many of your sciatic symptoms sound like a S1 nerve issue. No, we can't say or even venture a guess as to whether you reherniated or have permanent nerve damage -- actually, even the best spinal specialist couldn't tell you if nerve damage is permanent, unless it is severed, and even then, they have been known, on rare occasions, to rejuvenate!

    I do have a suggestion though. L5-S1 is the disc that gets injured the most often (which is not relevent...just thought you'd like to know that!). It also has an unfortunate location as it is very near a bunch of other stuff -- all the pelvic nerves and soft tissue are located close by and are very susceptible to becoming inflamed. Also, there are two large muscles in the buttock that can also play into this whole mix.

    One of these muscles, when disturbed can have symptoms that are similar to those of a herniated L4-L5 or L5-S1 disc. It is sometimes called the piriformis pinch. The sciatic nerve runs right underneath this muscle, so when it is in spasm or tensed or inflamed, it can cause a sciatic pain that affects the buttock and the leg, and can reach down to the ankle. Sciatica from piriformis tends to be worse when sitting, but is usually relieved when standing or walking. Lumbar disk herniation sciatic pain is often relieved by sitting in certain positions.

    Also there is increasing evidence (although many spinal specialists are not yet believers!) that pelvic floor dysfunction or having weak pelvic muscles can cause lower back pain that also resembles that of a herniated lower lumbar disk.

    I went back and read your first post where you described your symptoms. It really sounds to me that the S1 nerve is starting to react to the trauma of surgery and is causing the problems you mention. The disc fragment pressing against the nerve is enough to cause trauma. Also, when the disc ruptures, there is a chemical reaction at that location that also irritates the nerve. When you take this and the trauma of surgery into consideration, you can see that the nerve has been seriously disturbed. It may seem to be getting worse before it finally calms down.

    Another thing: before the surgeon closes you back up they irrigate the area with a long lasting steroid. The purpose of this is to try to keep the swelling down and it is supposed to last long enough to get you over the immediate post surgery pain. In reality, what happens is that it ends up scaring most of us because we think we feel so much better than before surgery and think we're making progress. Then when this wears off after a couple weeks, we "suddenly" have a return of symptoms and we panic, wondering what we've done to cause this return of pain. I imagine this is part of your perception of what is going on, too.

    They usually give a course of oral steroids as they work well on inflammation, and that is often the cause of pain. After that, they may suggest an epidural steroid injection, for the same purpose.

    Neurontin, Lyrica and gabapentin (generic form of Neurontin) are routinely given for nerve pain. Opioids do not have any effect on nerve pain. Neurontin makes the nerve pain tolerable for some people.

    Let's see -- walking -- do what you can. Distance is not as important as frequency. You are better off going for several small walks spaced out over the course of a day rather than one long one. Walking stretches out the nerve better than any other exercise and helps to keep blood circulating to the area so it can heal.

    I think you overdid it at the beginning if you were on your feet for several hours at a time. I would walk ten or fifteen minutes if you can do that comfortably, and then lie down for a bit. Then walk a bit more. Gradually build up your time, IF you can tolerate it. If the nerves are inflamed, your doctor may want you to back off the walking -- but you only have a small window of opportunity to have an effect on the healing -- 6-8 weeks for the nerve and scar tissue -- so you do want to walk if at all possible.

    On a final note, I've never known a surgeon to come out and say anything but "it went well." They always think they did a GREAT job. I guess it's just our bodies and the way we heal that sometimes screws things up!!
  • Hi All-
    I'm VERY new to this site,so I apologise if I'm breaking any rules for commenting.

    I'm very sorry to hear about the trouble you're having and can truely relate. I had the same surgery 15 days ago.

    Before surgery my right ankel, outside of my lower leg and most of my right foot were numb/tingly along with the usual sciatic pain. But my disk hadn't herniated, it had fragmented and pieces of it were pressing on the nerve root "eight ways to Sunday" (one of my NS's medical terms
    I guess).
    Post-op I have no sciatic pain, but within hours of the surgery, I began aving the same symptoms as you. The hypersensitivity, burning, numbness, sensation of swelling when none is present, etc. One minute my foot feels like it's in a freezer and then without warning it feels like it's on fire.

