Iliotibial band syndrome s/p SI fusion and piriformis release

[pinballgal]

I had bilateral SI fixation with right fusion in 2006. This somewhat improved my severe SI instability but led to piriformis syndrome. I had sciatic decompression on the right with piriformis release in 2007. Three weeks post-op I developed severe pain in my outer thigh that ran from my outer hip to just below my knee on the right side. It progressed in the following weeks to the left side as well. The leg pain and tightness causes my toes to go numb. EMG results have not showed anything significant. I have had hip MRI and X-Rays that showed nothing abnormal. It was diagnosed by one orthopedist as iliotibial band syndrome. I have had months of PT, trigger point injections, steroid injections etc. I can not sit, stand or walk for extended periods of time due to pain. The pain is also starting to affect my driving ability. I have trouble laying on either side due to the pain in the sides of my legs. I now use opiates, muscle relaxants, TENS, and a muscle stimulator to function during the day and take care of my family. I went from a medical professional working full time to disabled. Do you have any ideas or do you know what medical community would be best for me to seek help from? I have exhausted all resources in my area and all my local docs, including my surgeon, have thrown in the towel. They are trying to keep ahead of the pain but I am not giving up on a cure. Please know Dr.Rosen, that I did not enter into surgery either time without exhausting all the options I knew of first. Thanks in advance for your time.

[ptcruiser29]

had cervical fusion done in 1998 up untill  this date i have occured so many problems i will start with the  latest MRI states there is no sign of fusion with sagittal T1 w/contrast or without contrast findings C-2 and C-3 levels unremarkable don't quite understand doc be secret about findings. at C4-5 minimal disk bulging. C-5-6 disk protrusion enroachment upon left and right foramen is noted. C6-7  severe enroachment chronic degenerative narrowing spinal stenosis at both C-5-6 as well as C7-T1 slight deformity of the anterioraspect of the cord any suggestions would surgery help please awaitg to here from you soon

[terryterry]

My right SI joint shows severe arthritis and bone spurs on CT.  I have right buttock pain but the main problem is intense burning which goes down the back of my right leg all the way to the foot and cramps in my last two toes of right foot.  I cannot sit, stand, or lay without the burning.  I am told that no one operates on the SI joint.  I have tried steriods without success.  Is there a cure for me?  
Thanks for any help.

[Charles Rosen, MD]

Dear Mikie,

Wow.  The question is whether it’s related to compression that occurred on the spinal cord, in which case you should also have some leg or arm symptoms, or if it’s a separate problem that just came to light because of surgical stress.  Maybe you need to go to a doctor in the nearest big city for another opinion, where he doesn’t know any of your doctors.   You need a diagnosis.

Dr. Rosen

Charles Rosen, MD
Clinical Professor of Orthopaedic Surgery
Spine Surgery
University of California, Irvine, College of Medicine
Founding Director, UCI Spine Center  
Orange, California

[Mikie007]

Dr. Rosen,
I had cervical neck surgery 3 months ago. After surgery, there was no desire or feeling to poop. The MRI at fist showed full colon and intestines, then after about 30 days, nothing was still working and then we went to the hydrocolonics clinic and had everything cleaned out. Since then, nothing has happened, 100 days with no BM. I have to go to the Hydrocolonics clinic every 3 days now to get cleaned.  They tried everything form Reglan to you name it. THe doc who did the surgery will not talk or answer any questions, we found out that I had stopped breathing several times after the ventilator was removed in the OR. Then when I was finally breathing again after the crash cart came in 3 times, the doc ordered the recovery room anesthesiologist to give me 10 mg of Valium and 160 mg of Oxycontin.  No one knows what's wrong and I have been passed to 7 doctors now. All everyone seems to care about if I am suing the doctor who did the surgery.  Is there anyone who knows what this is??? I was 100% fine prior to surgery.

I was also given Reglan during surgery, and I had no problem for that medication.  

[Charles Rosen, MD]

Dear Pinballgal,

Main thing you need is a diagnosis.  It doesn’t sound like you have one.  
I can glean only a few things from what you say.  Firstly, it does not sound like IT band syndrome since it’s bilateral, and it’s still there despite reduced activities. Secondly, it sounds like you need an MRI of the lumbar spine.  Your symptoms are suggestive of an upper lumbar disc herniation or stenosis by the pattern of pain and weakness.

A last thought would be to make sure a CT of your SI joint fusions – which are unusual to do – are in fact fused and not a painful non-union.

Hope this helps.

Dr. Rosen

Charles Rosen, MD
Clinical Professor of Orthopaedic Surgery
Spine Surgery
University of California, Irvine, College of Medicine
Founding Director, UCI Spine Center  
Orange, California

[Mikie007]

Hi, MRI's and older CAT scans do NOT show nerve or nerve root impingements all the time.  You need to get under the 64 slice MRI that just came out, they can detect a pin point on your spinal cord. My MRI of my neck showed nothing, when the surgeon went in he found 3 ruptured disks and one embedded into my spine causing a U shape of my cervical spinal cord. Post surgery trauma is very common, you should take it easy once again for a few weeks, maybe your being too active too soon? You may have permniment nerve memory damage too.