[Jtal19305]

#23138

Hello Dr Corenman
You may recall my case through the past forum questions I have asked. I’m the male who had a posterior decompression of t12 l1 via a laminectomy and disectomy facetomy (left) with interbody cage fusion and hardware and an L23 hemi left laminectomy done at the same day. I am 15 months post op now. I had very bad left as well as right foot pain and Lower leg pain after surgery. We surmised this could of been cord irritation or something else with the cord and nerves. My left foot was “hot” burning on the sole for a long time. And I had strange nerve dysthetic pain in lower legs and feet. Surprisingly very little back pain now and never had back pain prior to the surgery. My issue was leg pain and weakness due to severe stenosis and large disc bulge at t12 l1. I re read an earlier pre op Mri report which said proximinal cauda equina at t12 l1. What does that suggest? I take it that sounds dire and serious? Well I have seen dozens of specialist in the Philly area and the latest doctor says no more surgery needed at t12 l1 but l23 could need further decompression because my left outer thigh is still numb and sensitive to touch. The doc said not to jump into it but if it doesn’t get better that it is a straightforward revision surgery. I gather he would take more of the lamina out but without fusing. Well I would to say after 15 months the burning in my left foot has lessened to where I have days which I feel almost pain free there. So many doctors including yourself told me this kind of recovery could take 2 years or even longer. I read someone got better after 5 years! Well this is very hopeful and encouraging for me. I’m still relatively young and have a better outlook for my future now. No doctors saw anything in the post surgery Mri at t12 l1 that jumped out as the root cause for the pain so I was frustrating not knowing where this would go.

I have a long way to go still but I have more hope that I can get through this. My conus was exposed during surgery , the thecal sac containing it so it must of been extremely irritated during the operation. I have my motor skills and all so they said it could not be cord damage as that would be other symptoms such as weakness and gait. I feel better I probably needed this surgery as much as I have regretted it due to the pain it caused.

I wanted to give you this update. I also value your insights and perspective.

Thanks
JT

[Donald Corenman, MD, DC]

#23162

Thanks for your update. This information is quite valuable to other individuals who have similar disorders and surgical results. The MRI reading of “pre op Mri report which said proximal cauda equina at t12 l1” probably meant that your herniation was large enough to possibly cause cauda equine syndrome at T12-L1.

Your outer thigh “still numb and sensitive to touch” is still probably a result of the compressive nerve injury. If there is still significant nerve compression at L2-3, you could undergo a SNRB of this nerve. Good temporary relief (see pain diary) could mean a decompression would help. However, minimal relief would mean that this is still a higher injury (at the surgical level) and decompression would not help.

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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