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Old 08-05-2011, 03:30 PM   #1
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Numbness after back surgery, 2nd surgery?

I'm a skier and 43. I was skiing all last year and had a little back pain, but was mostly fine. About 3 days after the last day of the season, I went to tie my shoe and had horrible back pain.

I drove, and walked into the hospital with back pain and some left leg pain. I ended up having surgery the next day because a disc was pressing on a nerve near L3-L5. I was also fused using a metal plate and some screws.

Immediately after surgery my left leg was completely numb. It has gotten better in some areas near my quad muscle, but other areas are still completely numb and the muscle is atrophied. I have been able to get some muscles stronger, but not nearly what my other leg is. Also, the numbness hasn't gotten better after 4 months.

I've gotten a few different opinions..
The original DR who did the surgery says that everything is perfect and the nerve may have just gotten damaged before surgery and that it may take w hile for things to get better. I may hit a plateau but that is the best he can say.

A second neurosurgeon thinks that if it hasn't gotten better by now that it most likely won't. He wants to do surgery and take out part of the metal plate and screws and see if anything is touching a nerve. he says that if I wait too long the nerve may be permanently damaged. I did have an EMG and it shows some pinched nerve (although I guess this could be nerve damage to?)

Finally, and orthopedic DR. Thinks that there is no reason to have surgery again, especially within a year after the 1st. He thinks I should just do PT and hope things het better.

I'm kind of confused. I guess I'm thinking if I have surgery again, at least I'll know if there is something going on, and it seems like the chances are that things will either be the same or better. I guess there is a small chance it could get worse.

Anyone had a 2nd back surgery? Would you recommend it?

 
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Old 08-05-2011, 03:35 PM   #2
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Re: Numbness after back surgery, 2nd surgery?

Btw. I had an MRI along with my EmG after surgery. The 2nd surgeron said that he can't see anything definitive that is pressing on a nerve, but that he saw some areas where it COULD be. He also said that the hardware in my back could be causing a problem too.

 
Old 08-05-2011, 04:29 PM   #3
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Re: Numbness after back surgery, 2nd surgery?

[QUOTE=Mogulman;4816771]I'm a skier and 43. I was skiing all last year and had a little back pain, but was mostly fine. About 3 days after the last day of the season, I went to tie my shoe and had horrible back pain.

I drove, and walked into the hospital with back pain and some left leg pain. I ended up having surgery the next day because a disc was pressing on a nerve near L3-L5. I was also fused using a metal plate and some screws.

Immediately after surgery my left leg was completely numb. It has gotten better in some areas near my quad muscle, but other areas are still completely numb and the muscle is atrophied. I have been able to get some muscles stronger, but not nearly what my other leg is. Also, the numbness hasn't gotten better after 4 months.

I've gotten a few different opinions..
The original DR who did the surgery says that everything is perfect and the nerve may have just gotten damaged before surgery and that it may take w hile for things to get better. I may hit a plateau but that is the best he can say.

A second neurosurgeon thinks that if it hasn't gotten better by now that it most likely won't. He wants to do surgery and take out part of the metal plate and screws and see if anything is touching a nerve. he says that if I wait too long the nerve may be permanently damaged. I did have an EMG and it shows some pinched nerve (although I guess this could be nerve damage to?)

Finally, and orthopedic DR. Thinks that there is no reason to have surgery again, especially within a year after the 1st. He thinks I should just do PT and hope things het better.

I'm kind of confused. I guess I'm thinking if I have surgery again, at least I'll know if there is something going on, and it seems like the chances are that things will either be the same or better. I guess there is a small chance it could get worse.

Anyone had a 2nd back surgery? Would you recommend it?[/QUOTE]

Mogul:

I've had three back surgeries and you'll find many folks here who have had lots more. There may be people who can give you good answers right now, but I'd like ot get some more info first. You say you had a fusion -- at what level was it? Did you have a two level fusion from L3-L5?

I've about two months out of a two level fusion and I worry about muscle atrophy, so I started on PT right awaqy. Have you had any physical therapy?

Numbness isn't all that unusual. Sometimes people have it forever and consider themselves lucky that it's not pain. I have numbess in my left leg accompanied by a mild drop foot. However, I've been assured that it could last as long as two years and still go away.

What were the qualifications of your original surgeon? How about the second neurosurgeon and the orthopedic doctor (is he a surgeon?)?

While it is true that waiting too long could cause more damage, I'd have to have definite proof before I let someone open me up again, especially so close to a surgeon. I think you need to have a CT myelogram and another EMG (unless it's a very recent one) before you consider anything like that. Do you trust the guy who did your surgery? Did he do a fellowship in neurology?

