Good news first..
Not MS, bone cancer or problem affecting the spinal cord. Bad news is more issues with my back resulting from the event at BBCL back when I was a page there ages ago.
Disc herniations occur toward the bottom of the spine at L4- L5 and L5- S1 levels. In addition to typical sciatica symptoms, nerve impingement at these levels can lead to:
L5 nerve impingement (at the L4 – L5 level) from a herniated disc can cause weakness in extending the big toe and potentially in the ankle (foot drop). Numbness and pain can be felt on top of the foot, and the pain may also radiate into the buttock.
S1 nerve impingement (at the L5 – S1 level) from a herniated disc may cause loss of the ankle reflex and/or weakness in ankle push off (patients cannot do toe rises). Numbness and pain can radiate down to the sole or outside of the foot.
As a disc degenerates and breaks down, the inner core can leak out through the outer portion of the disc, and this condition is known as a disc herniation or a herniated disc.
The weak spot in the outer core of the intervertebral disc is directly under the spinal nerve root, so a herniation in this area puts direct pressure on the nerve.
The nerve runs through the leg, and any type of pinched nerve in the lower spine can cause pain to radiate along the path of the nerve through the buttock and down the leg. This type of pain is also called sciatica or a radiculopathy.
Lumbar Herniated Disc Symptoms
General symptoms typically include one or a combination of the following:
Leg pain (sciatica), which may occur with or without lower back pain.
Typically the leg pain is worse than the lower back pain.
Numbness, weakness and/or tingling in the leg
Lower back pain and/or pain in the buttock
Loss of bladder or bowel control (rare), which may be an indication of a medical condition called cauda equina syndrome.
Cauda equina syndrome is a relatively rare but serious condition that describes extreme pressure and swelling of the nerves at the end of the spinal cord. It gets its name from Latin,”horse’s tail,” because the nerves at the end of the spine visually resemble a horse’s tail as they extend from the spinal cord down the back of each leg.
Cauda equina syndrome is a serious medical emergency that requires testing and possibly urgent surgical intervention. If patients with cauda equina syndrome do not get treatment quickly, adverse results can include permanent paralysis, impaired bladder and/or bowel control, difficulty walking, and/or other neurological and physical problems.
Cauda equina syndrome is caused by the compression of nerves in the lumbar spine and a narrowing of the spinal canal. This pressure on the spinal nerves can occur from several underlying causes, including:
Any spinal condition that may compress the nerves in the lower back, most commonly alumbar herniated disc or lumbar spinal stenosis
Inflammatory conditions of the spine, such as ankylosing spondylitis
Infections in the spinal canal, such as a spinal epidural abscess in the spinal canal
Keep the following issues in mind when considering traditional open spine foraminal stenosis surgery:
A 5- to 6-inch incision is made in order to access the area of the spine affected
Constricting bone matter and other tissue is removed
So, much like my initial surgery, ages ago. The bone spur developed as a protective measure by my body to prevent against the two vertebrae grinding, but the side effect is that bending and up step walking is difficult, not terribly coordinated and often painful. The air pocket is my internal organs screaming about how nature abhors a vacuum – gases stored in tissues filled up the opened space with a bubble that also tends to press that nerve bundle.
After I get the MRI, we will know better how to proceed.
Open spinal fusion surgery often follows, which may include bone grafts or rods, to stabilize the spinal column