EMG results

Hopefully, the 3rd time is the charm….I have posted this twice.  The first time it was moved to the general forum and the second time it just disappeared.  I am having such a difficult time trying to get someone to make sense of my EMG/NCS results. My OS referred to my report as “gobbelty gook” but said it looked better than the previous and was elated with the progress.  My PT however, sees it much differently. When I had my original EMG/NCS performed in Dec all medical professionals told me that in subsequent studies, we would be looking for axonal sprouting or regrowth, indicating that the nerve was regenerating.  I have an appt with a neurologist, but it isn’t until the end of Sept.

Because I want to give you the results to both EMG/NCS and because there is a maximum number of characters, please finish reading my post in the comments.  Thank you in advance for any insight regarding my tests.  I’m 10 months s/p my LTKR and am wondering how much longer I have until I stop healing, and it is what it is.  

I am a 45 F s/p LTKR 11/11/10. Also s/p ACDF and cannot undergo MRIs

LTKR-Spinal epidural, tourniquet used. No femoral block. Tourn 101 mins. Complicated postop

EMG/NCS 12/20- L femoral neuropathy proximal to motor branch of iliopsoas; w/ appr 50% motor axon loss to vastus medialis. Evidence of L focal femoral mononeuropathy of L iliopsoas, vastus medilis. Clouded somewhat by abnormalities thruout rest of L lower limb and in R. Side to side CMAP amplitude comparisons of vastus medialis from the femoral nerve indicate appr 50% motor axon loss

Possible L&R L5 or S1 radiculopathy, plexoapthy, cannot r/o L lumbosacral panplexopathy

Impression – L femoral neuropathy w appr 50% motor axon loss to vastus medialis. No current evidence of axonal sprouting/regrowth

CT myelogram WNL

2/22 MUA. ROM 110 in OR. In am I was 85. Discharged home on CPM. Today ROM 60 degrees, 80 w help

(Cont’d in the first comment)

[Frustrated_in_NY]

EMG/NCS 8/2/11- L femoral neuropathy. Evidence of L sided focal femoral mononeuropathy as shown by abnormalities on EMG of vastus lateralis & decreased L femoral CMAP to vastus medialis compared to R. Improved since previous study, no longer are abnormalities seen of iliopsoas or vastus medialis. No evidence of wide highly polyphasic low amplitude nor high amplitude MUAPs to suggest axonal regrowth or collateral sprouting.  May be normal motor units seen are evidence of mature axonal regrowth & may account for decreased abnormal spont activity. Side to side CMAP amplitude comparisons similar to previous study. Saphenous SNAP appr 50% amplitude on contralateral limb showing evidence of sensory axon loss

No longer evidence of L lumbosacral radiculopathy or plexopathy

Impression: Test shows evidence of some improvement. There remains a significant decrease in amplitude in the motor study to the vastus medialis compared to R. This can be due to both neurogenic & disuse atrophy or a combination

Thank you again for any help you can offer me.  I'm 45 and walk with a crutch which protects me from falling because my leg is very weak and gives out constantly.  I only have a max of 80 degrees flexion (about 60 on my own just bending it) with my foot braced against something.  I've been in PT since the surgery.  I'm in real estate for a living and this has hugely impacted my work life as well.  When I sit for longer than a few minutes, I get a sharp pain that starts right in the  middle of my butt and travels to my knee and below.  I take Percocet for pain, but just an amount to "take the edge off" and muscle relaxers at night.  I'm never without pain... both neurologic and orthopedic pain.  The latest issue is sharp pins & needle feeling in my left big toe - the rest of my foot is fine.

No one knows if it was the tourniquet that caused the issue or the spinal epidural anesthesia.  I'm confused and can't seem to figure this out, in spite of the numerous MDs I have seen.  Thanks again for any help you can offer.