    I've been on prednisone for the past week. It seemed to help the first 48 hours. I got some feeling back in my toes. That's all it did for me though. I take my last dose in about 4 hours. And when the NS office opens in 5 hours, I'll be calling them to find out what we do next. I'm hoping the NS didn't miss any fragments.

    I worry that my leg/foot is now stuck like this. I'm middle aged, a mom of 2 teenagers and prior to my back "going out" about 4 months ago I worked out frequently. Right now, just having a shoe on feels "odd" and if I'm not paying close attention to my walking I tend to "drag" that foot a bit. The thought of this being permenant is very scary!

    I wish you luck and good health and a fast recovery.

    If anyone else has gone through anything similar, please let me know cause, treatment, time frame for recovery....anthing you're willing to share. I know we all heal differently and everyones situation is unique. I guess I'm just looking some reassurance. This just isn't what I had expected.

    Thanks everyone,

    - Jani
  • Are you wearing a back brace? Although I haven't had surgery I had real issues withe L5 tear and disc material on the S1 exiting nerve root. My legs swelled up and my feet and my foot on top and bottom of foot were numb and I could barely move my toes. Now with nerve pain meds like Lyrica and amitriptyline and epi's I have way less numbness. And pain hops around top thigh to anle to butt to well you get the idea. I would call the Dr again and let him know you have new numbness and pain and what should you do about it? Also how much to walk everyday. Write the questions down when you call. I don't think they're bothered with you calling. That's what they do. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Lisa, any guess as to how long that nerve was compressed?

    Not to say what I experienced is what you are going thru, but after my L5-S1 md, I was basically crippled.
    Stuck in bed for about 4 weeks unable to move very much at all.
    I was absolutely positive I had reherniated.

    As it turns out, I hadn't and it was just swelling, inflammation and edema.
    I recieved an ESI into the site and 7 days later I was pain-free.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • I completely concur! I would like to add that I have heard it may take as much time for a compressed nerve to heal as it was compressed. I hope that has some truth to it considering that I am almost 3 months post-op. I think I am a little better in some ways. :? :/

  • I'm scheduled for an ESI and I hope I can get the same result. How long were you post-op?
  • what is an ESI? I am 13 days post op laminectomy and two level fusion. nerve compressed for a while, to the point I actually stopped feeling the pain down leg, butt etc. I started getting bladder symptoms which pompted my surgery. Anyway, I think I do have significant swelling, inflammation, the Dr said when he did the laminectomy he found the nerve all deformed under the bone and compressed so obviously, this has to now heal. I have weird pain in my butt, hip, leg, behind knee down to ankle. i also have patches of pain on my foot and calf that feel like rug burn but yu can't see anything. I am using cold compresses, ice packs. Does anyone suggest heatover cold packs? I am only 13 days out but i am an athlete and young and healthy ane the nerve pain reduced me to tears in the middle of the street today. Anyway, I did used to have sciatic pain a long time ago but it stopped and now, comparably, this pain is 100 times worse. I had the surgery preformed by the best Dr. around (neurosurgeon). He used my bone from the lamina and BMP and rods and screws for a two level fusion of S1 to L5 and then to L4. Apparently, he also was able to reduce my spondylolisthesis slippage from a grade 3 to a grade 2. When I used to lean forward, there was instability to the point that it was a grade 4- despite xrays all my life, nobody ever did the flex/ extension series or we would have prob. had surgery earlier. I was born wth this condition and wish I had it fixed a long time ago. Basically, I just want to know if this is my nerve recovering or what. How can I reduce inflammation? I am on neurontin, flexaril and percocet right now and finished a steroid pack already. Any advice on time line of nerve recovery would be appreciated. I am just not used to the nerve stuff after having no nerve pain for a long time. I am actually kind of depressed at this point. please help. I go for post op x rays 11/13 (4 weeks) to check on staus of fusion and see Neuro Dr. on 11/17 to go over results. Thanks, Laura
  • An ESI stands for Epidural Steroid Injection. Given to relieve inflammed tissues. From personal experience, that burning feeling is definitely a sensory nerve which is trying to heal. Nerves heal really slow and weird. You'll feel a whole array of sensations. I still do...

    Hang in there. :) There's a lot of great info here and people willing to help/listen.

    Please protect those other discs above the fusion by changing some habits if needed. I've changed how I sit, how long I sit and pay constant attention to my posture.

    You'll heal, but it may take the nerves quite some time to do so. Take Care.


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