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  • jbsangus
    Member
    Post count: 6

    Hi doc, I am 48 have had long history of leg pain finally had surgery 8 weeks ago. surgeon said worst stenosis ever in 25 years doing this surgery. Laminectomy 4levels from L2 to S1 both sides, right side was really bad, said nerve root at L5 down to size of pencil. Now after surgery i can stand straight and tip head back with no pain, but now back side of right leg and whole foot is numb right after surgery, also dural tear repair layed flat for 2 days. Motor weakness right buttocks,back of leg and ankle, can’t push down on toes. Been doing physical therapy and walking on treadmill everyday. I am walking with help of cane and severe limp. Doc says should come back in time. I was a very active person, how long should i wait before i get another opinion? What are your thoughts on this? Also, I still have bladder and bowel weakness and numbness. Thank You

    Donald Corenman, MD, DC
    Moderator
    Post count: 8368

    It sounds like the surgery for stenosis (I assume) was successful as now you can stand up straight without pain. The additional symptoms need to be addressed.

    The first question I have for you is what was your deficit prior to surgery? Did you have the weakness, numbness or pain in the leg before surgery? The inability to walk on your toes is the S1 nerve. Was that inability present prior to surgery?

    Did you have bladder and bowel dysfunction prior to surgery or is this new?

    Ask your surgeon if the dural tear was just a small pinhole leak with a repair or a large tear with herniation of the nerve roots through the tear. Were any nerve roots injured during the tear or repair? Is there anything else that he can tell you?

    An EMG may be helpful about 6 weeks after the injury to determine to what extent the problem is if the symptoms are new.

    Dr. Corenman

    PLEASE 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.
    jbsangus
    Member
    Post count: 6

    Thank you for quick response. My symptoms started in my 30’s have known i have spinal stenonsis for about 15 years doctors say it is genetic. was walking bent forward, could not walk or stand for very long because of leg pain. After surgery i have all these new symptoms with right leg numdness and weakness, right buttocks muscle won’t work, down back of leg to foot, limited movement of toes, foot completly numb. I do have strength in front of my leg so i can pull toes up with ankle. Bladder and bowel issues are new since surgery. My left leg came out of surgery perfect. I am a farmer and need to know if this is going to be permanent. I could walk on my toes prior to surgery. He did not say he injured a nerve but did say nerve will be swelled for a while and that nerves take a long time to heal, he said what don’t come back in 12 months won’t come back. Thank You Doctor.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8368

    Based upon your new onset of leg weakness and bowel/bladder dysfunction, there was some injury to the nerves. This would include the S1 and possibly the L5 nerve as well as the bowel and bladder nerves (nervi erigantes). The nerves can recover but may not fully recover. I agree with the surgeon that you won’t have a full idea for six to twelve months. A new MRI might be helpful to ascertain if there is any continuing compression.

    Dr. Corenman

    PLEASE 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.
    jbsangus
    Member
    Post count: 6

    Is there anything i can do to speed the healing of the nerves ? Will walking on treadmill and physical therapy daily help or hurt it? I will be trying to get back to a somewhat normal life a little at a time.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8368

    Unfortunately, nerves heal in their own due time. Nerve healing is very slow. There is not much that can be done to speed up nerve healing. There are some studies that might indicate using an electrical muscle stimulator is detrimental so if offered, stay away from that machine. You might need a custom orthosis for the weakness. That is a plastic device that fits over your ankle to stabilize your foot when walking and standing. I assume that your therapist has offered that to you.

    Dr. Corenman

    PLEASE 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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