By interpretation of your films and history, you had a degenerative spondylolisthesis of L4-5 with spinal stenosis. You underwent a typical posterolateral fusion with a central decompression of that level with what sounds to be very reasonable results.
“Tightness and spasm” of the dorsolateral thigh can have many potential origins. Of course one could be nerve root irritation and the fact that this new symptom occurred immediately after your surgery leads to the suspicion that it could be from nerve compression after surgery.
You underwent an epidural steroid or foraminal steroid injection in 2008 without any relief. The most important time to record relief after the injection would be the first three hours (when the anesthetic is working). If you remember back to the first three hours and no relief was afforded you in this time period (assuming the injection was placed in the correct location), then your pain is not from the nerve root injected.
Burning pain that is bilaterally equal is more concerning for peripheral neuropathy. See website for description of that disorder.
“Tightness and spasm” of the dorsolateral thigh could also originate from hip disorders. I assume you have had a pelvis X-ray. If not, that would be the next step. Trochanteric bursitis could also cause these symptoms. Deep palpation of this region could reveal the presence of this disorder and a simple in-office injection could resolve it.
Yes-a foraminotomy could still be performed after a fusion of this level. I would be happy to review your films. Please call the 888 888-5310 number.
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.