cgn5266MemberSeptember 22, 2012 at 4:38 amPost count: 1
had an intradural extramedullary schwannoma removed from L2 nearly 18 years ago. I was fortunate that I recovered quickly and with physical therapy resolved most weakness issues including a foot drop. 4 years ago I started experiencing a progressive numb left foot and tightness in my left calf. A MRI revealed clumped nerve roots extending from L1-3 where I had the laminectomy suggestive of arachonoiditis. I also have a dissecated disk at l4/5 and emg findings of chronic radical apathy at L4/5 with evidence of reinnerveation. Recently an orthopedist suggested that my symptoms are a result of the scarring and there not much to be done. My question is this – has anyone had scar tissue become active so long after surgery. Wouldn’t there have to be something that “caused” the activation that can be treated?
Any thoughts would be appreciatedDonald Corenman, MD, DCModeratorSeptember 22, 2012 at 7:12 pmPost count: 8611
Arachnoiditis can advance over years so your new onset symptoms is not necessarily a surprise. You did have injury to the L4 or L5 root with your schwannoma removal. The weakness resolved eventually after surgery but there was most likely residual injury to the root. I assume that your initial foot drop was on the left side.
A question is the contribution of the L4-5 level. You could have foraminal stenosis of that level. X-rays and MRI can help reveal the presence of this disorder. If there is any question of the diagnosis, a selective nerve block can be used for diagnosis (see website). A positive block (relief of pain temporarily-see pain diary on website), should help indicate if this root is involved. If the injury is “upstream” at the arachnoiditis, a SNRB of the L4 or L5 root should not yield relief
Another differential point is positional pain vs constant pain. If your pain is constant and does not change much with standing, the source is more likely arachnoiditis. If your pain is dynamic (pain with standing that disappears with sitting or leaning forward), there is more chance that the pain is generated by the L4-L 5 level.
Dr. CorenmanPLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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