EMG/NCS

[marci3636]

Over 15 yrs I've complained about lower back pain with numbness alongside left thigh and to left big toe. In 2009 I was finally sent to the spine clinic and was given an epidural injection at L5/S1. Three weeks later I was in pain again. I was the told surgery was my option. In the past I've tried EVERYTHING possible so I received two more epidurals which lasted two months and after 2 different opinions from two surgeons (orthopedic) I had surgery almost 9 months later (nine months of hell and surgery was 3/2010)
I had an anterior and posterior lumbar fusion with peak cage, bone fillers, 2 rods and four screws. Two months after surgery I notice my left thigh was getting numb much quicker than before, a burning sensation and pins and needle sensation in the bottom of both feet. I contacted the surgeon by email who responded with "it was go away or it may not." In October I saw a neurologist who said there's nothing else he can do for me but nerve block, Lyrica, and pain patch.
Was back to see the neurologist for an EMG today and the results are:
Chronic left L5 Radiculopathy
Acute Denervation of Lumbar Paraspinals
My insurance did not approve Lyrica instead they kept me on Neurontin, Vicodin, and a muscle relaxer. I also have IBS and panic attacks.
Can anyone tell me what the results mean?
Thanks
Marci3636

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

The EMG shows that you do have a nerve root compression that is longstanding. This is located at the lower back region (i.e., L5). This may be the area where the herniated disc has been compressing. The paraspinals are muscles in the back that are supplied by branches of the nerves in this region. The acute denervation may be related to the surgery itself. It takes time for nerves to reinnervate muscles. All of these changes can be heard/seen on the EMG screen.

For the pain itself, treatment would include re-operation, chronic pain intervention, rehabilitation, and/or neuropathic medications. It sounds like these have been discussed with you. Gabapentin, or neurontin, is a good alternative to pregabalin, or Lyrica.

You should continue following up with your neurologist. Have you been to physical therapy?

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[marci3636]

Thanks for your reply, the information you provided was clear. I forgot to mention that when I had the spinal fusion I also received a microdiscetomy at L5/S1, I thought the microdiscetomy was to treat the numbness. Am I wrong?