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Hip Pain After L4 L5 Surgery

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But I Had Hip Surgery Why Does My Knee Hurt

L4 L5 – L5 S1 disc bulge best exercise rehabilitation for pain relief

Your core muscles affect the alignment of your entire lower body. If the psoas and iliacus muscles are tight, they will tug on the entire interconnected line from your back, through your legs, and down to your toes. But you can often trace the source back to tension in those core muscles, even though youre feeling it in your toe.

Leg Pain After Lower Body Surgery

Just as with the lower back and hip pain connection, pain from hip to knee is a common issue. An unhealthy iliopsoas, and more specifically an unhealthy iliacus, has a profound effect on pain from hip to knee as well as the rest of the body overall.

Because a tight iliacus muscle twists the hip and thigh bone, it anatomically changes how your leg connects to your upper body. When the tension in your iliacus muscle is released, your leg and hip alignment will work as designed, but you are far more susceptible to pain when it is tight.

Although the direct connection between pain from hip to knee appears to be with a tight iliacus, that doesnt mean that the psoas muscle should be ignored completely. After all, together, they form the iliopsoas, so if one is tight, the other is directly affected.

When strain is put on your iliopsoas, it can create a pelvic rotation as the muscle pulls and tightens. This can be either an anterior or internal rotation. Your pelviss internal rotation is what could potentially connect hip to knee pain and knee to foot pain.

You can also experience an internal rotation that puts a strain on your knee. An internal rotation of your pelvis affects the way your leg works from the hip down and doesnt allow the kneecap to track correctly. This internal rotation can also cause the foot to flatten , which changes how your foot and toes are aligned.

Failure Of Solid Fusion After Spine Surgery

When the fusion is for back pain and/or spinal instability, there is a correlation between obtaining a solid fusion and having a better result of the spine surgery. If a solid fusion is not obtained through the spine surgery, but the hardware is intact and there is still good stability to the spine, the patient may still achieve effective back pain relief with the spine surgery. In many cases, achieving spinal stability alone is more important than obtaining a solid fusion from the spine surgery.

On postoperative imaging studies it is often very difficult to tell if a patients spine has fused, and it can be even harder to determine if a further fusion surgery is necessary. In general, it takes at least three months to get a solid fusion, and it can take up to a year after the spine surgery. For this reason, most surgeons will not consider further spine surgery if the healing time has been less than one year. Only in cases where there has been breakage of the hardware and there is obvious failure of the spinal construct would back surgery be considered sooner.

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Pain After Lumbar Discectomy L5/s1


I had a lumbar microdiscectomy 6 days ago and the pain was okay, well I thought it was but I just tried to lift my leg and it now hurts like it did before….my surgeon said there might still be some leg pain after surgery but surely they would have been straight after? Am I worrying too much?

i am diabetic by the way

2 likes, 58 replies

Persistent Back Pain After A Successful Surgery

Spinal decompression for herniated discs

Some people have long-lasting pain after a back surgery that was technically flawless. In these situations, imaging tests, such as MRIs and CTs performed after surgery do not show any significant abnormalities that would indicate a need for repeat surgery.

These people may have neuropathic pain , a condition where nerve fibers become overactive and send inappropriate pain signals to the spinal cord and brain. In this case, there is no constriction or narrowing that is squeezing a spinal nerve.

Some facts about NP:

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Using Heat And Ice Therapy

In addition to medication, ice packs and/or heat wraps may be used. Special caution must be exercised for patients who have decreased skin sensation at the surgical site and/or pre-existing conditions, such as diabetes.

  • Heat therapy may help relax tissues, reduce spasm in tight muscles, and improve blood flowaiding in tissue healing. Using a heat pack or hot water bottle before an activity can help loosen the tissues and improve the range of motion in the joints.
  • Ice therapy applied to the lower back can help decrease inflammation and pain. A plastic bag filled with ice or a commercial ice pack is especially useful after activity to decrease any activity-related discomfort or soreness.

Limit ice or heat therapy applications to 15 or 20 minutes at a time, with at least 2 hours of rest in between, to optimize tissue response between applications. A thin towel or t-shirt may be used as a barrier between the heat/ice source and the skin to avoid direct skin injury.

Will My Pain Go Away After L4

Pain may improve, stay the same or worsen after fusion surgery. The majority of people will see improvement in there pain, but few people will have complete pain relief. Unfortunately spine surgery does not give you a new uninjured back. I would discuss what the likelihood of you improving with your surgeon.

Spinal fusion surgery is usually done through an open traditional technique causing significant skin, muscle and bone damage. Recently open traditional fusion surgery is being replaced by percutaneous endoscopic fusion techniques I call Endoscopic Lumbar Interbody Fusion . These surgeries appear to have less bleeding, soft tissue and bone damage compared to open traditional fusion surgery. Due to less soft tissue and bone damage these endoscopic surgeries appear to have less post-operative pain and a quicker recovery.

For more information on percutaneous endoscopic fusion surgery please contact Executive Spine Surgery. Good Luck!

