foot drop after L4-S1 fusion

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wxKathy2

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Hi All,
I wrote before about my hubby and his waking up from surgery with foot drop in his left leg...they thought it was damage to the leg, but an EMG shows now that it is in fact his back at L5....Has this happened to anyone else? Did it heal? He cannot walk without the walker at 4 weeks out...he is getting some pain relief already in the back however, which is good, but we are very worried about this foot problem (he cannot raise his left foot toward his face) therefore, it is very difficult to walk and he cannot walk normally so it's hard for him to make good progress in his healing....also he is starting to compensate and developing some weird hip pain....they are going to try another steroid injection at L5....we'll see....I would be grateful to hear from anyone who had this happen to them and had it heal - i know nerves can take a very long time to get better...(also they did a CT and MRI the day after surgery to make sure no hardware was on the nerve)
Thanks all and best wishes to everyone....
Kathy
 
Kathy,

Although I haven't actually heard of this happening to someone, I know I've read that it is one of the rare possibilities of what can go wrong during a back surgery. I'm really sorry you and your husband are having to go through this.

Four weeks post-op is very early in his recovery and I'm sure there's still a great deal of inflammation in there right now. The inflammation should improve quite a bit during the next several weeks for him, and the injection should also help. It would be unlikely that the surgeon nicked or cut the nerve at all, but the surgeons often use tools to lift the nerves out of the way when doing surgery, and the surgeon may have irritated the nerve during the surgery by doing this. It's also possible the nerve may have been hit or smashed somehow when the work was being done and is now bruised really bad. There are web sites where you can watch an actual fusion being done, so if you're curious you can search for one of these and watch it.

I am now 10 weeks post-op from a fusion, and have healed quite a bit from the surgical pain since 4 weeks post-op; however, I am still having severe sciatica but not foot drop. My surgeon told me it could take 1-2 years for the nerves to heal and for me to notice major pain improvement.

Unfortunately, since your husband has already had surgery it would be extremely difficult to find another spine surgeon that would give you a second opinion at this point. If he doesn't improve some in the next month it might be worth a try to see if you can find another spine surgeon to review his information. It would be best, though, to work with the surgeon who did his surgery to try to find a resolution to this. Most spine surgeons really do care about their patients and want to see them recover to the extent possible. Be sure to be assertive with his surgeon and don't take anything less than progress for an answer.

Be sure also that your husband stay active to the extent possible. You don't need to have muscle atrophy and weight gain compound his problems in the days ahead. There are lots of upper body exercises that can be done with some light hand weights, and lots of leg exercises you can do while sitting. Of course get the okay from his surgeon before attempting any of these.

Warm wishes for the days ahead, and again I'm very sorry you are having to go through this difficult time mentally and physically.
 
Hi Brenda,
Thanks so much for your reassuring reply....yes our NS is very concerned for my hubby and wants to make things right - I don't think anything like this has ever happened to him in his career....he is visibly upset about it and has been consulting colleagues and researching....

He did tell us he used the nerve monitoring system during surgery that will set off an alarm if a nerve is being stretched too far...he said no alarms went off during the surgery....but he did say the nerve could be aggravated certainly....He also told us it could take months to years even for it to heal....my main concern is that he is not able to walk normally and has already developed a "lift hip" gait which I am certain is not good for the healing fusion in terms of having a asymmetric gait....we will be talking with the doc about this today....
I'm glad you are 10 weeks out! :) My hubby is very lucky he has an extremely high pain tolerance and yesterday he said he has "no back pain" and he is essentially off all pain meRAB but tylenol! I think his back is so much better already that he is forgetting and bending and twisting and moving more than he should - the NS did not want him to wear a brace but he may need one now just to remind him not to do those things....it's too early for bending and twisting isn't it? at 4 weeks?

He has been watching his eating very carefully and has actuallyl lost weight since surgeyr so that is good since he needed to lose some anyway....but he is not able to be terribly active in his walker - thanks for the suggestions of exercise - I will bring it up with the doctor this afternoon....

