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Old 04-24-2011, 02:14 AM   #1
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severe left leg pain following laminectomy

hello everyone,

I have been following threads in this forum for the past 2 weeks. May I say how much I admire the way you all encourage and support one another. My mother underwent a tripple lumbar laminectomy 2 1/2 weeks ago to relieve severe leg pain after years of crippling spinal stenosis. Immediately following the surgery she has a completely numb left foot. In the past week especially ( 1 week post surgery) she is now experiencing lightening sharp pains shooting down her left leg. Since leaving hospital ( she stayed in for 11 days) she has had no reduction in her pain medication. Hence, she still takes oxyc, endone, a pain patch on her arm and vallium. She is just beside herself. No one can give an answer as to why her left foot is now numb or why she is still in so much pain ( public health patient). She was originally told that she would stay 1-3 days in hospital and would feel immediate relief in her legs. I am just so scared for her. Will she get better?

 
Old 04-24-2011, 09:30 AM   #2
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Re: severe left leg pain following laminectomy

Welcome to the board. Glad you finally decided to join us, but I am sorry to learn of your mother's less than satisfactory results. When I first quickly read through your post, I saw laminectomy, and felt she shouldn't be having all these problems. But on closer reading, I see TRIPLE laminectomy, which raises some other issues that could be problematic.

It gets down to differences in surgical preferences between countries. The US has the highest rate of fusion in the world, for a variety of reasons that are not germane to this post. A surgeon in the U.S. would seldom perform a laminectomy for more than one level, because it often creates issues of instability when that much bone is removed. This can become an issue because it is easier for spinal nerves to get trapped or compressed when there is instability.

I cannot imagine why your mom was in hospital for such a long time. There must have been other complications...that you haven't mentioned or haven't been made aware of. A laminectomy, as spinal procedures go, is a fairly simple procedure, sometimes even done as a day surgery (for one level.) So I can't help but wonder if whatever else caused her to be in hospital for such a long time possibly contributed to the sciatic-type pain she is now experiencing.

With stenosis, the lumbar nerves can be "pinched" for quite some time. It may be that everything went fine and it will just take the nerves a long time to heal and settle back down from the trauma of the surgery.

Did she have this exact same left leg pain prior to the surgery? Or is this new pain, or in a different leg?

One can never say for sure whether nerve pain will lessen or go away entirely. It is one of the remaining "unknowns" in medicine. Has the doctor offered to do a MRI or CT scan to see what is causing the numb foot and leg pain? I would think that would be the next logical step to see if a nerve is still compressed.

Last edited by teteri66; 04-24-2011 at 09:31 AM.

 
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Old 04-24-2011, 10:58 PM   #3
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Re: severe left leg pain following laminectomy

Thank you so much for taking time to write back to me. Essentially, the only answer we were given for the extensive duration of her hospital stay was for pain management and to get her to a point where she was stable enough that she would not fall when using a cane/frame etc. The physio actually wanted her to stay another 2 weeks as an inpatient in rehab, but my mother just could not take it any more. The specialist who performed the op only visited once for 10mins and said that it was all normal and that nerves take time to heal, he did not address the foot drop at all. Physios kept saying the foot drop and leg pain will all return to normal after physio too. 2 days after the surgery the registrar wanted to do an MRI but was overruled by the surgeon ( this makes me wonder what he was trying to avoid). The whole thing is just so awful, all I can do is massage her leg to provide some kind of comfort. I have read through this site for hours in recent weeks and like you said, the procedure itself seems fairly straight forward, so the foot drop and leg pain lead me to believe something happened in surgery although the surgeon was quick to say that nothing went wrong in surgery. My mum did have leg pain ( hypersensitivity then numbness) prior to the surgery, but it is now worse and we were told the whole point of the surgery was to rid her of the leg pain. We knew the back could never be fixed and that stenosis would continue to be degenerative, but we were promised the leg pain could be fixed. We live in a small town 3 hours from the hospital where the op was performed. There are no neurosurgeons where we live and my mum is a public health patient, so it could take months for a follow up appointment. Sorry to ramble. I am worried that my suspicions that nerves were damaged during surgery might be correct? or is it just a matter of time to heal?

 
Old 04-25-2011, 08:00 AM   #4
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Re: severe left leg pain following laminectomy

It is interesting that the surgeon overruled on having a post surgery MRI....but I wouldn't read too much into it. I'm afraid I cannot provide any specific thoughts on what might have happened. I know that any time nerves have to be moved, they do not react well, and it can take a LONG time for the nerves to calm back down. If there was injury from being compressed from the stenosis, the nerves can repair themselves, but it is a very slow process...something like 1 mm a week....Many people say it can take a year for this process, but, in reality, nerves can continue to heal beyond that point.

One time when I was chatting with my surgeon he was saying how unpredictable any procedure involving the spinal nerves can be. He told me about two patients he operated on the same day. The first one had a surgery where he said everything went absolutely perfectly, and when he finished, he was positive that her outcome would be excellent. The second patient had nerves that were entrapped in scar tissue. He had to cut around them to free them and he said he tugged so hard on her nerves, he was fearful of the outcome. Both went home from hospital in about 3 days. A week later, the first patient with the "perfect" surgery called to say she had developed drop foot in one leg. The doctor told me he was shocked as there was no reason on earth why she should have developed the foot drop.
Patient # 2, with all the tugging on the nerves, recovered completely and had no nerve damage whatsoever. His point was, that even though he's been doing spine surgeries for 18 years, he is still surprised on occasion by the outcome...and it doesn't necessarily relate to what he did during the surgery.

It is entirely possible that your mom is in a similar situation. In all likelihood, with physical therapy she will recover the use of that dorsi-flexion in her foot.
I guess you really can't do much more than get treatment from the physio, have your mom work hard and hope that the nerves recover.

I would say though, if you are not seeing changes in six months' time, I would try to get a new MRI.

I'm sorry I can't be of more help. I know how crushing it is to think you are having surgery to relieve leg pain, and you come out the same or worse than when you went it. Since you need to deal with the situation as it is now, keep reassuring your mom that people do regain the use of their foot, and it does take time for the nerves to calm down. There are some medications that might help with her nerve pain, such as gabapentin/neurontin, or the newer Lyrica.

Your mom is lucky to have you looking after her. I wish you the best.

 
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mbro24 (04-26-2011)
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