Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Loss of ankle relex following spinal surgery

Forum: Neurology Forum
Topic: Neuromuscular


I experienced loss of left ankle reflex in 1981 resulting in removal of benign tumor from my spine. Then in 1993 I began to experience the same problem. MRI and mylogram confirmed no new tumors, however I continued to loose left ankle reflex and now loss of left calf muscle due to none functioning left ankle. My neurosurgeons diagnosis is scar tissue from previous surgery causing nerve compression. His only suggestion is to live with it! I am 56 and try to remain active, but it is getting more difficult every day. I ask if there is any new method to remove this scar tissue successfully to regain ankle reflex and calf muscle? I understand that scar tissue may again appear, but 10-15 years of ankle reflex and calf muscle would be better than limping around doing nothing. Any comments would be appreciated. Thanks for your consideration.

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The loss of an ankle reflex in itself is not odf any significance if it is
not accompanied by any functional defecit, frequently there is no return
of ankle reflexes after surgery (despite full functional recovery )and the
reflex is absent in large numbers of
people over the age of 60 in any case.
The loss of the ankle reflex is however of significance if it is a marker
for worsening nerve compression and is accompanied by clinical weakness as in your case.
It is very possible that this nmay be due toscar tissue but this should be
documneted by an MRI scan of the lumbosacral spine and ideally an EMG to
localize the problem and exclude any other cause for the weakness and
loss of reflex.
In looking for help with this, you should focus on functional recovery of
the calf muscle as an end-point and be very aggressive in pursuing this,
I would suggest a second opinion with MRI and EMG to find the underlying
cause.
The ankle reflex may never recover so I would concentrate on functional recovery.



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