MI lumbar decompression done through the psoas muscle

Posted by Phil, Alumni Mentor @upstatephil, Aug 15, 2023

The neurosurgeon did the lumbar 2-5 decompression in a (mostly) minimally invasive fashion through my right psoas muscle. I am three months post and have a lingering muscle bulge in my right lower abdomen. It can be painful at times, is certainly visible, and even after a CT scan with dye - no doctor has been able to explain exactly what the bulge is much less what can be done about it. The lingering bulge and the psoas cutting seem likely to be related? Anyone have a thought here?

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gently | @gently | Aug 15, 2023

Cross sectional abdominal CT can detect hernia, abcess, tumor, hematoma.
Possibly you have a collection of fluid from the procedure. It could be in the lymph nodes or just trapped between tissue. These collections can form harder knots but eventually your body dissolves the blood, lymph fluid, etc. Following an injury ( referring to surgery as injury) can take months for these lumps to collect and then disappear.
I mention hernia because I had a femoral hernia. . The buldge sometimes painful sounds similar to yours. Femoral hernias are common in the lower right abdomen.
More to your point:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159389/
I'm too new to this site to be allowed ot highlight links.

Phil, Alumni Mentor | @upstatephil | Aug 15, 2023

That is very useful information! My abdominal bulge is not near the incision site, however, and a CT scan ruled out physical processes such as hernias, etc. The idea that there is a post-op fluid build-up makes some sense to me - but the neurosurgeon was, quite frankly, stumped as to what the bulge is (mine was not his first psoas-entry surgery). I hope for the body's natural processes to gradually "wash away" this bulge...but as I learned early-on in. life: "hope" is not a strategy. I will continue to investigate until I have a better grasp of the causes and solutions. I monitor the bulge regularly and have noticed no-change in three months...