I guess what I'm saying in my usually verbose fashion is don't have surgery yet. Leave it way down on your list for now. I don't think you will find another doctor that will do surgery on you so soon after the last unless ut is an emergency -- and even then, they won't want to touch another guy's work unless it is a matter of life and death. Ask your surgeon that you want a CT myelogram to check for a nerve problen and its location. Then go from there.

That's my advice. There are smarter folks here then me who may give better advice, but I wouldn't have another surgery unless I knew for certain that it was necessary. I know you want to ski again --- I want to walk normally again instead of having this drop foot, but I wouldn't have surgery again unless it was a for sure cure.

 
Old 08-05-2011, 07:57 PM   #4
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Re: Numbness after back surgery, 2nd surgery?

[COLOR="DarkOrchid"]
I would make sure about the nerve damage before another surgery. I have perm nerve damage. I had 4 surgeries in 3 1/2 yrs. My problem was failed fusion from L4-S1. I didn't fuse solid for some reason my body just wouldn't grow bone, no bodies fault just didn't happen. I wish we had an answer for ya, as you know every person heals different and literally every patient has different outcome for the exact same procedure. I would try to verify nerve damage before doing another surgery because basically it would serve no purpose if the damage is already done and perm.
I have 5 screws, 2 rods, and 2 cages but am secured at a gr 2-3 splondy and it will stay that way unless something causes damage to it in the future. I do have double the scar tissue due to my body growing an over abundance of it and it is wrapped around my nerves and causing some issues it's not my big problem.
I hope you find some answers and I hope the posts on here have helped you at least know what you need to do to find answers to your problem. I will keep you in my prayers.

God Bless

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Old 08-05-2011, 09:13 PM   #5
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Re: Numbness after back surgery, 2nd surgery?

I did about 2.5 months of PT. I had two levels of surgery.

I am ok walking around. Going down stairs is a little hard. I rode my bike today for 10miles though. Yet I can't lift my leg off the couch. It's just certain muscles.

The surgeon who did my surgery is younger. He seemed confident and seemed to be rated well, but he just finished as chief resident at university of Alabama in 2009. He rea
Ly thinks things went as good as possible.

The other surgeon graduated from university of Colorado in 2003 and has done lots of surgeries. He didn't seem to spend a lot of time looking at my MRI or EMG before he thought that it would be good for me to have surgery. This concerned me, but maybe he had already reviewed it before my appt.

The orthopedic dr is part if a very highly rated clinic in Denver. I guess they do work for some of the Colorado sports teams. He is older, 40/50. Someone I know reco,mended I see him. He wants me to take some steroids this week, then do some more PT with a sports related PT.

 
Old 08-05-2011, 09:31 PM   #6
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Re: Numbness after back surgery, 2nd surgery?

[COLOR="DarkOrchid"]I would go with the ortho, I prefer ortho over neuro myself. ALWAYS go with surgery after you exhaust all other avenue's. Hope all goes well, keep us updated.

God Bless

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Old 08-06-2011, 11:00 AM   #7
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Re: Numbness after back surgery, 2nd surgery?

[QUOTE=Mogulman;4816969]I did about 2.5 months of PT. I had two levels of surgery.

I am ok walking around. Going down stairs is a little hard. I rode my bike today for 10miles though. Yet I can't lift my leg off the couch. It's just certain muscles.

The surgeon who did my surgery is younger. He seemed confident and seemed to be rated well, but he just finished as chief resident at university of Alabama in 2009. He rea
Ly thinks things went as good as possible.

The other surgeon graduated from university of Colorado in 2003 and has done lots of surgeries. He didn't seem to spend a lot of time looking at my MRI or EMG before he thought that it would be good for me to have surgery. This concerned me, but maybe he had already reviewed it before my appt.

The orthopedic dr is part if a very highly rated clinic in Denver. I guess they do work for some of the Colorado sports teams. He is older, 40/50. Someone I know reco,mended I see him. He wants me to take some steroids this week, then do some more PT with a sports related PT.[/QUOTE]

I still think you need to have more testing done. You don't have to open someone up to be sure that a nerve is touching anything. That is a terrible idea. Don't be impressed with positions foks have held when it comes to performing surgery. Make certain he or she has a fellowship in spinal surgery. Please be sure that you feel comfortable with him. Make a list of questions and get answers. Compare the three. You can get excellent results with orthopedic surgeons or neurosurgeons, but the key is still to make certain that your surgeon has specialized training in spinal surgery. An orthopedist might have performed many surgeries, but if they were sports injuries, that's not what you want. There is a very famous orthopedist in Birmingham who sees virtually every major sports star who suffers a joint injury, but I wouldn't let him operate on me for disc issues.

