Post-Surgery Complications of Lumbar Disc Herniation: A Patient's Journey

Q: Post-Surgery Complications of Lumbar Disc Herniation: A Patient's Journey

Hello Xiaowen： Physical therapy can be implemented. <br>However, you have already undergone two surgeries by other doctors, and the situation is more complex. <br>The second surgery was 1.5 months ago. <br>It is advisable to have a physician evaluate whether an MRI follow-up is n

Abnormal Conditions After Surgery for Intervertebral Disc Stenosis and Herniation

Hello Doctor, I would like to consult you regarding my condition.
I have been diagnosed with L4-L5 disc stenosis and L5-S1 disc herniation.
On February 10th of this year, I underwent endoscopic decompression and excision surgery performed by an orthopedic surgeon.
Prior to the surgery, I did not experience any numbness, but postoperatively, I developed numbness in the outer side of my calf and toes, along with tightness in my calf (which I did not have before the surgery).
Additionally, the pain in my lumbar region and piriformis muscle has not improved.
After two months of rest, my condition worsened.
Upon returning for a follow-up, the doctor informed me that I just needed more time to recover.
Therefore, I sought treatment from a neurosurgeon at a medical center.
The postoperative MRI revealed a dark area at the entry point of the endoscope, suggesting inflammation and a high likelihood of adhesions.
Due to persistent pain, I underwent minimally invasive surgery on May 12th to release the adhesions and clean up some of the old herniation, along with the placement of a spacer.
After the surgery, the numbness in the outer side of my calf has resolved, and the pain in my lower back and piriformis muscle has significantly decreased.
However, it has been one and a half months since the surgery, and I still experience tightness and swelling in my calf, which is quite uncomfortable.
After walking for 15 minutes, I begin to feel tightness and swelling, and the numbness in my toes has not improved.
I would like to ask if, in addition to supplementing with B12 and a multivitamin, I can start physical therapy for these two symptoms? Also, will I gradually recover? Thank you.

Xiao Wen, 40~49 year old female. Ask Date: 2022/06/23

Dr. Lai Zhaokang reply Neurosurgery

Hello Xiaowen: Physical therapy can be implemented.
However, you have already undergone two surgeries by other doctors, and the situation is more complex.
The second surgery was 1.5 months ago.
It is advisable to have a physician evaluate whether an MRI follow-up is necessary.
Best wishes from Dr.
Lai Chao-Kang, Director of the Spine and Neurosurgery Department at Changhua Hospital.

Reply Date: 2022/06/23

More Info

Post-surgery complications following lumbar disc herniation can be quite challenging for patients, as evidenced by your experience. It’s not uncommon for individuals to encounter new symptoms after surgery, such as numbness, tingling, or muscle tightness, especially if there were pre-existing conditions or if the surgery involved manipulation of the nerves and surrounding tissues.

From your description, it appears that you underwent a minimally invasive procedure to relieve pressure from the L4-L5 and L5-S1 discs. While many patients experience relief from their symptoms post-surgery, some may develop new issues, such as the numbness in your toes and tightness in your calves. These symptoms can arise due to several factors, including nerve irritation, inflammation, or scar tissue formation (adhesions) around the surgical site.

The MRI findings indicating inflammation and a high likelihood of adhesions suggest that your body is responding to the surgical intervention. Adhesions can form as part of the healing process, but they can also lead to discomfort and restricted movement. The fact that your symptoms have improved somewhat after the second surgery is a positive sign, but the persistence of calf tightness and toe numbness can be frustrating.

Regarding your questions:
1. Physical Therapy: Yes, you can certainly consider starting physical therapy. Physical therapy can be beneficial in managing symptoms, improving mobility, and strengthening the muscles around your spine. A physical therapist can design a program tailored to your specific needs, focusing on stretching, strengthening, and improving overall function. They can also help address the tightness in your calves and provide strategies to alleviate discomfort in your toes.

2. Recovery Timeline: Recovery from lumbar disc surgery can vary significantly from person to person. While some individuals may notice improvements within weeks, others may take several months to fully recover. It’s essential to be patient and allow your body the time it needs to heal. Symptoms like numbness and tightness may gradually improve as inflammation decreases and nerve function returns to normal. However, if symptoms persist or worsen, it’s crucial to communicate this with your healthcare provider.

In addition to physical therapy, consider incorporating gentle exercises, such as walking or swimming, into your routine, as these can promote circulation and aid in recovery. Staying active, while avoiding high-impact activities, can help maintain muscle tone and flexibility.

Lastly, continue to monitor your symptoms and maintain open communication with your healthcare team. If you notice any significant changes or if your symptoms do not improve with conservative measures, further evaluation may be necessary. This could include additional imaging studies or consultations with specialists in pain management or neurology.

In summary, while post-surgical complications can be disheartening, many patients do experience gradual improvement over time. Engaging in physical therapy and maintaining a proactive approach to your recovery can significantly enhance your healing process. Remember to listen to your body and seek support when needed.

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