After Cauda Equina Syndrome

[Dr_Bas]

Hello

I am medicine doctor from Syria

I just want to ask you something about my father's case

My father is intrnal medicine doctor too ... he got brucillosis from about 4 years and he cured from it from about 2 years
after that he got pain in his back & both legs wich inreased gradually ...he did an X-ray,CT & MRI to his vertebrae wich showed severe degeneration of his vertebrae... we accepted that it was a reactive arthritis wich came from brucillosis
he got many analgesics & as he is an internal medicine doctor he refused the surgery
from about 8 monthes he noticed a change in his urination & sexual activity & the pain increased so much... & here the neurosurgeons told him that he had Cauda Equina syndrome
here he decided to do the surgery from 7 monthes & the surgeon told him that the operation will be after 5 days
before the operation by 1 day he got an emergency acute attack ... as he dropped on the floor & couldnt control his urination or legs with severe pain
he went to the hospital for emergency surgery of Cauda Equina Syndrome here in Syria
the operation got about 8 hours by removing the narrowing of the vertebrae & putting palates in the L3 & L4
after the operation the pain in his back removed ... but the pain in his legs has changed in nature ... as he felt paraesethia with pain in his toes & sole of his feet & unable to walk or control his urination or defecation.. & he got back to home with physiotherapy & catheters
after 3 monthes of surgery he could control his urination & defecation & could walk with the walker but he still felt pain & paraesthiae in his both legs
after 6 monthes his walking improved well & could walk with a cane... but the pain & paraesethia was still present
after 7 monthes & now ... he can walk with a cane & can control defecation & urination ... but he is still unable to make a sexual activity even with Viagra & still feels pain & paraesethia in his legs that make depression to him
I want to ask you ... is this normal ? even after 7 monthes ?
he is now very depressed & thinks that he will never get off from his pain again ... he gets many medication as Pregabalin & NSAIDs that just decrease the pain... is there any hope for him to get off from his pain ? & is there anything to do with the physiotherapy & analegesics to stop the pain ?
thank you

[mystisfied]

I had Cauda Equina Syndrome 3 years ago which required emergency surgery. After much physiotherapy I went from a wheelchair, to a walker, to 2 four-pronged canes, to 1 four-pronged cane, to 1 regular cane, to walking on my own. Although my improvement has been amazing I still have much pain in my hips, legs and feet. I was told that it takes 2 years for complete healing so perhaps your father will continually improve. Best wishes.

[Dr_Bas]

thnx very much mystisfied ... i just want to ask how could you tolerate the pain & paraesethia ?

[mystisfied]

To be honest I think I just came to terms with having the condition. I was so focused on fighting to be able to walk again that I accepted that pain was going to be part of the equation. Pain is a daily reality for me now, when it gets too bad I take medication for it. It's important to keep moving too. I'm taking Gabapentin for the neuropathic pain and it helps.

[Dr_Bas]

thnx again mystisfied ... yes gabapentin is the best for him till now

[kay290]

From my research, the longer you delayed surgery the greater the liklihood of permanent damage.