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  • southsider
    Member
    Post count: 2

    Someone I know is being worked up for disc herniation at L4 and bulging disc at L5 and developed bilateral numbness and burning on the bottom of both feet while lying on the MRI table for a scan. He has been diagnosed with moderate spinal stenosis and facet hypertrophy as well.

    It gradually increased in severity but it came at the end of the procedure and the procedure was able to be completed.

    On getting off the table, he also had some noticeable difficulty in walking that he thought was due to weakness in his upper leg muscles. He was able to “walk off” the weakness but the burning persisted for several hours.

    Is there an anatomic explanation that can account for this?

    Thanks
    southsider

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    Bilaterally equal positional numbness in the feet can be related to lumbar spinal stenosis. Lying on the examination table, typically without a pillow under the knees will produce extension of the lumbar spine and increased compression of the lumbar nerves. The “burning” sensation that lingered in the legs could result from the prolonged compression of the nerves- from the hour requirement to lie still on the MRI table.

    Dr. Corenman

    southsider
    Member
    Post count: 2

    Dr. Corenman,

    Thanks for the explanation. Is this something that is amenable to or will probably require surgical correction? I have heard that the anatomic findings don’t always correlate with the person’s symptoms.

    southsider

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    Spinal stenosis is a variable condition in regards to surgery. If the stenosis or narrowing is not too significant and there is no motor weakness present, surgery can be put off with some risk. The risk is that with continued mechanical compression of the roots can cause arachnoiditis (see website for description). That risk is not too high with some estimates in the case of severe stenosis at 10-15%.

    Epidural steroid injections can give excellent relief sometimes for the longer term.

    Dr. Corenman

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