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What to do next, Updated

coachhccoachh Posts: 34
edited 11/05/2014 - 6:30 AM in Back Surgery and Neck Surgery
During the spring of 2013, I started having shooting pain in my right hip and down my right leg. A month or so later, my legs started going numb when I walked. After several tests, my surgeon decided to perform a laminectomy from L3 to S1. This procedure was performed in November 2013 and all went well. I was feeling much better and in late December started PT. During the 2nd PT session, I felt a pop in my back and all of the pain I had before came back but in my left hip and leg instead of the right. I went to several more PT sessions to try different things but no success. Surgeon orders new MRI, says he does not know what is causing the pain and sends me to Pain Management. In the last 6 months I have had 5 steroid epidurals and am scheduled for another tomorrow. These have not helped. I have tried so many different meds that I can not remember them all. I am still in pain constantly and am getting very little sleep. The Pain Management Doctor ordered a new MRI and the relevant results are below.

At L1-2, there is posterior disc bulging with a moderate-sized central disc herniation exhibiting some rostral and caudal extension. Canal narrowing is produced by the disc abnormalities in association with ligamentous thickening and facet joint hypertrophy. There is mild foraminal narrowing bilaterally.

At L2-3, there is minimal posterior disc bulging. There is mild foraminal narrowing bilaterally.

At L3-4, there is postoperative change characterized by laminectomy and spinous process removal. The spinal canal appears capacious. There is moderate posterior disc bulging with endplate spurring and a right extraforaminal disc protrusion. There is moderate foraminal stenosis bilaterally.

At L4-5, laminectomy and spinous process removal have been performed. There is no definite canal narrowing. There is some enhancing soft tissue in the lateral aspects of the spinal canal in keeping with postoperative scarring. There is posterior disc bulging and posterior bony spurring with a left paracentral/foraminal/extraforaminal disc herniation. Severe foraminal stenosis is present bilaterally, left side greater than right.

At L5-S1, laminectomy and spinous process removal have been performed. There is mild posterior disc bulging and posterior bony spurring at this level with mild foraminal stenosis bilaterally. There is no definite canal narrowing.

The primary concern on the Impression from the Radiologist is:
1. Postoperative change at L4-5, as described above. There is posterior disc bulging with a left paracentral/foraminal/extraforaminal disc herniation at this level, as well some postoperative scarring, as described above. Clinical correlation is recommended.

My question for those that have gone through lower back issues before, If a Laminectomy did not work and Steroid injections did not work, what else is there except for more surgery?

Moderator comments- No one is qualified to comment on your MRI report or it's findings. As to what other treatment options are available, that is something you need to discuss with your surgeon, as each person's results and treatment options differ a bit because of their individual conditions and prior surgeries.
2004 - 2005 - 3 surgeries in 18 months to fix/fuse C6-C7.
Nov 2013 - Laminectomy from L3 to S1
Nov 2014 - Micro Discectomy L4 L5.


  • Sounds like you have your hands full with all those issues. If you're looking to avoid a fusion, you can try hydrotherapy or mild PT for core strengthening. Acupuncture may help. I find walking and swimming to be therapeutic.
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • other surgeon for their opinion. While no one is permitted nor qualified to offer input on your medical imaging, if I were you , I would seek the opinions of another surgeon or two before undergoing much more in the way of further injections.....
  • I went to 2 different surgeons and they both told me that the MRI from August showed a much larger bulge in the L4-5 disc than one in May. Both suggested a micro discectomy I am scheduled for Tuesday the 11th. I will update after the surgery.
    2004 - 2005 - 3 surgeries in 18 months to fix/fuse C6-C7.
    Nov 2013 - Laminectomy from L3 to S1
    Nov 2014 - Micro Discectomy L4 L5.
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