If your original surgeon is highly qualified, seems to be honest with you, and you feel comfortable with him, then stay with him. If you want another opinion, tell him. It's very unlikely that any other doctor is going to touch you this close to your fusion. I can't imagine that your surgeon will agree unless that is an overwhelming reason. Tell your surgeon that you'd like another test (CT myelogram) so you'll know just what is causing the issue. Be sure about everything before anyone open you up again.

I think continuing witht the PT is a good idea, provided that your surgeon says that it is OK. 4 months out from a fusion is still pretty early. Be careful. You don't want to mess up the fusing process. Which levels did you have fused? I had a two level fusion from L4-S1. What was yours?

 
Old 08-06-2011, 05:13 PM   #8
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Re: Numbness after back surgery, 2nd surgery?

I agree - get another opinion from a board certified spinal surgeon.

Nerve damage is something that may or may not get better - nerves can regrow along the sheath(s), but they grow very slowly and may not reach all of the muscles they used to attach to. My leg has had numbness and weakness for a while, and it can be over a year before I find out if it's grown back or not (the sciatica can be caused by damage at L4-L5/L5-S1).

I would think that, unless there's an infection or a damaged vertebra, surgery so soon would be a bad idea. If you haven't started therapy yet, I would think that would be a better option than surgery so soon after the first. But the best option would be getting into a well-respected spine surgeon. Now, it may take a while to get into a good one, but you can get therapy while waiting. But that's just my opinion.

 
Old 08-06-2011, 09:53 PM   #9
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Re: Numbness after back surgery, 2nd surgery?

You absolutely do not want to rush into a second surgery without carefully considering all options and whether a second surgery would be more risky than potentially beneficial. From your description, it sounds like the first surgery may not have been necessary and that the decision was made rather spur of the moment since you were not dealing with a crisis situation. But, that is water under the bridge and now you need to figure out how best to proceed to try to rescue what has happened.

Take your time in selecting a spine specialist who has the experience and training that you can trust. Research your options and be sure that whatever route you choose, you will not be left in worse shape. Spine surgery, except in rare cases, is almost always considered an elective surgery. Do not rush into it again, without trying what conservative measures are available to you and after consulting with a number of spine specialists from different practices to see if there is a consensus of opinion on the best way to proceed with your case.

Also, bear in mind that a well-known specialist who treats professional sports teams is not often the best doctor for the average patient. A professional athlete's value to the team is when he is able to play his sport. It is in the interest of the team who is paying his big salary to get him back on the field, or court as quickly as possible without regard to what the injury might do to the player's over-all health down the road when he no longer is able to be involved in the sport. For example, it is not uncommon to send a football player back into training soon after performing a lumbar fusion -- much earlier than a normal person would be allowed to resume full activity. Usually a surgeon and a team of therapists can get a player back on the field, and able to hold together long enough to resume his career for a year or two longer...but at what cost to the player's future health?? What kind of problems is he setting himself up for when he's in his 5th or 6th decade?

Too often people assume a doctor must be brilliant because he is hired by a professional sports team...but you have to consider who is paying his salary or his fees and what are the objectives?

 
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Old 08-14-2011, 01:25 PM   #10
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Re: Numbness after back surgery, 2nd surgery?

Hi Mongul. I had 2 discs removed - L4 & L5, that was 5 yrs ago, i have a brace on my left leg to support my left foot, but I can tell you the brace is part of me now. surgeons told me if i had third opp more than likely I would end up in a wheelchair. I am not telling you what to do, but for God sake think about it. "Maninblack"

 
Old 09-22-2011, 08:09 AM   #11
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Re: Numbness after back surgery, 2nd surgery?

I've been doing more PT since the last time I posted. Over the weekend I wasn't feeling great, but the last few days I have been feeling stronger. I'm thinking things are getting better. I still have significant muscle weakness that wasn't there before surgery. I also get shocking/stabbing pain in my left leg intermittently.

I did schedule a CT Myelogram with a different board certified surgeon. My original surgeon sounded like he didn't want to have anything to do with me when I talked about getting another test when I talked to him a few months ago. I asked if I should make another appt with him after my 3 month followup and he said "only if you need to". So I haven't been back to him.

Anyway... I was having 2nd thoughts about the myelogram since things seem to be a little better, but since I have it scheduled maybe it is a good idea to find out once and for all if there is anything messed up from my surgery or if I just have some nerve damage/trauma that is just there and may or may not heal. Any reason for me not to get a CT Myelogram?

