Post-Surgery Concerns: Addressing Complications After HIVD Treatment

Post-HIVD surgery

Dear Director,
My mother underwent surgery for HIVD (herniated intervertebral disc) and spinal stenosis at the L3-L5 levels at the Taipei Municipal Hospital, performed by a neurosurgeon.
She opted for a self-funded artificial joint (a round one), which cost over NT$100,000.
However, after the surgery, the wound site has become prominent and feels like the shape of the artificial joint.
Whenever she wears a Taylor brace to walk, she experiences lower back pain and occasional numbness in her legs.
She cannot walk or sit for extended periods.
During each follow-up visit, the doctor has advised her to wait for another two weeks or longer.
What should we do? Is it possible that the artificial joint was not placed correctly? I have heard from a teacher that if the artificial joint is not properly positioned in cases of HIVD, it could lead to leg numbness and may require another surgery.
Is there a possibility of surgical failure?
Director, I kindly ask for your guidance.
Thank you very much.
I am very worried about my mother.

Charry, 30~39 year old female. Ask Date: 2008/10/10

Dr. Shi Guozheng reply Orthopedics

The cause may be the displacement of the implanted device, but this must be confirmed through X-ray examination.
It is also possible that the original spinal stenosis has not been resolved, leading to continued compression of the spinal nerves.
If either of these situations occurs, it is likely that another surgery may be necessary to address the issue.
It is recommended that you consult another physician to determine the underlying cause before proceeding with appropriate treatment.

Reply Date: 2008/10/10

More Info

After undergoing surgery for herniated intervertebral disc (HIVD) and experiencing complications such as a protruding artificial joint, persistent back pain, and occasional leg numbness, it is understandable that you are concerned about your mother's recovery and overall well-being. Here, I will address your concerns and provide insights based on medical knowledge regarding post-surgical complications related to HIVD treatment.

Firstly, the symptoms your mother is experiencing, such as the protrusion at the surgical site resembling the shape of the artificial joint, could indicate several possibilities. One potential issue is that the artificial joint may not have been positioned correctly during the surgery. If the joint is misaligned, it can lead to abnormal pressure on surrounding tissues, resulting in pain and discomfort. Additionally, if the artificial joint is not properly integrated with the surrounding bone, it could lead to further complications, including the risk of dislocation or failure of the implant.

The persistent back pain and occasional numbness in the legs could also be attributed to unresolved issues related to the original condition that necessitated surgery. If the spinal canal remains narrowed or if there is residual pressure on the spinal nerves, these symptoms may persist despite surgical intervention. It is crucial to conduct follow-up imaging studies, such as X-rays or MRIs, to assess the alignment of the artificial joint and the condition of the spine.

Regarding the recommendation from the attending physician to observe the situation for a few more weeks, it is not uncommon for doctors to take a conservative approach in the immediate postoperative period. However, if your mother’s symptoms do not improve or worsen, it may be prudent to seek a second opinion from another orthopedic or neurosurgeon. A fresh perspective could provide additional insights into her condition and potential treatment options.

In terms of rehabilitation, it is essential to engage in a structured physical therapy program tailored to her specific needs. Physical therapy can help strengthen the muscles supporting the spine and improve overall mobility. However, if physical therapy is causing significant pain, it may be necessary to reassess the therapy techniques being used. Communication with the physical therapist about her pain levels and any discomfort experienced during exercises is vital for adjusting the rehabilitation plan.

Additionally, it is important to monitor for any signs of infection at the surgical site, such as increased redness, swelling, warmth, or discharge. If any of these symptoms occur, it is crucial to contact her healthcare provider immediately.

In summary, your mother's postoperative symptoms warrant careful evaluation and possibly further imaging studies to determine the cause of her discomfort. If the current medical team is unable to provide satisfactory answers or solutions, seeking a second opinion is advisable. Ensuring that she engages in appropriate rehabilitation while monitoring her symptoms closely will be key to her recovery. It is understandable to feel anxious about her condition, but with the right medical support and proactive management, there is hope for improvement.

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