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  • lip26
    Member
    Post count: 5

    in July 2011, I fractured t12. After 2 months i started therapy 3x/wk. in dec i started acupuncture 1x/wk as well as massage therapy 1x/k. i have an e-stim device that i use usually every other day. I stretch everyday.

    i have a dropped right foot which causes an off looking gait. I use an AFO and a cane out of the house. i will not be using either forever and i will run again (any comments??)

    can you recommend anything else you’ve seen that has helped others in my situation to add to my routine??

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    I am concerned that you have foot drop as the result of a fracture at T12. This area of the canal contains the nerve structures conus medularis and the beginnings of the cauda equina. It is highly unusual to have a foot drop (L4 or L5 nerve root injury) with a fracture of this area. Did you have a burst fracture that caused spinal canal narrowing? Have you seen someone to look for other causes of foot drop like a disc herniation of the L4-5 disc or foraminal stenosis (see website)?

    Do you have an angulation at the site of the fracture called a kyphosis and if so- what is the measure of the angulation?

    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.
    lip26
    Member
    Post count: 5

    Thank you for responding so quick Dr. Corenman.

    Its my understanding that there are pins are T10, T11, T12 & L1. There was also swelling and bruising of the cord involved.

    A med student explained it like the swelling is blocking the nerve signals to/from the brain. As the swelling goes down I will see improvement…?! He also said that if nerves are compromised at T12, that everything below that is also compromised to some degree…?!

    No doctor has mentioned kyphosis to me, and I have no problem sitting or standing up straight, well except my balance!

    Also, my neurologist recently did an MRI and said that there is healing in the thoracic area, which is great news. How long does the thoracic usually take to heal completely? I have an appt on thurs. to ask more specific questions about the MRI – like if there’s scar tissue potentially blocking signals; how the lumbar region was affected; was there a blood clot; what was injured that caused the foot drop, etc.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    Now I understand. You had a significant fracture of T12 (most likely called a burst fracture) and canal compromise from fracture fragments pressing in the canal. You underwent surgery to correct the angulation (kyphosis) and remove the fragments from the canal. You were left with motor deficit of the L4 or L5 nerve root on one side resulting in a foot drop.

    The end of the spinal cord (where the injury occurred) contains the nerves to the bowel and bladder. Do you have difficulties with those functions?

    You are now about 6 months from surgery. The fusion at the injury level must be healed or close to being healed now. The foot drop could be permanent but it might take another 6 months to know. Make sure that there are no other problems lower in the lumbar spine that could cause a secondary compression to these nerves. An EMG of the affected leg might be helpful at this point.

    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.
    lip26
    Member
    Post count: 5

    I understand that L4 & L5, even S1, control the legs and toes. My Physical Therapist explained to me that even though my injury happened at t12, it makes sense to say that i’m functioning at level L4/L5, because thats where I start having difficulties. I do have trouble with Bladder & Bowel functioning; not as much control, i do have residual urine but my urologist says its not so much that he’s pushing me to cath, as long as I continue to manage going to the bathroom before i feel the need.

    My neurologist did an EMG on both legs and said that I was going to be fine…but to be patient cause it’ll take awhile. I’ll quote him, “You won’t be a tennis star or anything, but you’ll be able to do mostly everything as before”. Do you recommend another EMG at this point? When I told the surgeon I had an EMG, he asked why because we already knew that the nerves just need to regenerate…!!?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    The injury was at T12. The bowel and bladder injury makes sense as this is the level of the conus medularis which is the “nerve center” for the bowel and bladder. The fact that you have a reasonably functioning bladder is wonderful and you dodged a bullet with this injury.

    If you have an intact gastroc-soleus muscle group (the calf muscle- meaning you can walk on your tip toes without heel drop), this means that the S1 nerve is functioning well. Why the L4 or L5 nerve would be damaged but the S1 nerve right next to these nerves would be intact is an unanswered question. There are always unusual injuries that can’t be explained well and this most likely is one of them.

    The EMG can determine if there is active denervation (possible continuing compression and nerve injury) vs. chronic denervation. I have to assume that the neurologist found only chronic denervation. I also assume the lower lumbar spine was imaged to make sure there was no lower spine disorder (HNP or fracture) that could also cause the L4 or L5 radiculopathy.

    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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