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Pain After Spinal Fusion May Be From Post

Many people have successful spinal surgery. Some do not. There are many reasons why someone will have a failed spinal surgery. One reason among the many causes can be the muscle damage caused by the fusion surgery itself.

Back muscle degeneration in lumbar fusion patients

A team of surgeons published a paper examining the post-surgical phenomena of back muscle degeneration in lumbar fusion patients. The goal was to find answers for failed back surgery syndrome. What the surgeons found was Up to 25% of patients report unimproved or worse pain and up to 40% are not happy with the outcome of lumbar fusion.

  • up to 25% of patients report unimproved or worse pain and up to 40% are not happy with the outcome of lumbar fusion.
  • While the researchers acknowledged that there are many possible reasons for poor results, including instrumentation failure, inadequate surgical technique, and poor patient selection, they were looking for the relationship between back muscle injury after surgery and the patients chronic back pain.

The relationship was found. In patients who had continued pain after back surgery, muscle biposies revealed:

  • atrophy of paraspinal muscles,
  • loss of muscular support leading to disability and increased biomechanical strain,
  • and possibly failed back syndrome.

Exposure Of Disc Space And Retractor Docking

L4 L5 – L5 S1 best seated exercises

Direct inspection of the surgical corridor and avoidance of sharp dissection minimize the risk of neurologic and visceral injuries inherent to the approach. Moreover, safe surgical corridors have been described in several cadaveric and clinical studies. While exposure of L2-3 does not pose any risks of nerve injury, the genitofemoral nerve is anterior and superficial to the psoas muscle at L3-4 and L4-5 . Additionally, multiple studies have shown the dorsoventral migration of the lumbosacral plexus traveling from L2 to L5. One should especially be cognizant of the ventral migration at L4-5 as the plexus can be located as far anterior as at the midpoint of the disc space . In a cadaveric study, Uribe et al. divided the disc space equally into 4 segments, defined as zones I through IV going from anterior to posterior. From L2 to L5 the femoral nerve traverses the psoas muscle in a gradual dorsoventral trajectory and is frequently found in the posterior middle quarter of the L4-5 disc space. Results of this study indicated that zone III is generally a safe surgical zone at all levels in patients without significant spondylolisthesis or coronal deformity . Finally, attention should be given to effective anchoring of the retractor to the vertebral body during deployment, particularly in the presence of osteophytes, to prevent unintentional migration of the retractor and possible risk of nerve injury .

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How Long Does It Take For Nerves To Repair After Surgery

Most episodes of nerve damage after surgery last for a few weeks to a few months. If they last longer, then the rate of nerve regrowth is about an inch a month. Therefore, if the nerve is able to regrow, a nerve injury in the back could take years to regenerate the entire nerve from your back to your foot . However, many times scarring in or around the nerve prevents regrowth .

Is Failed Back Surgery Syndrome A Disability

Is failed back surgery syndrome a disability?

Failed back syndrome is typically not a disability. However, if it prevents you from being able to work and you can prove it, it could be termed as a disability. If you can prove that the disability will last for at least 12 months, you may be entitled to Social Security Disability benefits.

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Why Is There Typically Hip Pain After Back Surgery

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If You Have A Stabbing Pain In Your Hip The Cause Might Be A Herniated Disc In Your Lower Back However This Symptom Is Usually Associated With Other Symptoms And It Is Best To See A Specialist For An Accurate Diagnosis In The Following Article Well Tell You More About It

Pin on Lumbar Degenerative Disc Disease shown on Color X

Suppose Ashley has been suffering discomfort in her lower back for some time. However, lately, she has also begun to notice pain in her hip and leg. A specialist will tell you that these are probably not isolated symptoms and that they most likely share the same cause. In the case of an L4-L5 lumbar disc herniation, the lower back pain can radiate to the hip and leg.

When you have a herniated disc in the lumbar spine, the pain is not always located in the affected area. In many cases, the patient begins to notice discomfort in areas that are related to each other. So in addition to lower back pain, they may feel pain in one buttock, or the back of the calf, and they might feel numbness in the sole of their foot.

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What Can Help Keep Spinal Stenosis

Depending on the severity of the hip pain, patients may be able to manage it with conservative therapies and small lifestyle changes. For instance, a doctor may suggest the following:

  • Taking over-the-counter medications such as aspirin or ibuprofen, which can help reduce inflammation and pain.
  • Undergoing physical therapy, which can strengthen the muscles around the hips while helping stabilize the spine.
  • Wearing a temporary lumbar brace or corset, which can provide additional support while restricting motions that could make the hip pain worse.

If the hip pain persists after several months of conservative treatment methods, surgical options may be an appropriate next step. USA Spine Care performs minimally invasive spine surgery for the treatment of spinal stenosis that can be performed on an outpatient basis using a less than 1-inch incision. Contact us today to learn more.

We can help you receive a free MRI review* to find out if you are a potential candidate for minimally invasive spine surgery at USA Spine Care.