Thanks for telling me the inflammation shouldn't be gone yet....I did not know how long and the NS doesn't want him taking any anti-inflammatories too - so it makes sense it could still be quite aggravated....I think it was pinched too - and I've read that sometimes when a pinched nerve suddenly has room again, it can "freak out"....

Thank you so much for writing....we are really upset about this "complication" and the fear he might have to use a walker the rest of his life - but I think it's too early to go there in our heaRAB right? He is 47...I am 44....I have chronic health problems of my own so I worry I am not helping him enough....like with exercise....but we'll get through it....

I wish you pain relief and good success from your surgery!! I really appreciate your reply and your reassurance......I'm sorry you are having to go through this too....I watched my Dad go through it when I was 16.....I am very sorry for your sciatica...I have mild sciatica but I can't imagine what you all go through.....I'm glad you have no foot drop! but it's not easy any way you do this fusion!

Thanks again for your support and warm wishes!! I greatly appreciate it!! :) All my best wishes to you for your recovery and relief!

Take care,
Kathy
 
Hi my name is jack i had foot drop after my surgery . I am 5 months out and i can pick my foot up some now . Tell him to try and look at his foot and tell it to move with his mind . I know this sounRAB fun but it will work . Ask his doctor about a muscle stimulator that has help my with pt. Just tell him to hang in there it will get better. When he first starts to move it it will hurt some. My foot and leg is still weak i have to use a cane when i am out walking. I hope this helps. God bless.
 
My husband had the same area operated on and he was left with a weak right leg. His doctor cut his spinal cord open which was a mistake ...it also cut several nerves so it gave my husband an automatic nurabness to many of his lower areas of his anatomy...and it also made his right leg very weak which has progressed to muscle atrophy over the past 3 years. I am sorry your husband was left with foot drop but something the surgeon did has caused this to happen...if he didn't have foot drop going in but did coming out then something happened. It will be very important for him to get physical therapy to learn how to walk and deal with the foot drop. If he has not gained any use back within 6 months of surgery that will be it and but then he might need some sort of brace to help him walk better. I am sorry he has to deal now with this which will also cause other problems like you have already noted. I wish you all the luck in the world as this will be such a life changing event for the both of you. Good luck.
 
Jack and Ann,
Thank you for your replies...We saw the NS today and he used a nerve monitoring device during surgery to make sure no nerve were being stretched, but even though no alarms went off he admits that hubby's left L5 nerve must have been stretched and even had tears in it to cause the foot drop. He did not have the foot drop before the surgery. Since the NS does not think it's inflammation they are not going to do any steroid shots. Jack your experience at 5 months out is very hopeful for us and Ann thank you hubby is already in PT with electrostimulus adn they are going to send a unit home with us so we can continue at home. He also does the mental exercises all day long even though the foot won't move upward...there are some vibrations. Also the EMG did show the nerve was not nicked, or severed in any way adn is fully intact, thus the doc thinks it will heal - it's a question of time - perhaps up to two years he said....We already have the AFO splint but he is still using a walker...but it's so early - only 4 weeks.

The good news is he said yesterday that his back pain was almost nothing! I don't think he realizes how lucky that is! He is not a patient person or a sit still type - so I just pray he takes it easy and slow enough to preserve that 0-1 pain level - he doesn't know how lucky that it....my father suffers terribly - his fusion fractured a few years back and there is not enough bone structure for them to do anything for him except steroid shots and pain meRAB....I pray my hubby doesn't ever have to suffer the way my Dad has all his life...

One other good thing is that hubby doesn't seem to have pain anymore in the leg with the foot drop -he did have nerve pain at first in the whole leg but it's better now - maybe that's some sign of healing too....

So thank you all so very much for sharing your experiences and hope and I wish you all the very best as well.....

Thanks so much!
Kathy
 
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