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Leg pain following a L4/5 and L5/S1 TLIF (lumbar interbody fusion)

4 replies

Jules2 · 28/06/2017 18:00

I am 55 yrs old and in Dec 2016 had a lumbar interbody fusion to resolve or reduce fairly severe back pain - this involved placing 2/3 screws and cages in between the vertebrae to decompress the area. I am overweight but reasonably fit and the op went well. However, I woke from surgery with excruciating left leg pain - like the worst cramp you could imagine (I'm sure I was shouting for help!) - and was given Morphine. Spent 5 days in hospital with on/off left leg cramping and numbness in left foot. Given Gabapentin in hospital and on discharge - but on review in January it didn't seem that was helping much so the registrar advised weaning off it. Tests showed no nerve damage but some possible 'stretching of the nerve' and the screws and cages were not pressing on any nerves. 6-7 months post op my back pain is on a scale of 0-2 (much improved) but my left foot and lower calf are much the same - a mixture of numbness and tingling, cramping which can be severe, my 2nd and big toe feel like they are inseparable and I have a hammer toe developing which I believe is due to the fact my big toe has little movement. I can walk around OK but if I do too much I feel more pain subsequently. And I don't trust my left leg not to buckle somehow so tend to go slowly up and down stairs. In sum, I seem to have swapped one type of pain for another and the doctors I've seen since the op have said it's an unusual outcome (but not rare) and may or may not resolve by itself. I have googled and found plenty of anecdotal evidence (mostly from the US) that it happens more often than not with various outcomes. I'm wondering if anyone has had a similar experience - in the past or ongoing - and can give me any advice or information. I'm due for review again in December but if the problem hasn't resolved by then I don't know what's next.

OP posts:
Hotbot · 28/06/2017 19:52

Think if you haven't had follow up scans you need to insist on having them.

Jules2 · 29/06/2017 08:48

I did have a CT scan and nerve conduction study done in December. The CT scan established that the screws and cages were in the right place and not impinging on any nerves. The NCS showed no sign of nerve damage - just some possible stretching of the nerve - they said it might resolve by itself. That's as much as they will do for now. The last registrar I saw wanted to put me on a 1-year review - I insisted on 6 months which will mean 12 months post op. If there is no improvement/resolution by then, one option is to 'numb' the nerve, I believe - replacing pain with numbness. I wonder if that's really the only option?

OP posts:
crashandburnt · 29/06/2017 09:40

I haven't had a fusion but I have had a number of discectomies. Is your nerve swollen? Mine is and I get lots of
The symptoms you describe. You may do well to go for the injection to give your nerve more time to recover. Everything is very close in there and a leakage of the surrounding fluid can irritate the nerve considerably. I've come off all drugs now as they don't really help and just leave me feeling woozy. I manage by not doing too much which is a rubbish solution. I'm nearly a year on from my last surgery and it is getting slowly better. It's a long process though. Are you seeing a neurosurgeon?

crashandburnt · 29/06/2017 09:42

Also I think you need MRI not ct. maybe
Wrong but I have been seen privately and have only ever had mri's.

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