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  • ColoradoPT
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    Post count: 4

    I have been dealing with spinal issues for the past 30 years. At 25 I underwent L5S1 discectomy and another L5S1 discectomy at 30. I had no problems for years. At 45, I had a C5C6 fusion due to compression and developing motor weakness. At 50, I had interlaminar spacers placed at L3L4 and L4L5. At 51, I had a 4 level C/S fusion (C34, C45, C56, C67). All of these surgeries were 100% successful, but–no surprise–I’m developing lumbar symptoms suggestive of L2 and/or L1 nerve root compression.

    As you know, soft tissue hypermobility is on a continuum of Ehlor’s Donlos Syndrome to the opposite end of extreme stiffness. I am definitely near the hypermobile end as I developed a painful right shoulder from years of swimming and the pain was only corrected at the age of 23 with a capsular shift. At 52, I underwent surgery to correct what was diagnosed as Basal Joint OA in my left thumb but one look at the X-ray would show you the extent of dislocation that was present at the trapezium-MC joint. Plus, per the above, I’ve had four spinal surgeries in the last 25 years.

    I learned from you that spinal discs lose blood flow circulation when we are very young and clearly, muscle strength alone is not enough to keep our spine from collapsing/deteriorating. (I work in the healthcare field and I have an in-depth understanding of muscles and how they work.) Since I am on the hyperflexible, most likely breakable, collagen spectrum, I tell people my spinal issues are genetic. Would you agree?

    Immediately after my lumbar surgery in 2017, I had numbness on my right thigh in the distribution of the lateral femoral cutaneous nerve. No big deal, it was just numbness. One year ago, 2021, I developed symptoms that strongly correlated with meralgia peresthetica (on the right side), and the neurosurgeon I consulted agreed. During the last three months or so, this numb area has gradually become VERY painful to any pressure. It’s numb to light touch but if I lean against a table or rest the lateral side of my thigh against the arm of a chair–forget it–it’s sharp and very painful and often eliciting an involuntary “Ouch.” I have increasing severity of aching pain in the groin and deep anterior hip and recently the buttocks; hip extension with gait is becoming increasingly more painful, lying supine with legs extended for about 5 minutes results in aggravation of the deep nerve symptoms. All symptoms are right-sided.

    Looking back, I think my meralgia peresthtica was related to irritation of the L2 nerve root. yes?

    I see my neurosurgeon this week. Any thoughts from you? Any advice for imaging? What might be options for treatment? If surgery, what are options considering I have interlaminer spacers, which, according to my neurosurgeon are intact and look good.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    “I tell people my spinal issues are genetic. Would you agree”? Absolutely.

    Generally, allodynia (pain with light touch) is associated with root injury and not with a sensory root compression (meralgia paresthetica) although I can’t see why that can’t happen. Deep pain in the hip region is not associated with meralgia paresthetica. It can be a hip disorder however this would not cause allodynia. I think your idea of an L1 or L2 disorder makes more sense. A standard lumbar MRI would reveal this disorder. If a root is compressed, a direct decompression would be in order.

    Dr. Corenman

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