A-typical Lhermitte's Phenomeon with prior lumbar fusions

[Christina31]

I had a slip/fall and ended up with 6 lumbar surgeries, most recent fusion L3-S1.  Later I ended up being in a slow speed car accident, causing neck pain/ tingling in my arm.  MRI showed small rupture to C5-6, no compression.  That was 2004.  So I was put on some powerful opioids (chiefly for the lumbar issues), Neurontin, Skelaxin, and IBU.  I had less back pain and little pain elsewhere with the medications.

Following this surgery, my back pain is mostly gone with some residual pain, i.e. muscles are weak, nerve damage.  In May I asked to go off the opioids.  I noted about a week later that my previous neck issue returned (?meds keeping pain under control).   I did have a neck injection back in ’04 and asked to have that again.  May ‘07 Getting prepped for the injection, felt pressure from the lidocaine and suddenly (when steroid needle injected) my entire body went numb and couldn’t move for a 2-3 seconds.  I was helped off the table my legs were numb and I was white as a ghost.  Now, with neck flexed I get the sensation electricity down my legs, searing pain in my peri-area.  I also lose the feeling in my right leg, which, if I am not paying attention, has caused me to fall.

Since that time I’ve been a mystery to the neurosurgeon and neurologist.  I’ve had many MRI’s.  The C5-6 disc is about a mm from the cord, but no compression noted.  They think it’s Atypical Lhermitte Phenomenon (caused by trauma) however baffled because the  symptoms are from the waist down, when in most cases it is neck down.  I am in PT and OT, looking at assistive devices. I hope you can suggest something that I should do, my doctors said I should seek out someone else’s opinions, maybe what I have is something entirely different, or something some doctor somewhere has seen before and knows what to do to treat it.  Would a discectomy or fusion at that level help?  Is it possible that when my head is in flexion it causes just enough pressure on the cord to cause problems?  

[Stephen Ryu, MD]

You mention that you have had 6 lumbar operations. You should avoid any more surgeries if possible.

I don't know what happened to you when you had the injection and afterwards. It is very strange. Was there a complication with the procedure? Did your cord or nerves get injured - if so, the injury will take time to heal. Were your nerves clumped because of arachnoiditis and they bundle got accidentlly injured? I can only speculate.

Assuming your MRI are more or less normal looking given your surgeries, have you had a myelogram to look for scar tissue along the spine cord? I would not touch the neck unless there was good correlation with your symptoms. I agree that Lhermitted usually goes down from the level of injury hence if the neck from the neck down. As your symptoms are in the legs I wonder if you have a lumbar problem.

[Christina31]

I guess no one else out their has any clue either?  Not even Dr.Ryu?  Someone must have heard of this...or have some suggestions for me.