I had a microdiscectomy done on March 2nd at L5-S1. I had a free fragment removed that was compressing the S1 nerve root.
I fell down on March 26th, and boy did I hit the floor hard, knees first, then the rest of me. I was in pretty severe pain and requested an MRI to see if there was more damage.
My first MRI (done on 2/27) before the surgery showed:
lumbar spine shows advanced multilevel intervertebral disc degeneration for age. Large inferiorly extruded disc is present at the L5-S1 level. Multiple other levels of disc bulging are present, accelerated for age.
The axial images show:
T11-T12: Tiny left paracentral disc protrusion.
L1-L2: Broad-based disc bulging. No canal stenosis.
L2-L3: Facet joint hypertrophy.
L3-L4: Facet joint hypertrophy. No canal stenosis.
L4-L5: Facet joint hypertrophy with ligamentum flavum thickening. Disc bulging eccentric to the left side. Mild narrowing of the upper left lateral recess. Mild left-sided foraminal narrowing.
L5-S1: Inferiorly extruded disc in the central position, measuring 11 mm transversely, and extending inferior to the level of the L5-S1 intervertebral disc space, posterior to the S1 vertebral body, x 11 mm. There is also inferiorly extruded disc the right of the midline, causing asymmetric posterior deflection of the right S1 nerve root.
1. Large inferiorly extruded central disc at the L5-S1 level, also with inferiorly extruded disc in the right paracentral position, with impingement and posterior deflection of the traversing right S1 nerve root.
So on March 2nd, I had the microdiscectomy done, and both the pre & post-op diagnoses were:
1. Herniated lumbar disc L5-S1 with free fragment and compression of S1 nerve root on the right.
2. Lumbar radiculopathy S1 nerve root on the right.
Operative procedure: Microlumbar discectomy L5-S1 right with removal of herniated lumbar disc and decompression of S1 nerve root.
Fast forward to 4/2, which is when I had another MRI after the surgery, and after I fell, due to continued, worsening pain.
There has been interval postoperative change of the right side at the L5-S1 level. The previously seen central and right paracentral disc is now mainly absent. Minimal disc material remains.
There is epidural fibrosis about the right S1 nerve root, with mild asymmetric enlargement and enhancement of the nerve root.
A postoperative fluid collection is present to the right of the L5 spinous process, likely benign postoperative fluid.
Further superiorly, there is long segment enhancement and enlargement of the intradural right S1 nerve root, extending at least to the L4 level.
The sagittal images also show linear enhancement about the conus.
At the L4-L5 level, there has been interval development of several tiny annular tears. Tiny central disc protrusion is present, not causing canal stenosis.
The remainder of the lower thoracic and lumbar spine are stable, with minor disc bulging.
1. Interval postoperative change in the right side of the L5-S1 level, with the central and right paracentral disc material now being largely absent. Minimal central disc material remains, not causing nerve root impingement or distortion of the dural sac.
2. Asymmetric intradural and extradural enhancement of the right S1 nerve root compatible with radiculitis.
3. Interval development of small annular tears at the L4-L5 level.
4. Element of linear enhancement about the conus. Probably related to postoperative inflammation.
5. Small postoperative fluid collections on the right side of the L5-S1 level, favored on the basis of benign fluid.
I just would like to know how much longer I will be feeling so badly! Is it normal for me to be feeling this awful this long past surgery and injury? I went shopping with my family today, and I could barely keep up with them. I felt like my legs just didn't want to carry me any longer. I felt so weak and tired, like I could collapse any minute. I was probably on my feet all of an hour!
I sleep poorly~ well, I wake when I am feeling pain, and I can barely find the strength to turn over in bed. Getting out of bed in the mornings is so trying!
I have switched to a new family doctor and she has reviewed my reports. She gave me Flector patches and Lidocaine patches for my back. The neurosurgeon also has me on Flexeril 10 mg three times daily; Lortab 5/325, one by mouth four times daily, and Ibuprofen 600 mg, three times daily. After I got the report from the second MRI, the doctor on call for my family doc admitted me to the hospital for pain management, because my neurosurgeon refused to answer any pages sent by the answering service.
The neurosurgeon came to visit me in the hospital the next day, and gave orders to fit me with a back brace. I do feel better with the brace on. It can get a little bit cumbersome when I sit down with it on. I feel like Kate Winslet's character from the Titanic movie with this thing on.
My old family doc (and this is why he's now my 'old' family doc) was angry that I had asked his on-call physician to intervene when my neurosurgeon ignored my pages. I know I could have gone to the ER, but all they will do is give me a pain shot and send me on my way. That might be helpful for a few hours! What about the rest of the time I'm in pain? Am I supposed to just keep running to the ER and racking up all kinds of bills? That seems like a poor answer to my problem.