- I have new onset pain in my back and leg, what
happened?
- What is spondylolysis ?
- Why do I get crippling back pains ?
- What can be done to decrease nerve scarring ?
- What is a dural leak ?
- My scoliosis is progressing, how can this be
stopped?
- Why does my
arm feel like pins and needles?
- What
can be done for back and leg pain in pregnancy?
- What
can be done for a chronic disc herniation?
- Why does my
bone graft site still hurt?
I have been busy for days moving some heavy boxes and some I have moved with
my foot. Now I am experiencing some severe pain in my left buttock and radiating
to the groin area. I cannot step on my left leg and walking is difficult. Does
this sound like a back strain or is it possible I now have a disc problem? I
normally have a sore lower back but this pain is new to me.
Answer:
What you are describing is typical for a "pinched nerve" or
herniated disc. This needs to be evaluated by a doctor. If this is
associated with increasing weakness or changes in bowel or bladder function, you
must call your doctor immediately or present to an emergency room.
I have a 20 yr old sister who is a college gymnast. She was diagnosed with
spondylolysis a little over a year ago. She has been told it will probably
require surgery involving a bone graft, pedicle screws etc.
Answer:
Spondylolysis is a defect in a region called the pars interarticularis (Latin
for "the part between the joints"). This area is susceptible to
a stress fracture, particularly in athletes. Usually, surgery is not
necessary. There is a rehab protocol that was devised specifically for
spinal rehab in athletes. Many high level athletes are able to compete
with spondylolysis by strictly adhering to the protocol.
Surgery is necessary is pain persists or if the bone slips (spondylolisthesis).
The common surgical techniques for repair of the defect (avoiding fusion)
include either a direct (Buck) with bone screws or a construct with pedicle
screws and wires. The Buck repair has been felt by some prominent spine surgeons
to be a less invasive procedure. Some surgeons perform a true spinal fusion and
not a repair of the defect.
I'm a 41 year old male, I have an intermittent lower back problem where all
of a sudden, without doing anything in particular, tightens up, and then I am
basically a cripple for 2 weeks. The pain so intense I literally scream.
Is this a common ordeal or do you think I'm just another poor slob with lower
back pain? I have been lifting weights 3 times a week for about 11 years, and
consider myself in good physical condition.
Answer:
Sounds like you may be suffering from degenerative disc disease. It is a
common cause of back pain. You should see a fellowship trained surgeon to start
the appropriate work-up, which may include X-ray and/or MRI studies.
I was wondering what you think regarding the use of Adcon-L for Lumbar
discectomies?
Answer:
The research shows that post-operative scarring about the epidural space may
be less with Adcon-L (manufactured by Gliatech). The functional data demonstrate
good outcomes as compared to control subjects over a period of time
postoperatively. It needs to be applied in a specific fashion. If not properly
applied, there can be impaired wound healing (the material prevents scarring).
Currently, Adcon-L has not been re-released in the U.S., but apparently
is available in Europe.
My husband had surgery two weeks ago to remove fragments that resulted from a
herniated disk (L4/5). He has been told that there may be a spinal fluid leak
from the surgery and that now, after two weeks of being up and around, he must
stay in bed for a week. How often does this happen and why?
Answer:
This is a known complication of a laminectomy/discectomy. It is caused
by a small leak in the nerve (thecal) sac. If found during surgery, it is often
closed with a stitch or patch. Occasionally, it is diagnosed after
surgery. Bedrest can definitely help, but occasionally the wound may need
to be reopened to find the source of the leak and to seal the leak. Make
sure the wound is dry. If there is drainage from the wound, make sure that
the surgeon is made aware.
I had 45 degree scoliosis two years ago. I went back recently to get new
X-Rays and now I am at 54 degrees. I am only 19 and I live with constant back
pain. What needs to be performed?
Answer:
You need to be evaluated for scoliosis fusion. There are different ways
to perform this type of surgery, all customized to the curvature present.
For adolescents with less degree curves, bracing may be recommended.
About 6 months ago my right arm began to periodically itch from the shoulder
to thumb. Then the upper arm started going into some sort of spasm which felt
like a blood pressure cuff being over- inflated. I sometimes get electric
sensations down my arm and I feel that my strength in my arm is decreasing.
Answer:
You may be suffering from a cervical disc protrusion or cervical nerve
stenosis. This needs to be evaluated with a good neurologic
examination. Possibly, studies such as a MRI may need to be
performed. Occasionally, nerve studies with a neurologist may be necessary
to verify the source(s) of the nerve entrapment. Based on the medical
work-up, various non-operative and/or operative approaches to the diagnosis
would be discussed.
I am a woman 20 weeks pregnant with acute pain in lower
back and left leg. My treatment so far has included anti-inflammatory
drugs, physical therapy without ultra sound and two steroid blocks.
The two neurosurgeons (first and second opinion) found that left foot
reflex is absent, that there is also certain lost of strength with a dragging of
my left foot, mostly upon walking on my heel. I am in constant pain and
can't stand up for more than a few seconds.
Answer:
It appears that you have a significant neurologic
weakness from an apparent disc herniation. If agreed by your obstetrician,
an MRI can be performed. In certain cases surgery can be indicated, but
strict obstetrical monitoring is required.
Spinal surgery in pregnancy is avoided if possible,
with the exception being cases with severe neurologic
impairment/compromise. Most women can expect some back pain in
pregnancy. Common aids, such as maternity belts, can help alleviate some
of the discomfort. Prior to any self treatment, one should check with the
obstetrician in regards to medications, exercises, and support belts.
I am a 22 year old female with radiculopathy in my right leg and a
huge extruded disc at L5-S1. I have experienced neurological deficiency
in that my right foot reflexes are impaired. It has been three years, do
you think I should have surgery? What do you recommend?
Answer:
We don't know the entire situation, since we can't examine you over
the 'net. If you are symptomatic, you may require surgery. If it has
been three years, surgery may help, but possibly not as good if it was
performed within one year of the occurrence. Surgical options in
this case may include laminectomy and/or spinal fusion.
I have had spinal fusion surgery 12 years ago. My leg and back pain are
better from the surgery. The area over the right hip (iliac crest) bone
still bothers me. Why does this still hurt?
Answer:
Most patients who have had spinal fusion surgery do complain for some time of
the bone graft donor site. The majority of these patients do not report
significant discomfort after six months. There is, however, a subset of
patients who chronically complain about this problem. There are not many
good avenues to pursue for the full relief of this pain. The good news is
that with the current research looking into bone morphogenic protein, we are
starting to see very promising results with early human trials. We soon
will be able to have the option of performing fusion surgery without harvesting
and transplanting bone. We are joining a study that will be involved in
this important endeavor.
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