Sciatica

Hi Jennifer:
Thanks for kind advice: Wife will not go back to surgeon who did laminectomy While she had bad pain in back and leg from stenosis it was nothing compared to very terrible pain that she has now after the operation 7 months ago. X rays show spine column has now shifted post op
with misalignment Do not trust this surgeon do revision surgery for problem that he created
in first place. Here in NY no other orthopedic surgeon will see her or even comment on future options once they are aware of prior surgery.Obviously some thing bad happened as a result of what was supposed to be a simple laminectomy.

@anoyymous123 I do agree, and I wouldn't trust that surgeon either. I wanted you to know that surgeons are not all the same. Some are excellent and gifted, and I had one of those. I spent 2 years trying to get help for my stenosis and 5 surgeons missed the correct diagnosis because my symptoms were unusual, so none would help me. There was only one out of those 5 that I would have trusted, but he thought surgery would make me worse because he thought my pain symptoms was an inflammatory problem like MS. He is a top surgeon and department head at a major medical center, and he still missed it. I actually found a case like mine in medical literature, and with that in hand, I contacted a surgeon at Mayo. I think the difficulty of being dismissed so many times helped me get into Mayo Clinic to the best of the best places for spine surgery. I think my surgeon at Mayo would help your wife if you have the ability to travel for care and if your insurance is in network for Mayo. I tried to stay local, and was turned away 5 times, so I got progressively worse. The CEO of Mayo at the time responded to my complimentary letter saying that my spine neurosurgeon was one of Mayo's top surgeons and that was pretty exciting for me to get his personal letter.

May I ask a favor? Would you have your wife read the exchanges we have had here on Connect? She is welcome to join Connect. I learned so much about spine surgery in those 2 years I was searching, and reading medical literature and watching online recordings from spine surgery conferences. I am here to help any way that I can, so please ask questions.

Well, who is this gifted surgeon? The answer is in this post in the "Spine Operation" discussion that you started.
https://connect.mayoclinic.org/comment/954224/
Please share your thoughts.

Jennifer

My Right- sided sciatica, going from my butt all the way down to my ankle has now crippled me. The pain is excruciating and I am having difficulty sitting, standing and walking. My question is: Who do I turn to for treatment? and what treatment/procedures or surgery can be done to help this? My back condition is: Lumbar spinal stenosis which I believe is the cause of the sciatica and I have had an MRI. I'm scheduled to have an epidural steroid injection, but it's only a band-aid and don't think it will help. What treatments has anyone else had for this debilitating condition?

I went to a highly recommended neurologist. This was after epidurals and nerve blocks were of no help, She did nerve conduction tests. Ultimately she prescribed tramadol, diadepam, and gabapentin. It took my body 2 or three days to adjust to the drugs; effects, but it sure helped a lot. A real game changer, as they say.

@denman55 Have you consulted a spine surgeon? Personally, I prefer a neurosurgeon, but both orthopedic and neurosurgery specialties can do spine decompression surgery. I know you have been suffering with this for a while. Find the best surgeon you can at a highly rated hospital. surgery at the lower end of the spine is more painful and a more difficult recovery because you are bearing most of your body weight there.

Find a reputable neurosurgeon or an orthopedic surgeon who has done a spinal fellowship. There are solutions.

I had exactly what you describe but in episodes that would lessen in severity and then return. I had one injection to L2-L3 (L4-L5 was too constricted to allow the needle in. The timing was while the radiculopathy episode was waning so not sure it helped. My spine specialist was willing to do one more 6 months later when another episode hit. He also wanted me to consult a neurosurgeon colleague in the spine clinic. I did so and scheduled surgery at that 90 minute consult. I had anterolisthesis and dangerous degree of movement of the L4over L5 (shown in X-rays done with your back extended). I needed that to be stabilized since a large additional movement could be catastrophic. My surgery completely solved my leg and butt pain. I could walk pain free the day after surgery. I am 4 months out and gradually getting back to normal level of activity. Still so grateful for the surgery which was done with an orthopedic spine specialist attending and 3rd year neuroscience fellow assisting. I recommend finding a surgeon who spends time to explain your individual situation thoroughly. Mine along with his team spent nearly as long before surgery as during surgery (5 hours) explaining to my husband and me. They accurately predicted the hallmarks of my recovery. Best wishes. We are all different challenges but yours sounds so much like mine I had to write!

What does the MRI indicate as the cause of the spinal stenosis. Cause will dictate remedy and as intense as sciatic pain is, there is (I'm not allowed to say likely on this site) remedy. If you have a readout from the MRI check for description of the stenosis. Bulging disc, folded ligament, spondylolythesis, loss of vertebral or disc height.

I'm so sorry you're going through this. Here's my sciatica story: Around the age of 45 in 2008, I had the same issue but only occasionally now. I still have slight numbness on the side of my foot and pinky toe but it was much worse and covered most of my toes back then. I also had muscle loss in my calf. So during one ER visit in 2008, I was given IV gabapentin and an overnight stay then sent home on a steroid Medrol dose pack taper. Up to that point, the pain was so bad that I literally wanted my leg cut off! I was scheduled for surgery prior to that ER visit but after completing the steroids I never got the surgery. I even showed up for surgery and got undressed! By the time my son parked and came back up to the waiting area, I had changed my mind because I felt so much better! On discharge from Johns Hopkins for the NON-surgery😁, I was advised to keep my weight down, do the physical therapy stretches, and stay active. It's been almost 16 years and the only time it flares up I notice is when I don't stretch for awhile being lazy and don't get much exercise. My issue was at L5-S1. I also was out of work for 2 months so I think that also allowed me to heal. Good luck and speedy healing to you. I'll be praying!!

https://www.ansellchiropractic.com.au/what-causes-sciatica-type-pain/
Even a tight muscle can trap and squeeze the sciatic nerve. The piriformus. If the MRI doesn't indicate a herniated disc, you might consider a chiropractic visit. You can usually get in to see a chiropractor quickly often same day. You'll know a lot more about the pain after a chiropractic assessment because they are usually very thorough.
I didn't mean to send this in two parts.