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Foot drop post spinal fusion


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Old 12-07-2017, 01:06 AM   #1
gabrielalo
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Foot drop post spinal fusion

I had my mis tlif on L4-5 4.5 weeks ago at ucsf. Surgery took 8+hrs instead of 3 due to dura tear and other issues. I woke up with pain and numbness from left thigh to toes. dr said it will go away in 2 week. I was in strict bed rest 48 hrs and then was discharged home the 3rd day.
Started walking small but knee and hip hurt thinking it's nerve was irritated as dr said.
Last week a PT friend told me my left foot slapped, knee pulled back and hip dragged behind-foot drop! And yes I cannot heel walk nor dosiflex!
Called hospital and was told a medical emergency go to ER! But I'd it for last 5 weeks so is it permanent and unrecoverable?
What are my options now?
My first post op appt is 5 week away! Can I wait or should I see my PCP to get Emg or MRI done soon?
Per the surgery note the left L4 screw has no good purchase due to soft and eroded bone but they left the screw there thinking it should not touch the nerve. Also would the dura tear caused any nerve compression even though they sutured with muscles graft and dura seal?
Any input and advices would be appreciated
Thanks
Glo

 
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Old 12-07-2017, 08:12 AM   #2
teteri66
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Re: Foot drop post spinal fusion

I don't think you would gain much by going to the ER. Other than doing some imaging, what are they going to do?

MRI will show nerve compression. However, it will not show nerve irritation, which I suspect is causing the drop foot. It would probably also show if the screw has migrated and is now resting on or becoming entangled in a nerve.

At this point I don't think the EMG test would be particularly helpful, and if you are like me, you don't want to go through it unless you have to! It will show nerve damage...but, you already know that! It won't give you any more information on what is causing it, whether it will fully recover, etc.

Does your PT friend think you should be doing isolated exercises for foot drop?

 
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Old 12-11-2017, 06:14 PM   #3
gabrielalo
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Re: Foot drop post spinal fusion

Hello Teteri66,

Thanks for your response.

Like you mentioned, MRI will show nerve compression but not irritation. Would the XRays show if the screw has migrated and touching the nerve? I know I will get Xray on my post-op next month.

I heard that a standard MRI will NOT work anymore with implants and Myelogram is the only imaging procedure for implants? I'd heard horrid stories about injecting dye into the dura matter and caused more damages to the nerve and excruciating pains. Are there other imaging procedures still work with implants?

I'll start at home PT this week. Not sure what they will do?
I heard about electric stimulation, massage, strengthening exercises might help with foot drop and numbness. Do you have any experiences with these modalities?

I sure hope it's nerve irritation but so far it has not improved at all. In addition, left side of my back started aching! So far nothing has improved and I hate to have more issues....

thanks for listening...

thanks
gabriela

 
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Old 12-11-2017, 09:38 PM   #4
teteri66
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Re: Foot drop post spinal fusion

Your information about having a MRI after fusion is not correct. You can have one but there is a possibility that the hardware will through off the clarity of the images. So doctors will recommend you have a MTI "with contrast." The material that provides the contrast is gadolinium which is injected into a vein in your forearm.

Usually they will perform the MRI in the usual way, then pull you out of the tube, inject the dye, and push you back into the tube to finish the exam. The gadolinium circulates through the blood and is absorbed by organs and soft tissue. It attracts the magnets and as a result, makes certain areas display better. Unlike iodine which is used for X-ray and CT scan, few people are allergic to gadolinium. However, you may need to have a blood test (creatinine clearance) done prior to the MRI with contrast to check the rate at which things clear the kidneys.

A myelogram is a much more invasive procedure, and is best avoided when possible.

I do not really know what you will do in physical therapy. It varies a lot according to the doctor and the training of the therapists. I stayed with an aunt who'd had a stroke at age 90, and had drop foot as a result. I took her to all her therapy sessions. She primarily did exercises. It helps to build new neural pathways that help in recovery and helps to keep muscles from atrophy. She also wore a brace for a time that helped to keep the toes from dragging. She eventually recovered full use of the leg and foot. I think it was around 9 months, but I don't really remember.

 
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Old 12-28-2017, 03:49 PM   #5
teteri66
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Re: Foot drop post spinal fusion

Any change in your foot drop?

 
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