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Suggest Treatment For Severe Pain In Lower Back, Buttocks And Leg

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Posted on Thu, 23 Jul 2015
Question: Hi,
I had a slipped disk back in 2013. i had it operated on but still suffer with lots of pain in my lower back, bum and down my left leg. im left unable to walk very far. I was told that the surgery had failed. I have 2 links below 1 of my mri before and one the following year. please can you give me your opinion on what you see.
2013
https://www.dropbox.com/s/er51mx83uhuiaj6/MRI%202013.zip?dl=0
2014
https://www.dropbox.com/s/bxxl92ffi0iiypt/MRI%202014.zip?dl=0

XXXXX
doctor
Answered by Dr. Olsi Taka (31 minutes later)
Brief Answer:
Left L4-L5 disc herniation.

Detailed Answer:
I read your question carefully and I am sorry about the issues that you are experiencing.

I viewed both those MRI images. They both have similar findings, a herniated disc at the L4-L5 level with narrowing of the left foramina (which in turn leads to nerve compression and the symptoms you describe).
Narrowing is present on both MRIs, actually it is even more marked in the second MRI in my opinion, so if they are pre and post surgery it is true that the surgery has failed, there is new disc material herniating and compressing the nerve root.

There is a mild protrusion at L5-S1 level as well, but it leads to no narrowing or compression, shouldn't be causing any symptoms.

I remain at your disposal for further question.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (7 hours later)
Thank you for your fast answer. One more thing. What would you recommend as treatment ?
doctor
Answered by Dr. Olsi Taka (5 hours later)
Brief Answer:
Another surgical procedure might be considered.

Detailed Answer:
I suppose since it's been some time you must already have tried non invasive measure like physical therapy, anti-inflammatory medication (like Ibuprofen, Naproxen etc) or other over the counter painkillers, neuropathic pain medication (gabapentin, pregabalin, amitriptyline, duloxetine etc).

So what is left now are invasive methods such as local injections with steroids and analgesics which may help the symptoms for some time, or re-address the disc with by having surgery again. Failed back surgery is not that uncommon, as surgery removes only a small fragment of the disc and it is well possible there to be other fragments herniating subsequently which can be addressed through another surgery.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Suggest Treatment For Severe Pain In Lower Back, Buttocks And Leg

Brief Answer: Left L4-L5 disc herniation. Detailed Answer: I read your question carefully and I am sorry about the issues that you are experiencing. I viewed both those MRI images. They both have similar findings, a herniated disc at the L4-L5 level with narrowing of the left foramina (which in turn leads to nerve compression and the symptoms you describe). Narrowing is present on both MRIs, actually it is even more marked in the second MRI in my opinion, so if they are pre and post surgery it is true that the surgery has failed, there is new disc material herniating and compressing the nerve root. There is a mild protrusion at L5-S1 level as well, but it leads to no narrowing or compression, shouldn't be causing any symptoms. I remain at your disposal for further question.