Am I overdoing things by getting opinions? I feel like I am sometimes, but other times I feel like I just want to make sure I'm doing the best that I can....

 
Old 09-22-2011, 09:53 AM   #12
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Re: Numbness after back surgery, 2nd surgery?

I would have the mylogram. In the effort to find out what is causing my foot drop problems, I had a CT/myelogram done. It didn't help any, but it eliminated some things that might have been major issues. It's no big deal and the results could be extremely important in your situation. Nerves feel better one minute/hour/day/week/month and worse the next. If you have ongoing nerve damage, why not find out what is going on? Information is golden when it comes to your spine. If there is a chance that waiting will lead to more problems, have it done now.

 
Old 01-20-2012, 09:30 PM   #13
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Re: Numbness after back surgery, 2nd surgery?

It's been a while since I posted. I did end up having a CT Mylogram back in September. I also saw a few other Neurgosurgeons.

None of them saw anything that would explain the left leg numbness that I had. Two of them saw that my back hadn't fused yet.

One of the Drs was really highly regarded in my area, and I liked him, so I decided to keep seeing him. He had me on a Bone Growth Stimulator for the last 4 months, but the bone isn't fusing.

I had another CT scan and it shows the material that was used in the original surgery the vertebrae rubbing and actually wearing away some of the bone. Also, it looks like the screws holding rods into my back look like they are coming loose.

He wants me to have do another MRI and thinks its a good idea for me to have surgery where he would go in through the front/side and put something into my back to hold things together and promote bone growth? He would also reset the screws in the back.

He said he also noticed some (scar?) tissue around some of my nerves, so he said he would open some of this up, and hopefully this would help with my left leg nerve issues.

He said the surgery wasn't immediately necessary, but it will be eventually, as the non-fusion in my back would get worse...

Anyone had anything like this?
Any suggestions?

I have the MRI on Mon and go back to see him on 2/3. I'm assuming the surgery would be scheduled sometime after that.


As far as how I feel right now... I think my left leg is a little stronger than it was 4 months ago, but I have been working out 3-4 times a week and skiing 1-2/week (a little bit). So I have really been working my leg hard. It is still sore a lot and most of the inside part of my leg (upper and lower) is still numb and not any less numb than 4 months ago.

My back itself, has been getting a little more achy over the last few months. Not exactly painful, but I especially notice it going to bed and getting up in the morning.

 
Old 01-21-2012, 11:05 AM   #14
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Re: Numbness after back surgery, 2nd surgery?

What the surgeon is recommending to you makes sense. I would just like to give you a couple things to think about. You should regard this surgery as a rescue surgery and your last opportunity to get it right. You want to be very sure that your current surgeon is the best man for this job. Don't settle for someone because he is close to your house or convenient or you like him best.

I generally think of an ortho spine surgeon as being best for revisions, and often, neurosurgeons will not even touch a patient who needs a revision, but that is just my personal preference. Just make sure, in your own mind, that this is the best surgeon for you.

He is now suggesting that he will perform a typical ALIF surgery, and then they will flip you over and he will remove whatever hardware is loose or out of place, and will redrill holes if necessary, and then will put in hardware (hopefully in the proper location) and finish what would probably be considered the standard PLIF. Hopefully this time the bone will all grow and you will be solidly fused. Hopefully once the screw gets off the nerve, your residual nerve problems will go away as well.

Recovery will probably be about the same as for the first surgery, but hopefully you won't have anything but surgical pain to recover from.

I feel very bad that you are having to go through all of this, and it is hard to not hold that first surgeon responsible. You were really rushed into that first surgery when, in all likelihood, had the circumstances been different, you would have been advised to try all conservative treatment first. The fact that the first surgeon wouldn't continue to work with you kind of says it all.

Anyway, if you really feel confidant in your current surgeon, I see little point in waiting. You are now about six months post surgery and you are not fusion. I suppose if you are showing signs of fusing you could afford to wait to see if that happens. Once a solid fusion has occurred, the surgeon could go in and remove the hardware...but you are gambling that the nerve damage might become worse during that time. I think if I were in your shoes, I would just go ahead and proceed with the new surgery. That way you will have a better chance of fusion, and you'll get the nerve freed up. The doctor can cut out the existing scar tissue, and you will be sort of like starting from scratch.

Please keep in touch and let us know what you decide and how you are doing. Don't be a stranger! And, good luck.

 
Old 01-21-2012, 06:05 PM   #15
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Re: Numbness after back surgery, 2nd surgery?

It's more like 10 months post surgery without any signs of fusion.

I'll let you all know how it goes.

 
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