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A punch in the gut and a kick in the ....

scmgurusscmguru Posts: 103
edited 06/11/2012 - 8:43 AM in Back Surgery and Neck Surgery
Just over 8 weeks out of my L5S1 MicroD, bilateral foraminotomies.

I've been trying to tell my doctor for well over a month now that SOMETHING is WRONG!

I kept being told to call them back in a few weeks if it worsens.. Well it did and I called last week..

Guess what.. they told me to call them back in a week if it doesn't get better!

So I took another route..

Thank goodness for my physical therapist who was concerned something wasn't right and referred me to a physiatrist who examined me and ordered the MRI and EMG.

Received my MRI Results from last week and also had an EMG today..

Post Op MRI Results:

Well defined small disc recurrent disc protrusion 3mm Centrally

Amorphous material within the left paracental and foraminal zone which is new with possibility of recurrent disc herniation or postop granulation.

Secondary left neural foraminal stenosis which is of moderate degree, appearing worse than pre-op exam in 1/2010 which involves the left lateral recess with likely associated stenosis affecting the transiting nerve root.

Right neural foramen also reveals evidence of a disc herniaiton versus postoperative change resulting in moderate stenosis also with interval worsening.

Mild facet disease at the MID lumbar levels (I NEVER had this before above L5S1!!)

In Summary: I've more than likely got 2 new disc herniations, my stenosis is WORSE and I've got facet disease starting in my mid lumbar region.

To Add Insult to Injury: I had an EMG today.. the results indicate active nerve damage most likely being caused by the new herniations and increased stenosis.

I'm so upset about this..

My next step is to get another MRI w/ contrast this week to try and differentiate the problem areas as scar-tissue or re-herniations.

I'm heartbroken that I have the exact same leg radiculopathy I did when I started and now additional back pain and an L5S1 full of scar tissue and who knows what.

I have no idea what to do now..


  • Did you have the MRI at the same place?

    At what levels are the new issues and the nerve problem?
  • All MRI's done at the same facility. All new herniations, stenosis are at the same level L5S1 as the original MicroD level..

    Nerves involved are the same nerves.

    New facet issues are above the L5S1 Level.
  • i had the same thing with my surg doc i new some thing was not right after surg but he keep telling me it was all normal 9 months later fired surgeon and gp doc and pt doc -new gp sent me for new mri the next day she got the radio report 3 days later i let my new pt doc reed it to day sounded like the pre op mri but the words little different besides the new tear was the same radiologist as last time the pt doc flipped he say i should go see my new surg doc as soon as i can i have appointment in 17 days he say i should try to get in sooner --ya like getting kicked in the gut and n-s at the same time -then he started talking about a friend that had a fusion -i am almost sick its like whats next ya i hear you jest keep pushing on their has to be something good on the other side of the mountain
  • Can understand your frustration with the microdiscectomy not helping. I had a similar experience in 08, and once I started walking outside the house, I knew something was wrong. The neuro I was under at the time thought it just needed time to settle down and to do physio. I did 5.1/2 months of physio which made my pain worse. After seeing two more neurosurgeons, I was finally booked in for fusion, and I've got my life back again.

    I'm not saying that you'll need fusion (because I'm not a medical expert), but it would be worth your seeing another neurosurgeon or orthopaedic surgeon once you've had your MRI with contrast done.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
  • Hey there...I think many of us can understand your frustration and uncertainty about 'what next'.

    Just to help, typically the surgeon will not re-MRI a microdiscectomy patient until the 3month mark unless there is a significant reason to do so. And, after surgery you definitely need with/without contrast to be able to distinguish scar tissue.

    That being said, it sounds like your surgeon may have been following the 3-month rule of thumb but you speaking up clearly helped expedite the MRI.

    My current surgeon is waiting for the 3-month mark. While I've shown only slight improvement, my nerve was severely compressed for 5 months. I asked him what signs to look for to know if I should call him sooner. I asked him what his plan is at 3 months if I am status quo. He's already told me that if I have no change at 3-months, he'll re-MRI as a precaution. If I don't show rehernation, then he'll see me again at 5-6 months to determine if I have permanent nerve damage.

    I will say you can use this as an opportunity to gather information and opinions on doctors. I tried so hard to find a doctor out of the hospital I felt most comfortable with but was unable to find a doctor in-network at that hospital. So I ventured out and solicited feedback on doctors and other local hospitals to find one I was comfortable with. I also stayed in close communication with my PCP.

    We'll be here for you to help answer any questions you have or help you with what questions to ask your surgeons.
  • Sometimes it isn't so easy to see another surgeon in the group. Just to warn you. If it is a large group and you want to see someone quickly, they can allow it (this was the case with my first 2nd opinion...I went back the the NS that saw me after my trip to the ER. The group said he was booked for some time but allowed me to see another Ortho in the group since it was a 2nd opinion).

    But with my surgeon...I tried to get his partner to see me but they said there would be no benefit to that b/c they generally would agree on approach and it was best if the original surgeon did the revision.

    Try it!
    I would recommend looking for a doctor in another group for a true 2nd opinion.

    Good luck. You seem to be staying positive until you have more definitive information.
  • I guess I'm not clear on what it is you hope to accomplish. Are you looking for a second opinion, or do you want the surgeon who did your MicroD to continue on with your case?

    First, if you are returning to your surgeon who did the surgery, be prepared for him to be annoyed that you went to another doctor to get the MRI. Perhaps your surgeon is different, but many would dismiss you from their care for having done this. You are so early in your recovery. Many doctors would take the fact that you went elsewhere as a sign that you have no confidence in him any longer, and he would not keep you on as a patient. This may not be how your surgeon response, but do not be surprised if you get a dismissal!

    If you are looking for an opinion that is something more than a rubber stamp of the operating surgeon's work, you will need to go to another practice...preferably one that is not even in the same city or within about 30 miles of the first doctor. Doctors are often reluctant to contradict a colleague's opinion or work, particularly if they know each other, or work out of the same hospital.

    But, again, it is so soon after the surgery that you may find that anyone is reluctant to take you on.
  • The MRI was done by the physiatrist who is an MD associated with the physical therapy place I was referred to.

    This Dr doesn't replace my surgeon or offer any surgical opinions, they just make sure I am recovering the way I should be.

    If I'm not, they let my original surgeon know and I go back to him.

    Regarding seeing another physician in the same group, I was simply trying to get some pain relief while my original Dr was out of town..

    I didn't think it made sense for me to sit on my hands for a week.

    Most offices have someone "covering" for surgeons who are out of town.

    If he dismisses me as a patient, so be it.
  • Thanks for the kind words everyone..

    I've got to wait until Monday to see my surgeon.. he is out of town until then.

    Have been trying to keep positive and get my work done.

    I'm going to see if I can see another surgeon in the same Ortho group..

    I'd think there should be another surgeon there who can look at what has been done and possibly provide some relief (until my original surgeon comes back).

    From what I'm understanding, I will more than likely get some injections into the area to see if that will help the inflammation.

  • I see. I didn't realize the physiatrist was associated with your surgeon. Hope it all works out for you.
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