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Neurology (Expert Forum)
Re: Nerve Damage - Over 2 years and Getting Worse
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Re: Nerve Damage - Over 2 years and Getting Worse
by Kristy__0__0, Jan 01, 1995 12:00AM
Posted By Kristy on July 07, 1999 at 09:19:08
I had a C-Section over 2 years ago where I was administered a spinal
(not an epidural). This was the nurses first time doing a spinal and
long story short - over 8 tries later, it finally took. I noticed
that when the spinal was wearing off, my leg and toes were still numb
as if the numbing medicine was still in me. I have had 3 MRIs which
have come up fine and only 1 out of 3 EMGs came up positive.
I do not feel anything on the bottom of my foot or my first 3 toes.
My knee down and knee up is numb with hot/cold, tingeling sensations.
Up until a year ago, I had no pain, but I now have debilitating achy
pain. It starts as a lightening strike pain and ends with what I call
a thunder storm - where the pain hits certain unknown points in my
leg and foot. I was recently referred to a physical therpaist again
who told me that it felt as if my muscles and tendons in my back
were swelled. They put me in traction and did
I had a C-Section over 2 years ago where I was administered a spinal
(not an epidural). This was the nurses first time doing a spinal and
long story short - over 8 tries later, it finally took. I noticed
that when the spinal was wearing off, my leg and toes were still numb
as if the numbing medicine was still in me. I have had 3 MRIs which
have come up fine and only 1 out of 3 EMGs came up positive.
I do not feel anything on the bottom of my foot or my first 3 toes.
My knee down and knee up is numb with hot/cold, tingeling sensations.
Up until a year ago, I had no pain, but I now have debilitating achy
pain. It starts as a lightening strike pain and ends with what I call
a thunder storm - where the pain hits certain unknown points in my
leg and foot. I was recently referred to a physical therpaist again
who told me that it felt as if my muscles and tendons in my back
were swelled. They put me in traction and did
Doctor....could you please translate the results of this MRI...I have been diagnosed (6/25/98)Residual Cauda Equina and Chronic Radiculopathy (based on this MRI and neuro exam)....this is following surgery in 98 for L4-L5 disc herniation w/right foot drop and bladder problems....surgery was Microdisectomy, Spinal Decompression and Laminectomy....the report reads...
History: Post Op. Recurrent low back and right leg symptoms.
Findings: The lumbar spine was imaged in the sag. and axial planes pre and post contrast util. T1 and T2 weighted sequences. Comparison to prior exam of 5/11/98 (which state DDD, spinal stenosis, moderate arthosis...and large median to paramedian right herniated disc...extruded fragment could not be ruled out....(I waited for 5 months before going to the Dr...when I did it was consider an emergency from the Cauda Equina)...myelogram was done and the compression to the nerv root was so severe that after 20 mins in the CT Scan....I was pulled out and told to sit up for 5 mintues and turn over twice....the dye was not able to get past the herniation.....back to the report...
The conus is normal. Bone marrow is intact and the alignment of the spine is anatomical. Disc spaces are normal down thru the L3-4 level. At L4-5, there are post operative changes observed. There is enhancing epidural fibrosis seen in the ventral and right lateral aspect of the spinal canal. This extends to and involves the origin of the right L5 nerve root. There is no evidence of disc recurrence. Defect with the posterior dis annulus is seen and there is enhancing epidural fibrosis/granulaiton tissue which extends into the central aspect of the L4-5 disc space. There is no evidence of frank discitis. The L5-S1 is unremarkable. There are some reactive changes in the marrow of the L4 and L5 vertebral bodies adjacent to the L4-L5 disc space. IMPRESSION: Post operative changes at L4-L5 with evidence of enhancing epidural granulation tissue/fibrosis. This especially involves the origin of the right L5 nerve root. .....corralte for a right L5 radiculopathy...My question is...will this continue to get worse...my neuro did not want to do surgery now..mentioned fusion in the future....so is this scar tissue excessive and causing my severe back pain and right leg weakness/pain...newest thing is my quads seem to be getting weak again...my knee & ankle reflex in both legs, but especially the right were very diminished on exam....neuro said I will never be able to sit more than 20 minutes...and have to take pain meds, muscle relaxants and arthitis meds for life...I am 43 years old...my neuro is great...but I don't think he is wanting to explain the full reality of this injury...and God Bless him for his compassion and not wanting to "plant a seed"...but I need to understand and plan accordingly...and not be kept in the dark...I wear an AFO and use a cane...which he does not want me to use...wants me to remain as stable and upright as possible...please give me the honest truth...I can handle it...thank you
Dear Diane:
Sorry to hear about all your back and lower extremity problems. What the exam is basically saying is what you already know. You had a pretty severe disc herniation which compromised the spinal cord. This cause your symptoms. The surgery corrected the disc, fused the degenerating vertebrae and prevented the problem from getting really bad. However, it sounds like the surgery limited the progression but did not provide alot of relief. This is what we see alot with problems like you had. I am so sorry. The surgery changes that are described such as scar tissue can produce added symptoms by the constriction of nerves. This is what it sounds like what your having. At this point, it is vigorous rehab, proper PT, and medications. It is likely that you will have to live with some pain. Much research is going into periperal nerve pain and hopefully some break throughs are in the future (soon we hope). I really hope that you find relief for the pain. It is of utmost importance that you do everything you can to keep stress off the lower spine (abnormal weight and gait or mechanical stress). That is why PT and rehab is so important. Hang in there. I wish I could tell you better news.
Sincerely,
CCF Neuro MD
Follow Ups:
Re: Nerve Damage - Over 2 years and Getting Worse Diane E 7/18/1999
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Nerve Damage - Over 2 years and Getting Worse CCF Neuro[P] MD, RPS 7/20/1999
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