It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Back Problems Message Board

  • EMG/Nerve Conduction Results after fusion

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 07-20-2011, 12:48 PM   #1
    bracer
    Veteran
    (male)
     
    bracer's Avatar
     
    Join Date: Mar 2011
    Location: North Florida
    Posts: 319
    bracer HB Userbracer HB Userbracer HB Userbracer HB Userbracer HB Userbracer HB User
    EMG/Nerve Conduction Results after fusion

    I went to the neurosurgeon today and received the following findings from last week's EMG:

    "Evaluation of the Left peroneal motor nerve showed reduced amplitude (1.5mV) and decreased conduction velocity (B fib-Ankle, 33m/s). The Right peroneal nerve showed reduced amplitude (1.6 mV). All remaining nerves were within normal limits.

    Needle evaluation of the Right Anterior tibialis and the Left anterior tibialis muscles had 2+ PSW's with normal insertional activity, morphology, and recruitment. All other muscles had normal insertional activity, silence at rest, morphology, and recruitment."

    My surgeon seemed pleased with these results, telling me that I should begin to see recovery in my drop foot (the left one) and with the numbness and weakness in my right foot within 3 months. He said I should have total recovery in both legs within 6 months. However, he did say that my inability to walk on my left heel was not explained by these results, so he's sending me to a neurosurgeon for further evaluation.

    Mostly good news, I suppose, though the problem with heel-walking on my left foot leaves me troubled. I hate the idea of limping around for six months. Maybe I'll be lucky and things will start happening sooner than expected.

    Does anyone out there have any knowledge about these things you can share?

    Last edited by bracer; 07-20-2011 at 12:59 PM.

     
    Sponsors Lightbulb
       
    Old 07-20-2011, 01:28 PM   #2
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,229
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: EMG/Nerve Conduction Results after fusion

    Hmmm. Frustrating. I wonder WHY both pereneal nerves were affected? Did he trace it back up to one of the lumbar spinal nerve roots? Something must have happened during the surgery to end up with this result.

    Does he want you to have an ESI or a Medrol pack to see if inflammation is causing or contributing to the problem?

    I don't have any of my spine stuff with me, so can't check my various EMG studies to see what type of readings I had....Maybe when I get home, I'll think to do it.

    My aunt had her surgery this am. They were able to use the DaVinci robotic system so I'm hoping her recovery will be somewhat quick and she won't suffer any setbacks on her drop foot rehab. She was just about ready to make the transition from walker to cane...which we were all looking forward to.

    You must be relieved to know your EMG was mostly normal.

     
    Old 07-20-2011, 02:20 PM   #3
    bracer
    Veteran
    (male)
     
    bracer's Avatar
     
    Join Date: Mar 2011
    Location: North Florida
    Posts: 319
    bracer HB Userbracer HB Userbracer HB Userbracer HB Userbracer HB Userbracer HB User
    Re: EMG/Nerve Conduction Results after fusion

    I can tell you what the surgeon said: He said that the moron who was responsible for positioning didn't do the job right on either leg. The doctor who did the EMG said the same thing "damaged occurred at the knee." Fortunately, it's not a crush injury, just a matter of decreased blood flow to the nerves (and therefore inadequate oxygen leading to axonal damage).The three soft supportive devices they use should have done the job, but this clown in charge of pillows evidently spent the entire four hours doing something other than his or her job (at least this part of it). It makes me want to get my surgical records and post the name of the responsible party all over the local internet.

    He said inflammation isn't an issue. In fact, he thinks that if I sat around doing nothing for the next six months, my nerves would recover the same amount as if I worked hard at physical therapy (which is what I'm doing). Of course, that wouldn't be good for my fusion recovery.

    Yeah, I'm glad it's mostly positive, but it is frustrating to think that it's all unnecessary. This is why surgery should be looked upon as a last resort -- especially under general anesthesia. You're putting yourself at the mercy of people whose lack of ability, caring, or just having a bad day could have long-lasting and catastrophic results for you, the patient.

     
    Old 07-20-2011, 03:26 PM   #4
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,229
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: EMG/Nerve Conduction Results after fusion

    Was your surgery four hours?

    I hope your surgeon is right about the reason for the damage.

