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Neurology (Expert Forum)
Post-laminectomy lower leg parasthesia
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Post-laminectomy lower leg parasthesia
by david, Jan 07, 2000 12:00AM
I am a 41yo male who had an L5-S1 laminectomy in August '99. I still have numbness and weakness in the tibialis anterior and extensor digitorum muscles in my left leg. I am normally very active, having run a marathon last June. I have been able to resume limited running, 15 to 20 miles per week. I have to be very careful though, because my left foot "dangles" and I have tripped. My neurosurgeon initially said I should be able to run marathons again, just more slowly. I'm beginning to question that. My questions are: (1) How much more improvement in this parasthesia can I expect? It seemed to improve noticably during the first six weeks post-op; now at five months post-op, monthly change is almost imperceptible. And (2) are there therapies that could help? Does exercise help? The muscles described above actually feel weaker after running, and there is some pain then - does exercise hurt? Someone has suggested accupuncture for parasthesia; has that proven successful? Thank you.
Doctor's Answer
by CCF Neuro[P] MD, RPS, Jan 07, 2000 12:00AM
Dear David:
It is difficult for me to tell you any sort of prognosis I haven't seen the images, done the exam, and have access to the surgery. Your symptoms fit the type of lesion you have and the location of that lesion. Has your foot drop gotten any better? You will have to be very careful when you run because the foot drop can cause problems with pot holes, etc. Alot depends on how bad your lesion and nerve damage was prior to surgery. If it was extremely bad (yours sounds that it tended to be in this direction if you had foot drop), then recovery will take time and 6 months is still in the early stage. The outer limit for nerve regeneration is 18 to 20 months. Also, one has to be worried about if the surgery did some damage, but the early improvement would suggest against this. Rehab is so important in spinal surgery cases. I would take to your rehab specialist and see what they have to say. I would be very careful about axial load (bad lifting technique, uneven surfaces to run on and even hard surfaces, heavy lifting, etc). You may want to see if your neurosurgeon has any suggestions at this point.
Sorry the advise is so iffy and fragmented. It is just difficult to tell you anything being so far out of the loop.
Sincerely,
CCF Neuro MD
It is difficult for me to tell you any sort of prognosis I haven't seen the images, done the exam, and have access to the surgery. Your symptoms fit the type of lesion you have and the location of that lesion. Has your foot drop gotten any better? You will have to be very careful when you run because the foot drop can cause problems with pot holes, etc. Alot depends on how bad your lesion and nerve damage was prior to surgery. If it was extremely bad (yours sounds that it tended to be in this direction if you had foot drop), then recovery will take time and 6 months is still in the early stage. The outer limit for nerve regeneration is 18 to 20 months. Also, one has to be worried about if the surgery did some damage, but the early improvement would suggest against this. Rehab is so important in spinal surgery cases. I would take to your rehab specialist and see what they have to say. I would be very careful about axial load (bad lifting technique, uneven surfaces to run on and even hard surfaces, heavy lifting, etc). You may want to see if your neurosurgeon has any suggestions at this point.
Sorry the advise is so iffy and fragmented. It is just difficult to tell you anything being so far out of the loop.
Sincerely,
CCF Neuro MD
