It is relatively unlikely that you have sustained a spine fracture, but there is a reasonable chance that you have a lumbar disc herniation. The fact that you are unable to move your foot may indicate significant nerve compression that requires medical attension sooner rather than later. Your doctor may order an MRI study to confirm the diagnosis and to make definitive treatment recommendations. If you cannot make an appointment today, you should probably present to your nearest emergency room.
I am in complete agreement with the recommendation by Dave. Your neck pain is now considered chronic, and may or may not be related to your sinus infection. Please find a clinic in your area and seek medical attention, at least to reasure yourself that other than your symptoms, there is no underlying spine condiiton that requires intervention. I wish you all the best.View Thread
Your concern is certainly understandable, though it would be rather unusual and difficult to explain sexual dysfunction in isolation, resulting from a lumbar epidural steroid injection. That being said, I do not have any information about other potential symptoms such as increased leg pain, weakness, or groin numbness, or bowel and bladder dysfunction, all of which could represent a rare complication called Cauda Equina Syndrome. Though the likelihood of Cauda Equina as a result of an Epidural Injection is very rare, and unlikely based on the limited information you have provided, there is no question that your doctor would want to examine your husband to rule it out and reasure you. Once you have ruled out Cauda Equina Syndrome you will most likely find that your husbands sexual dysfunction symptoms will gradually improve. In conclusion, your husband is obligated to open up to his doctor and tell him all his symptoms including intimacy issues - it is in his best interest.View Thread
The majority of patients with severe symptomatic stenosis such as you may have at L4-5 do not require a fusion. Surgery which is typically indicated as a last resort after failure of non-operative interventions (therapy, medications, epidural injections, etc) usually involves a decompression. This procedure can often be done minimally invasively and as an out-patient procedure. The use of a Laser is most likely irrelevant in this case, though Endoscopic decompression might be appropriate depending on your specific condition. Regardless of technique, in general, you have to remember that surgical intervention for stenosis is more predictable for relief of your lower extremity pain and somewhat less predictable for relief of back pain. If a surgeon recommended you to have a fusion operation based on your specific diagnosis, it would be very reasonable for you to obtain a second opinion before proceeding.View Thread
As a spine surgeon, it gives me great joy and satisfaction to read your story and that of others who have had sucess with spine surgery. As we all know, spine surgery can be very challenging not only from a technical standpoint, but from a patient management standpoint. Cases in which patients report less than desired pain relief despite a technically successful surgery are equally frustrating for the surgeon as for the patient. Therefore, cases such as yours serve to reasure and encourage us to offer spine surgery to patients who seek a last resort option after failing all other treatments. Thank you!!View Thread
You are currently only one month out of a 2 level instrumented spinal fusion. I am in agreement with the other respondents that based on your description of your activities, you are overdoing it particularly in terms of activities requiring lifting and bending. Furthermore, you seem to have a somewhat unrealistic expectation as to the time frame for recovery. You have to understand that the fusion needs months to heal. In the meantime your best activity is walking until your surgeon will stary you on a physical therapy program. I tell my patients that I would like them to increase their walking after surgery so that by 3-6 weeks post surgery they are able to walk for a full mile. I recommend minimal lifting and repetitive bending at this state particularly since these activities clearly worsen you symptoms. On the positive side, it is very unlikely that you have dislodged or loosened your implant and screws, and therefore it is unlikely that you will have long term consequences to your over activity at this point. Your surgeon will most likely obtain Xray or other imaging studies on your next follow up visit to confirm stable position of all hardware. I wish you a speedy and full recovery.View Thread
From your description it sounds like you may have a partially sacralized lower lumbar vertebra. First, be reasured that this is not a dangerous condition. As many as approximately 5% of the population have a transitional vertebra and in most cases this represents an asymptomatic incidental finding.
Given your occupation as a CNA, it is possible that due to the functional requirements of your job which may include repetitive bending and lifting, you are at a higher risk for developing chronic low back pain. This does not mean that your job is causing you any structural demage, but it may mean that in the long term you may be better off finding an alternative occupation with reduced functional requirements.
I think your best next step is to see a spine specialist who may refer you to a good excersize based physical therapy program. Such a program can be helpful in teaching you an escersize routine for stretching, strengthening, general conditioning, and lifting and bending mechanics. Good luck, and keep us updated.View Thread
In general, peddicle screws are intended to go threw the pedicle and into the vertebral body. Despite our best efforts as surgeons, and even with the use of fluroscopic and other imaging guidance and neuro-monitoring, a small percentance (typically <10%) of screws do not have a perfect trajectory on post operative CT scans. Fortunately, in most cases, that does not mean that they need to revised. As long as the screw gets sufficient purchace in the pedicle and does not compromize the canal or the actual nerve root, or a major blood vessel, it will do its job.
In your particular case, your surgeon will review the CT scan in the context of your left lower extremity symptoms and clinical exam. He or she will determine whether the location of the screw is clinically relevant to your leg pain. In other words, it is possible that despite sub-optimal screw position, the position of the screw does not explain your symptoms, and no intervention is indicated. In rare occasions, a mal-positioned screw may be the cause of nerve irritation and in these cases the surgeon may sometime consider removal or re-positioning of the screw. Please review the CT scan with your surgeon and I am sure he will provide you with a more specific answer pertinent to your case.
I wish you all the best, please feel free to update us.View Thread
More typically patients who had a lumbar decompressive laminectomy with fusion report improvement in their lower extremity symptoms before they report improvement in their back pain. I therefore tell my patients that the predictability for success with this operation is higher for relief of lower extremity pain with standing and walking than it is for relief of back pain. In your case your experience is somewhat atypically the opposite. Though I am pleased to hear your back pain is much improved, it appears that you are still having significant claudication symptoms affecting both your lower extremities. I agree with your surgeon that nerves may take long to recover after chronic compression, and unfortunately, sometimes permanent nerve demage can presist despite an otherwise successful decompression. Nevertheless, at 9 months post surgery consideration can be given to obtaining updated images (MRI and/or CT) to look for compression at the operated and possibly other levels. Other underlying causes of lower extremity claudication should also be reconsidered such as vascular causes, for example. I am confident your surgeon will perform the appropriate workup. Don't be discouraged and I hope you will continue to progressively improve.View Thread
Though the MRI report points out to multiple disc herniations and other abnormalities it does not appear particularly concerning in terms of stenosis or instability. However, the interpretation of the study is meaningless without:
1- Your surgeon looking at the actual images 2- Your surgeon interpreting the findings in the context of your history, symptoms, and clinical examination.
Please make sure to bring the actual images to your surgeon or pain management physician on your follow up visit.