Post-Surgery Complications After HIVD: A Patient's Journey - Orthopedics

Post-operative complications of HIVD are unhelpful?

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Hello Doctor: In December 2005, I experienced pain and numbness below my right buttock due to a herniated intervertebral disc (HIVD).
Under the diagnosis of Dr.
Chiu from the neurosurgery department at Chi Mei Medical Center in Tainan, I underwent surgery at the L3-L4 level.
After the surgery and a three-week recovery at home, I felt well enough to return to work.
However, after working for just one week, I began experiencing severe nerve pain below my thigh, which was so intense that even minor movements were painful.
I had to take an ambulance back to Chi Mei for treatment.
Dr.
Chiu advised hospitalization for observation.
After two weeks with little improvement, I underwent another MRI, and he suggested cleaning up the area around the L3-L4 level.
After discharge, I followed up with rehabilitation and physical therapy, which improved my condition.
I could walk, but my right foot was turned outward while walking.
Unfortunately, less than a month after the second surgery, the pain returned, and I could not even lift my thigh.
During my follow-up visit, another MRI was performed, but Dr.
Chiu said there were no abnormalities and advised rest and rehabilitation.
However, the physical therapy caused me so much pain that I could not continue.
Dr.
Chiu mentioned he had never seen a patient with such symptoms but worked hard to find the cause, conducting nerve conduction studies and rheumatological tests, all of which returned normal results.
Later, I consulted Dr.
Huang Bo-Chang in orthopedics, who performed a CT scan with contrast injection but found no results.
From January 2006, after my second surgery until the end of April, I struggled with sleep.
Whenever I lay down, my right leg felt paralyzed, and I could not move it at all, not even perform basic leg movements.
I also experienced severe muscle atrophy and accompanying nerve pain.
At the end of April, I visited Dr.
Huang Hsu-Lin at Kaohsiung Medical University’s neurosurgery department.
After reviewing the reports from Chi Mei Medical Center, he ordered another MRI and noted that there was degeneration of the cartilage at either the L3-L4 or L4-L5 level, recommending a surgical procedure involving screws.
Since I did not meet the criteria for health insurance and labor insurance, I had to pay out of pocket.
After the surgery, I told my mother that my nerves were bruised and swollen, but my condition improved, allowing me to put weight on my leg and alleviating some pain.
I thought that with diligent rehabilitation and medication, I would recover.
However, shortly after returning home, I began experiencing intermittent pain again.
Although the nerve pain had subsided, I still had pain in my knee (at the hip joint and thigh connection) and buttock.
I am now back at Chi Mei Medical Center, consulting with Dr.
Kao Chen-Hsing.
He reviewed my situation and advised me to first see orthopedic surgeon Dr.
Qin for an examination.
If there are no issues with my hip joint, I should return to him.
The orthopedic department conducted a bone examination to assess wear and tear, but the report will not be available until July 13.
I am currently in pain again, and my lower back has also started to ache.
What should I do?
Dr.
Wang, I have several questions:
1.
Can incorrect posture due to pain lead to degeneration of the hip joint and knee?
2.
The orthopedic department performed an MRI on my knee but found no significant abnormalities; why can I sometimes not even complete a bending motion?
3.
Can I request a steroid injection at the pain points? (Why did the injections in my inner thigh and knee not help?)
4.
Both the doctor and the physical therapist said that as long as I can tolerate the pain during rehabilitation, my foot pain should not last long, and I would gradually regain lost muscle and nerve function.
However, my pain episodes last a long time; is this normal?
5.
My walking posture causes my right foot to turn outward, making me appear limping, and I cannot walk for long.
If I walk today, I will be in pain for several days.
Sometimes even painkillers do not help.
Could there be other underlying issues?
6.
Dr.
Huang mentioned that after the screw surgery, I could stop wearing the brace after a little over a month, but now my lower back hurts and aches.
Is this pain related to not wearing the brace? Could there be other issues with my back?
7.
What foods can help promote muscle growth and accelerate nerve recovery? If I rely on medication to control pain long-term, will it become a burden on my body?
8.
As a 30-year-old born in 1985, should I take supplements like glucosamine to protect my joints?
9.
Can the hip joint wear down due to long-term poor posture, or does the nerve damage from the HIVD cause changes in the hip joint?
10.
Are there any precautions or considerations I should be aware of?
I apologize for having so many questions.
I often think of things to ask during my visits but forget when I see the doctor.
Could you please help me with answers and advice? I have been unable to work for over seven months due to this condition and have spent nearly NT$200,000 out of pocket on medical expenses.
(In December 2005, I initially injured my back after falling from an A-frame ladder at work.
Although I did not feel much pain at the time, I visited a nearby clinic for pain relief injections.
After a few days, I felt better, but sneezing caused my leg to become numb and painful.
I thought seeing a doctor would resolve the issue and did not consider using labor insurance for treatment.
After two surgeries, when I applied for labor insurance benefits, they said I had not provided the doctor with a detailed account of my condition and did not use the labor insurance hospitalization form, so they denied my claim.
They also stated that the reports from Chi Mei indicated degeneration at the L3-L4 and L4-L5 levels, which was not covered.
However, both the neurology and orthopedic departments did not mention this issue.)
Dr.
Wang, can an MRI detect bone wear? If so, why have none of the doctors I consulted informed me of this condition? I have asked them, and they only mention the HIVD.
What should I do? Dr.
Wang, could you please provide me with your valuable advice? Thank you.

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Xiao Yuan, 30~39 year old female. Ask Date: 2006/07/10