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Pain doesn't match tests

gaj399ggaj399 Posts: 270
edited 06/11/2012 - 8:41 AM in Back Surgery and Neck Surgery
I have a Microdiscetomy scheduled on Feb 25th on L3-4, but most of the pain I have lately has been from my left buttox down to my left calf and around the front of my lower leg. Also pain in my two smallest toes on both sides. This to me sound like L5-S1. I also have the pain involved with the L3-4.When I asked my surgeon he said he could find nothing to cause the L5-S1 pain.I just wondered everyones thoughts on this, I hate to have the micro-d and then find out later that I still have to have a fusion on the L4-5-S1 that I had operated on earlier in June 2009.

I've had MRI in December, X-rays in November and A Myelogram done in January 2010. So he had plenty of tests to see what was going on. He attributed some of the pain to the fact that I'm still only 7 months out from Laminectomy on L4-5-S1, but this pain is new in the last month or so, so it worries me.

Any thoughts would be appreciated.


  • Does the doc say he will look at the l5/s1 while he is in there? How many times have we all heard that they found something different when they were actually in there?
  • Personally I would be questioning the surgeon about whether there might be some instability at the site of your laminectomies.

    The location of the pain you mention sounds like a problem with the S-1 nerve. I would be concerned that the laminectomies had resulted in some instability and the result is slippage at the L5-S1 segment, compressing the S-1 nerve.
  • I have the same pain But mine is do to fail back surgery at l4-l5 with nerves.

    hoping you have pain free days ahead

  • I agree with Gwennie your new symptoms do sound like the l5s1 area, but not necessarily from a disc problem. You could have 2 different things going on in there, I think you should at least get a second opinion.
    I also know Kris is correct in that sometimes docs find more once they "get in there".
    So I would 1.get a second opinion and 2.ask your surgeon if he is going to look at the l5s1 area while he is in there, it could be just that the nerve is irritated from all the testing going on,a bone spur may have formed that is not showing up on your testing for whatever reason, or like Gwennie mentioned instability post op.
    Whatever is going on I hope pain relief is close for you. Keep us posted.
    God bless and keep you,
  • Thanks for all your input. I have decided to tell the surgeon if he sees anthing while he's in there that he should do what he has to to fix it. My NS is great as far as I'm concerned and I would trust him with my life. I'm signing papers so that my wife can sign for me if needed so that more can be done if needed. I talked to his office today and he is going to look at the tests again to make sure he didn't miss anything. His nurse thought that the myelogram dye may have irrated the area as this sometimes causes more pain.
  • dilaurodilauro ConnecticutPosts: 9,865
    While you have new pain, could it be contributed to another disc area? Sure, but people here can only provide a personal opinion.

    The only way to know for sure is to discuss it in details with your doctor. Discuss the results of all your diagnostic tests and have the doctor explain why they feel your pain is the aftermath of your surgery.

    Honestly, 7 months post any lumbar surgery is really not a long time. You have already started to feel better, but many times, until a year passes by, you can have some ups/downs. Could be a result of something you did , over did, etc.

    Important thing is to keep track of this, to see how it is progressing. Is it getter better each week or not? Still, the person who will have the correct answers are your doctors.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I realize that the people on here are not experts, I was just looking for suggestions and as always I think I got what I needed. I have my NS looking into this and he is one of the best in the country so I think if there is anything to be found he will find it before or during surgery.

    Although I don't post often, I do get much needed info from this site by reading other peoples posts.

    As always thanks to all that help.
  • BotzBotz Central FloridaPosts: 223
    You mention that you had L4-5-S1 operated on in June. I had a laminectomy/discetomy at L3-L4 in 1999 and a L5-S1 fusion in 2007. When the surgeon performed the fusion he removed lots of scar tissue. About the time I recovered from the surgical pain the nerve pain returned. I have been told by several PM doctors that my pain is from scar tissue that is pressing on the nerve. I have had numerous injections that last about two weeks. I have also done PT with no help whatsoever.
    My PM wants me to see the surgeon and discuss removing the scar tissue again. Untill they find a way to permanently remove the scar tissue I’m not letting anybody operate.
    You might ask your doctor about Scar tissue and see if that might be causing the pain.
    Good Luck,
  • Just one point -- your surgeon will want to make the smallest incision that is needed to access where he needs to operate. They cannot "see" an adjacent level, let alone a level farther away. He will not be making an incision that runs from L-3 down to S-1 unless he is doing surgery on all those levels.

    I basically said the same thing to my surgeon...while you're in there, could you check to be sure my fusion is OK? He looked at me as though I were crazy, and then patiently explained what I just repeated above.

    I guess some docs perform "exploratory" surgery, but mine is not among them. Just be sure to tell your surgeon where your pain is and your concerns that working on L3-4 is not going to resolve the problems.

    Good luck.

  • dilaurodilauro ConnecticutPosts: 9,865
    different surgeons follow different techniques.
    While they may be some psuedo-standards in the field, there is no sure thing to state that what one surgeon might do, is something to expect from another surgeon.

    Its not even about Wrongs or Rights, its the decision that ONLY the surgeon makes
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com

    I might have missed it, but have you had a discogram?

    My NS was going to fix L4/5 because it looked the worst on the MRI.

    We did the discogram and found out that L5/S1 was the main pain generator and I would have had virtually NO relief if we'd only fixed the one disc.

    It saved me from another surgery and another year of pain and thinking that I must be nuts to still have pain after having the whole fusion done!

  • I haven't had a discogram yet. I'm waiting to hear back from the surgeons office to see where to go from here. I'm sure that my pain is way worse and does not go along with a L3-4 problem only. Hopefully I'll get some answers in the next few days. It is possible that I injured something else as I fell about a month ago getting out of the shower. I could have done something then. This was after the MRI but before the myelogram.
  • I may be a little late chiming in here but I have similar symptoms to you w/pain indicative of problems in both of the lower lumbar discs. My surgeon thinks there is a conjoined nerve root and that my protrusion at L4-L5 is also affecting the S1 nerve. He said that while this may be a "common" problem I would never have known if the herniation was not pushing directly on it. Obviously, I have no idea what your specific problems are but I just wanted to let you know that there are other possibilities for the pain. Good luck and I hope your doctor gets to the bottom of it!
  • There may be something that is avalible for scar tissue that is compressing a nerve. It is a type of injection that is done by PM designed to break up scar tissue. I have BC/BS POS but in June '09 when we were looking into it , my insurance considered it experimental, thus wouldn't cover it. We considered paying independently for it and it was around $200.00, however, it was shortly thereafter that my MRI's revealed scar tissue wasn't my issue. Best of luck!
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