     
    Old 07-20-2011, 04:06 PM   #5
    bracer
    Veteran
    (male)
     
    bracer's Avatar
     
    Join Date: Mar 2011
    Location: North Florida
    Posts: 319
    bracer HB Userbracer HB Userbracer HB Userbracer HB Userbracer HB Userbracer HB User
    Re: EMG/Nerve Conduction Results after fusion

    Yeah, it was just under 4 hours. Are you concerned that he is right about the reason because... why? You know me by now, Teri. I'll take any statement and run paranoid with it. Am I in danger if there is some other reason for the damage? If it's from the nerve root, could things turn out differently?

    To be fair about the EMG: I didn't post the impression of the doctor who performed it:

    "There is electrodiagnostic evidence of a bilateral Peroneal neuropathy at the knee. Patient has good recruitment, therefore prognosis is good. I do recommend a repeat electrodiagnostic evaluation in two months."

    Does that help in the evaluation of the EMG?

    I made a mistake in my original post: The neurosurgeon is referring me to a neurologist outside of his practice (not another neurosurgeon) to check out the reason I can't walk on my left heel. I'm hoping that he will be a fresh eye on this and able to spend some time explaining the numbness and neuropathy I'm feeling in my right leg, in addition to giving me his advice about the foot drop and heel issue. By the way, don't you think that the foot drop and my inablility to heel walk are related? Are most folks with foot drop able to walk on their heel? If I could raise and keep up the toes on that foot, I think heel-walking would be a breeze. Speaking of toes, I sure hope that as the peroneal nerve improves, the pain I have when something rubs against my toes on that right foot goes away. I may have to get a note from my doctor explaining why I have to wear sandals and/or flip-flops and expose my ugly man-feet every day at work. We are near the beach and are a pretty relaxed school, but I felt strange wearing them the final two months this past school year. Now the neuropathy is in all five toes and (to a much lesser degree) on the ball and right side of the foot. Just another thing that I'd like to see clear up in the next four or five weeks.

    I'm also going to be able to talk to my pain management guy about this stuff. He is anxiuos to see my EMG, so much so that he told me to stop by this week when I could and he would take me in right then to talk for a few minutes. His head nurse, who I've become pretty good friends with over the past 6 years, is also really curious about the test. They both are really disappointed in the way things have gone, particularly since they recommended the surgeon to me. They've gone way beyond the call of duty when it has come to listening to me and prescribing the medications that are best for me.

    I also thought I'd mention this: My surgeon was amazed at how well I'm able to walk and move around. If it weren't for this foot drop, I think I could go for a couple of miles. My stamina is returning quickly and the pain, though present in a vicious way at times, seems to be waning just a bit. I know that I need to be wary of overestimating my ability, so don't worry. I'm following the advice of my doctor and PT to the letter. I don't want to take any chances. I also told my surgeon that I had decided not to take the naprosyn he gave me at the last visit. He said that was OK and that I don't need to take it now.

    Best wishes to your aunt. It would be great to hear a success story, especially from a stroke victim. Strokes can be nasty, but I've seen some folks recover so nicely that the therapy gets them in better shape than before the stroke. I hope things go fantastically well.

     
    Old 07-21-2011, 09:52 PM   #6
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,229
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: EMG/Nerve Conduction Results after fusion

    Sorry I didn't get back to you...busy days. I'm not implying anything. I was just under the impression that you didn't fully trust what the surgeon was telling you, and that you felt he was minimizing the drop foot problem.

    Now that you have the results of the EMG I guess you are comfortable with the surgeon's treatment.

     
    Old 07-21-2011, 10:21 PM   #7
    james079
    Senior Veteran
    (male)
     
    james079's Avatar
     
    Join Date: Mar 2011
    Location: B.C. Canada
    Posts: 719
    james079 HB Userjames079 HB Userjames079 HB Userjames079 HB Userjames079 HB Userjames079 HB Userjames079 HB Userjames079 HB Userjames079 HB Userjames079 HB Userjames079 HB User
    Re: EMG/Nerve Conduction Results after fusion

    I'm not quite with this difficulty on heel walking. Is it that your forefoot hits the ground first. If this is so why are you not wearing a drop foot splint which will acomplish this?
    James