Is Spinal Fusion A Major Surgery

Absolutely! The surgery involves cutting through important muscles, ligaments, and tendons to access the targeted disc. The disc is then removed and the area is packed with bone and often times a spacer. To stabilize the spine, screws are placed into the spinal bones above and then below the disc that is removed. The screws are stabilized by additional hardware including plates and rods.

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Paraspinal Muscle Changes After Single

A February 2020 paper examined the widely accepted surgical technique, posterior lumbar fusion that had been related to the possibility of paraspinal muscle atrophy after surgery. In this study the research surgeons investigated one-year postoperative changes in the paraspinal muscle to assess atrophy. These patients underwent a single level fusion at L4-L5.

Highlighted below is the multifidus muscle

multifidus muscle

In this study, atrophy of the multifidus muscle was prominent this, the researchers noted was consistent with the findings of previous studies. Because the multifidus muscle is an important stabilizer of the lumbar spine, multifidus muscle atrophy is considered to be related to low back pain.

Interestingly the researchers also noted: In our study, the association between low back pain and severe multifidus muscle atrophy during the one-year follow-up was unclear. Considering the stabilizing effect of the PLIF surgery, it is difficult to observe the correlation between muscle atrophy and low back pain in the short term follow-up. However, given that previous studies have stated that the reduction of paraspinal muscle volume is associated with pain, the apparent post-operative multifidus muscle atrophy observed in our study may have a negative impact on the long-term clinical results.

A Patient’s Guide To Complications Of Spine Surgery

Right L4-5 Minimally Invasive Transforaminal Lumbar Interbody Fusion


With any surgery, there is the risk of complications. When surgery is donenear the spine and spinal cord, these complications can be veryserious. Complications could involve subsequent pain and impairment and theneed for additional surgery. You should discuss the complications associatedwith surgery with your doctor before surgery. The list of complications providedhere is not intended to be a complete list of complications and is not a substitutefor discussing the risks of surgery with your doctor. Only your doctor can evaluateyour condition and inform you of the risks of any medical treatment he or shemay recommend.

Anesthesia Complications


When blood clots form inside the veins of the legs, it is referred to as DeepVenous Thrombosis . This is a common problem following many types of surgicalprocedures. It is true that these blood clots can also form in certain individualswho have not undergone any recent surgery. These blood clots form in the largeveins of the calf and may continue to grow and extend up into the veins of thethigh, and in some cases into the veins of the pelvis.

Reducing the risk of developing DVT is a high priority following any type ofsurgery. Things that can be done to reduce the risk of developing DVT fall intotwo categories:

  • Mechanical – getting the blood moving better
  • Medical – using drugs to slow the clotting process



Lung Problems


Hardware Fracture

Implant Migration

Spinal Cord Injury

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Acute Sciatic Neuritis Following Lumbar Laminectomy

Foad ElahiAcademic Editor: Received


It is commonly accepted that the common cause of acute/chronic pain in the distribution of the lumbosacral nerve roots is the herniation of a lumbar intervertebral disc, unless proven otherwise. The surgical treatment of lumbar disc herniation is successful in radicular pain and prevents or limits neurological damage in the majority of patients. Recurrence of sciatica after a successful disc surgery can be due to many possible etiologies. In the clinical setting we believe that the term sciatica might be associated with inflammation. We report a case of acute sciatic neuritis presented with significant persistent pain shortly after a successful disc surgery. The patient is a 59-year-old female with complaint of newly onset sciatica after complete pain resolution following a successful lumbar laminectomy for acute disc extrusion. In order to manage the patients newly onset pain, the patient had multiple pain management visits which provided minimum relief. Persistent sciatica and consistent physical examination findings urged us to perform a pelvic MRI to visualize suspected pathology, which revealed right side sciatic neuritis. She responded to the electrical neuromodulation. Review of the literature on sciatic neuritis shows this is the first case report of sciatic neuritis subsequent to lumbar laminectomy.

1. Introduction

2. Case Report

3. Discussion

4. Conclusion


Conflict of Interests

What Happens If My Spinal Fusion Failed

A percentage of patients may still experience pain after a spinal fusion. This is known as failed fusion syndrome. It is characterized by intractable pain and an inability for the patient to return to normal activities. The patient may undergo another surgery to fix the condition. However, the surgery may not eliminate the pain.

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What Does Spinal Stenosis

For some patients, spinal stenosis-related hip pain is mild and occasional. For others, the pain is severe and increases gradually over an extended period of time. It is also possible for the hip pain to extend through the buttocks and the groin or radiate down through the legs.

Generally, spinal stenosis-related hip pain only affects one side of the body. It typically occurs when the space inside the spinal canal and between vertebrae narrows and compresses a nerve root in the lower spine. Nerve roots are structures that branch off the spinal cord on the left and right sides of the spinal column and travel out to provide motor and sensory function to the rest of the body. The pain caused by nerve root compression is often limited to the side of the body served by the nerve root being compressed.

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