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  • Ducati2018
    Participant
    Post count: 1

    Hi Doctor,

    I have a 3/5 strength footdrop after suffering a herniated disc at L5 4 months ago.

    My surgeon has offered a far right lateral discectomy as he can see from the MRI that some disc material is in the foremen space.

    However he and his MDT team are reluctant to undertake the operation as I have ZERO pain of discomfort and am able to walk reasonably normally. At least for a while until the TA fatigues.

    I have been doing a lot of physio and have corrected my slight tender berg gait by strengthening gluteus which were also affected.

    However my footdrop won’t improve from a 3/5 and fatigues quickly still.

    My surgeon says an operation may fix it but he could put me through it for no gain and possibly make matters worse?

    I have made minor gains since the injury first happened but I am worried that if I don’t try surgery and things get worse I will wish I had tried.

    Both physio and Surgeon think that I won’t get worse unless I re-injure myself but can’t guarantee it.

    I would like to see if you feel at this stage an operation would be appropriate ….I am fine with day to day activities but can’t run or play squash/tennis with the TA weakness.

    I have basically been told I can have surgery but with the caveat I may not improve or even get worse ?……. Not an easy decision 🤪

    I think that if the consensus is that my motor function will not get worse without the operation I will keep working hard on physio and hope for minor improvent over time.

    Other than some intermittent pins and needle in my big toe I have no other symptoms other than weak Tibilais Anterior and Glutes

    Any advice appreciated

    James

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    Please be more specific as to the level of herniation and the level already operated (if so). The levels are labeled L5-S1 for the lowest movable level and L4-5 for the level above that. Herniation position is either postero-lateral or far-lateral which makes a difference as to which root is involved. Foot drop could originate from the L4 or L5 nerve. If you have weakness of the extensor hallicus longis (EHL) muscle, the muscle that lifts your great toe in addition, it is the L5 nerve root involved. If that muscle is strong, the injury is to the L4 nerve root.

    Dr. Corenman

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