[Shirleyv]

#35749

I was involved in a serious fall injury 20 months ago. I was diagnosed with a broken left femoral head fracture, T12 vertebral body burst, fractured L4 and L5. A complete left hip replacement was done. I was fitted with a full body TLSO brace for 3 months. No back surgery was done.

I do have weakness in my back but my primary problem is my walking disorder.

Twelve weeks after the accident, an EMG was done as requested by the surgeon that did the hip replacement. I had a severe limp and he said it appeared that the nerve was not firing the muscle. I can forward a copy of the test results, but the following is a summary:
There is electrodiagnostic evidence of a lower lumbosacral plexus injury preferentially affecting the peroneal/fibular fibers of the sciatic nerve. There is denervation most notably in the fibular/peroneal innervated muscles including the biceps for Morris short head and EDB muscles. But there is chronic reinnervation changes in muscles innervated by the tibial/superior and inferior gluteal nerves.

It was explained to me that there was nerve damage that was causing the gluteus medius muscle not to function. He told me it may heal itself over time but he was not optimistic.

Despite months of physical therapy, and exercises in a gym, there has been no improvement in my limp. I have tried without success to find a neurologist that will review my records to see if anything can be done to help me.

Your article on Walking Disorders (L5 Nerve Injuries) describes exactly the type of limp I have. Further reading on your website indicates that the time has expired for the nerve to regenerate and the muscle to begin working again. If that is the case, is there anything I can do to improve my situation? At this point, I’ll try anything!

The limp is affecting my back and my knees as my body tries to compensate for the lack of the gluteus medius muscle. I’ve read that one can “retrain” their brain on motor skills but where do you find someone that can help you do that?

[Donald Corenman, MD, DC]

#35750

If the nerve to the glut med is “out”, no retraining will help. If it have been 18 months to 2 years without recovery, it is unlikely to return to function. Now, an MRI might reveal continued compression of the L5 nerve and rarely, decompression can 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.

[Shirleyv]

#35762

Thank you for your reply. I was hoping for some chance of regaining a normal walk but you confirmed what I already expected. Thank you again for your time.

[Donald Corenman, MD, DC]

#35763

Thank you, Please keep in touch with further developments.

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.

[Author]

Posts