     
    Old 07-22-2011, 06:37 AM   #8
    bracer
    Veteran
    (male)
     
    bracer's Avatar
     
    Join Date: Mar 2011
    Location: North Florida
    Posts: 319
    bracer HB Userbracer HB Userbracer HB Userbracer HB Userbracer HB Userbracer HB User
    Re: EMG/Nerve Conduction Results after fusion

    [QUOTE=james079;4805555]I'm not quite with this difficulty on heel walking. Is it that your forefoot hits the ground first. If this is so why are you not wearing a drop foot splint which will acomplish this?
    James[/QUOTE]

    James:

    In this instance when we're referring to heel-walking, we're talking about the diagnostic test where the doctor has the patient lift up the ball of the foot and walk towards him or her using just the heel of each foot. I'm able to do this with my right foot, but I can't lift the toes or the ball of my left foot off the ground when I try to do this just for the purpose of heel-walking. When I'm walking around for exercise, I am able take steps without dragging my toes on the ground, but just barely. The heavier the shoe, the tougher it is. So far, my doctor has said that I don't need an AFO. He feels that it would only serve to weaken the muscles that do work properly in my leg and foot. He's quite confident that my condition won't worsen and, given a few weeks or months, will resolve itself completely. I hope he's right.

    Last edited by bracer; 07-22-2011 at 06:38 AM. Reason: spelling

     
    Old 07-22-2011, 06:48 AM   #9
    bracer
    Veteran
    (male)
     
    bracer's Avatar
     
    Join Date: Mar 2011
    Location: North Florida
    Posts: 319
    bracer HB Userbracer HB Userbracer HB Userbracer HB Userbracer HB Userbracer HB User
    Re: EMG/Nerve Conduction Results after fusion

    [QUOTE=tetonteri66;4805545]Sorry I didn't get back to you...busy days. I'm not implying anything. I was just under the impression that you didn't fully trust what the surgeon was telling you, and that you felt he was minimizing the drop foot problem.

    Now that you have the results of the EMG I guess you are comfortable with the surgeon's treatment.[/QUOTE]

    Teri: You're quite right in that I don't fully trust what the surgeon is telling me, but it's not necessarily his fault. He seems to really expect me to make a full recovery. I think he grew aggravated with me as I continued to press him on this point at my Wednesday appointment. He said that he can't think of any other way to tell me that he expects me to fully recover from the foot drop and other nerve issues in my leg and feet using this as a reasonable time frame: Some noticeable improvement within two weeks; Significant improvement within three months; Complete recovery within 6 months. I hope he's right. Being an anxious worrier at heart, my mind continually ponders the "what-if" scenarios. That is, what if I'm no better in 3 months or 6 months? What will we do then? Is that even a possibility?

    It didn't really help when he made the remark about not understanding why I can't walk on the heel of my left foot and then referred em to a neurologist to "make sure there's nothing we're missing." Maybe he just wants to reassure me, but that didn't do much to settle my stomach. Could be he's sending me to this fellow (who is one of the top neurologists in our big city) to show me that a second opinion will come to the same conclusion. If that happens, I'll feel much better -- though when it comes down to it, seeing is believing.

    BTW, thanks for the link. It made me a feel better to see that in writing. It makes sense, doesn't it? However, I talked to a PT friend of mone who used to work with folks much worse off than me (severe spinal cord injuries and such) and she said that he may be checking to see if there is damage from another nerve. One would think that the EMG would have shown that, but maybe not. Just another question for the neurologist when I see him.

    Last edited by bracer; 07-22-2011 at 06:53 AM. Reason: add a little bit

     
    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    teen daughter has possible L4 nerve root irritation, nothing on X-ray StacieinTX Back Problems 26 02-10-2010 03:18 PM
    nerve conduction study/EMG results - please help me understand! tnquilter Back Problems 3 02-13-2009 12:47 PM
    Nerve Damage after Fusion???? sundee Back Problems 10 04-15-2008 05:46 AM
    Finally the results of the nerve conduction test clover60 Back Problems 7 08-01-2007 07:54 AM
    EMG Nerve Study Results and Questions notpain Back Problems 0 10-18-2005 01:11 PM
    Neurontin effect on EMG and nerve conduction study frank0678 Back Problems 4 06-23-2005 05:57 PM
    Interpreting Nerve Conduction and EMG results frank0678 Back Problems 0 12-28-2004 02:56 PM




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is Off
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 01:03 PM.





    © 2020 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!