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  • Wmltb
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    Post count: 2

    I am 38 yo healthy female and had an L5/S1 fusion (went in from front and also back) 5 months ago. I had two discectomies prior to that without problems, it just kept reherniating.

    I have done well post op, and about 2 months post op took neurontin for a while due to some continued burning nerve pain on the right, especially in my foot. That resolved after about a month and so I stopped the neurontin. However, it has now returned—primarily in my calf and outside of my foot, made worse by cycling. I also have very annoying fasciculations in that calf, which are much worse after exercise.

    Is it possible for the nerve root to get irritated or re irritated five months after fusion? I felt so good at month 3 I didn’t expect this setback. Is there anything to be done about the fasciculations, which keep me up at night? I see my surgeon in another month and am debating calling about both symptoms. Appreciate your input!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    Did you have a fusion surgery due to another recurrent disc herniation? if so, the surgeon had to go from a posterior approach to removed the herniation. If he didn’t go from the rear to do a decompression along with placing the screws, possibly there still could be some residual nerve compression although you should have had some nerve symptoms prior to the five months. It is not out of the possibility that you have herniated the disc above.

    Fasciculations are a minor “fluttering” contraction of the muscle. Do you mean dystonia or an actual cramping of the muscle which is more painful and can wake you up?

    A new MRI should be helpful.

    Dr. Corenman

    Wmltb
    Participant
    Post count: 2

    Thank you. He did do a posterior decompression. I had a follow up MRI a month after surgery because I had an incisional seroma (now resolved) and it didn’t show any remaining compression.

    What I feel in the calf is not painful, but definitely a fluttering (feels like worms under the skin, if that makes sense). I would not call it a cramp. I also have constant tightness in that calf, mostly the lateral calf. Both symptoms (fluttering and tightness/burning) are worse following activity.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    You note “a fluttering (feels like worms under the skin…). I would not call it a cramp. I also have constant tightness in that calf”.

    What you have are faciculations of the muscle, in your case most likely due to nerve injury. The muscle cells that do not have a direct nerve connection due to the nerve injury become irritable and start to contract and relax without your input. Many of these cells will eventually reconnect to a local nerve in a process called budding. See https://neckandback.com/conditions/how-muscles-recover-from-nerve-injuries/.

    The “tightness” of the calf is also due to nerve injury and should lessen over time.

    Dr. Corenman

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