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Where do I go from here?

Sorry for the long post but I am at a loss as to what to do now. I am 54 years old with a long history of lower back pain. In Nov 2013 I had a laminectomy from L3 through S1 because of severe sciatica. Operation seemed to be a success until I started PT. I felt a pop and pain down my left leg. During 2014 I had 5 steroid injections to try to calm the L4-L5 nerve and a nerve conduction study to check the nerve. The nerve conduction study was normal but due to the pain, I had a mico-discectomy on L4-L5. I wake up with no pain but no strength on my left quad and numbness from mid thigh to mid inner calf. Doctor gives me 2 rounds of steroid packs which do not help and then runs another nerve conduction study and MRI. MRI shows that L1-L2 disc has now herniated and nerve test shows damage to nerve that is from L1-L2. Doctor offers me PT or more steroid injections to see if either will work. I decline the steroid injections (5 in last 9 months is enough) and try the PT. I do my 1st session and go home and to bed. Pain that I had not had is coming back. I go for my 2nd session and therapist spends 75 min working on pain issues to try to help. I get some relief but next day, bad pain again. The pain is more like what was associated with L4-L5 issue, not where L1-L2 should be. PT pattern continues for 3 more sessions, light PT, a lot of pain relief attempts and feeling worse each time. Yesterday, my therapist showed me a copy of my MRI that I had allowed her to request. In addition to L1-L2 issue, and stenosis and all the other problems, it also says that the radiologist thinks that L4-L5 might have re-herniated. At least I now have an idea why the pain might be coming back. Therapist also loaned me a home tens unit to try to help with the pain and said she would call the doctor to let him know what is going on.

I am now trying to figure out what to do. PT hurts my back/hip but to get my leg stronger I have to do it. I would prefer no more surgery but my pain is getting worse. I chose this doctor after 3 visits to others in the area but is it time to move on? If L1-L2 is bad and L4-L5 is bad again, can micro discectomies be done at both levels or do I have to start considering the dreaded fusion option.

Any thoughts, ideas or similar stories would be appreciated.

Here are the impressions from my latest MRI.
1. Extensive postoperative change at L4-5, as described above. Using the criterion of gadolinium enhancement of scar tissue, the findings at this level are most in keeping with spondylosis, some postoperative scarring/granulation tissue, and a possible recurrent left paracentral/foraminal/extraforaminal disc protrusion. Clinical correlation is recommended.
2. Postoperative change at L3-4 with spondylosis and a right extraforaminal disc protrusion.
3. Postoperative change at L5-S1 with spondylosis.
4. Posterior disc bulging with a moderate-sized disc herniation at L1-2 which exhibits some rostral and caudal extension and which produces moderate canal narrowing. Clinical correlation is recommended.
5. Central disc herniation at T11-12 exhibiting caudal extension. This appears similar to previous study.
6. Minimal left paracentral disc bulging at T12-L1.
7. Mild anterolisthesis of L4 on L5.
8. Foraminal narrowing, as described above.
9. Small fluid collection (18 mm in AP, 9 mm in transverse, and up to 42 mm in craniocaudal dimensions) within the subcutaneous fat in the lower lumbar region (L3-L4). This likely represents a postoperative fluid collection such as a seroma. Close clinical correlation is recommended
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.


  • shortfuse5691sshortfuse5691 Posts: 407
    edited 02/07/2015 - 2:25 PM
    Sorry I won't be much help most of my problems are cervical. I did have a lumbar diskectomy 10 years ago and afterwards my therapy was Aqua therapy in a warm pool. I did that for several months and in the water my pain was gone. When I was sitting I sat on a heating pad for years.

    Good luck :)
    2005-ACDF with Corpectomy at C3-C-5.
    2006-L4-L5 diskectomy.
    2009-Cervical laminectomy at C3.
    Steroid injections series x 4.
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