Seven wks. ago I had L/4-5 bilateral lamino-tomy/Foraminotomy Decompression of nerve root w/L-sided approach at LSI,Tampa,Fl. On 4/30 started exp. some "flopping"of L foot.5/4 talked w/PA,told her of this, advised to go immed. to ER for a MRI. MRI shows herniated disk.Can this disk be replaced after prev. surgery?
Person's Gender: Female
Person's Age: 63
Previous went to 8 wk.PT, massage therapy, epidural - did not help, MRI before 1st surgery.
HI I am a neurologist and can answer your question
I am waiting for you to come online to discuss
It looks like you are offline, so I will leave my answer, and when you return, please review it and if it answered your question, please hit the accept button as that is how I am compensated for my work, ok? If you have further questions, please just ask them and I will return to answer them.
so you are a 63 year old, with probable left leg pain in the distribution of L5 (did you have any weakness in the dorsiflexion of your foot prior to the surgery? of just pain and tingling/numbness?) who had a L 4/5 laminectomy and foraminotomy on that side (did you get a bilateral lam? why?)who presents 6 weeks later with a foot drop (L5 radiculopathy). the question is whether you can get more surgery to "replace" the disc,as the recent MRI shows a herniation.
Well to answer you question, you had an unfortunate outcome, no question. Did you do something strenous or anything to make this disc blow out? I would need to look at your MRI (or if you could type in the report impression, that would be helpful) but I would like to know if the herniation is lateral, into the neuroforamina (or what is left of it), or more of a central disc bulge/herniation, or if it is an annular tear. That matters in terms of deciding on further surgery.
Now the risk of going in is generation of scar from reopening that area. The scar can obliterate any improvement done surgically to the site. One question would be on the approach, I am hopeful that this was done endoscopically (?), but maybe not. If done endoscopically, then the risk of re-exploration and repair is less. But there is no replacement of the disc, it would have to be removed and the vertebral bodies fused, I expect. There might also be the consideration of placing hardware (a cage) to stabilize the L4/5 interspace
These are all specific neurosurgical decisions, and I am a neurologist, so I cannot be more specific with your question, but if you can get me the information on the recent MRI, that would help.
If you feel I answered your question, please hit the accept button as that is how I get compensated for my work, or please ask questions and answer the questions I posed to you, send me the information if possible, and I will discuss it with you. Dr. Frank T.
General Adult Neurologist. Board Certified. Experimental Neuroimaging and Neurodiagnostics
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