Laser Spine Surgery

Merry Christmas to all of you from New England through Florida through Texas and every other state that has turned to this Forum for help or information. May your New Year be Healthy, Wealthy and Wise.

Marie B.

Dear Fran, Marie B. & Rich T:

My steadfast three muskateers! You guys are the true "backbone" of this and the other thread! Thank you for your wonderful advice. I'm feeling guilty at the response to my post . . . I didn't mean to stress, and worry everyone . . . I've even re-read my post . . . I'm sorry, it sounds worse in print than perhaps the life I’m living. I don't want to be the one crying "wolf" unnecessarily. I don't want this response to sound ungrateful or defensive, but I may need to retract or explain . . . holidays don't always bring out the best in moods or memories (except for you Fran!) . . . but honestly

Fran: I don't drag my foot all the time, I shouldn't have written that. That's what I call my limp or slightly longer pause when walking???? I've lead a very sedentary life, for the last three years. And I can walk and make my limp hardly noticable on good days. . . I have a handicap sticker for when I have to park at the university, so I don’t have to walk miles from a parking lot. How is it that I feel I'm blessed to be able to sit for such lengths of time to write? I joke around that my daughter is my wife, as she does everything I used to do around the house . . . (truth be known, EVERYONE needs a wife!) While I may not be able to pick up the grandkids, it doesn’t stop them from crawling on my lap and snuggling . . . or reading a book. I really am doing o.k. honestly. The falls to which I referred happened only when I tried to negotiate a step up. It could be an issue with my depth perception as well . . . my eyesight, memory etc have not responded by becoming more acute, it you know what I mean . . . it's hell getting older . . . I am concerned and rightfully so, as Fran pointed out to the foot cramps. I'm even more worried about her upcoming surgery on L3!!

I think there is truth to the fact that while I can't get my mind wrapped around the notion of back surgery, minimally invasive or otherwise, the true issue is my inability or refusal to recognize the seriousness of my symptoms. I meant for my post to be on the light side. Unfortunately we can't read "tone." I’ve always thought my situation pales in comparison to others. One thing that haunts me is someone who said, "you'll know when surgery is right, because you won't be able to stand the pain and the compromise on the quality of your life." Well, I guess I am able to stand the pain with the shots and right now, I'm literally not doing anything but getting myself to and from work, which entails more sitting than standing (I don't have a classroom full of kids). My wonderful family has taken on my previous household chores. I do what I can, and what is left over allows me time to write. So, I'm thinking I'm living a very charmed, and spoiled life right now. I know in my heart of hearts, I could be doing much worse. I’m sorry I set everyone off worrying about me.

MB: It was I who made the wisecrack about doing the research. I can be a rather pompous ass at times, now that I re-read how that remark must have sounded!

Rich T: Thanks for explaining the Kenalog feature of the shots. Perhaps that is why I respond so well to them???

MB: I have not limited my research to laser surgery. I have done a lot of related research regarding back centers in the greater Dallas area. They seem to be popping up all over. One thing I have noticed over the years, is that the umbrella of “minimally invasive” is being used in all types of surgeries. I think this is a good sign. It almost seems common sense to want to impose the least trauma to the body as possible.

You guys are such a strong support group! I can’t thank you enough. I will take all your advice and regroup. I know I will need new MRI’s as the problem is not going to go away on its own. What to do is the hard decision. Thanks to your help and friendship, I know I will find my way! You guys are the best!
Happy Happy New Year!
C

Hello Carol,

Thanks for your very kind words to your friends, the "three muskateers".

Permit me to "read between the lines" a bit. Perhaps our perception of what you wrote in your previous post was not as you intended. However, Carol, to be honest with my feelings/perception of your current post, I get this very uneasy feeling that you are trying to minimize and somewhat "cover up" how things really are for you. Be careful not to have your mind convince yourself that your back is not at bad as it is.

I am glad that you are looking into all the options for your back.

Honestly, your previous post made me take notice and realize that I need to get busy and have my "ducks in a row" so that when that time comes I don't have to be running around trying to make a final decision. On a good day like today it is very easy to just sit back and say "everything is fine, no worries". That I know isn't true. I do want to and need to contact Dr. Tollis in Florida, Fran's great doctor and also Marie's excellent surgeon. AND though over the ocean, surgeon Mr. Knight in London is honestly at the top of my list. Thanks for the "BOOT" to not just ease off on the current "good days".

Take care. May the new year take you on the right road.

RichT

Carol, You are never pompous when you are sharing with us. It is true that we few brave researchers have done a lot in viewing spine surgery of various types, and that doesn't include all of the reading we have done.
I think that is why my surgeon, at my first visit when I asked him a zillion questions, chuckled and commented that the ortho surgeon studying spine surgery with him had taken 6 years of study to get where he was and I wanted my surgeon to explain everything in an hour visit.

I just want you to have your ducks in a row, as Rich mentioned. Get your Extension/Flexion X-Ray ready for correct spondy DX. Your MRI must be no more then a year old. Be ready as you keep observing your symptoms. My gut instinct still says you need to have that stenosis taken care of.

Now re-read what you are saying to us about what you have given up of your life to your family because you can no longer do certain things at home. Now, if you don't want to do certain household things then that's another story. But you have turned things over to others. That can be good or that can be bad.

Also climbing steps...believe me if you are lifting a leg up, you can very easily fall because that stenosis can cause the knees to buckle with no warning. That is when I started to get serious about surgery. Climbing my steps became a nightmare of hanging on to railings to get to the top. And it was that buckling (I fortunately was able to catch myself before falling) that sent me to the first surgeon in my area.
That is also when I learned "spondy" had entered the picuture. I am so glad that I was already in the process of getting my injections because it was that first dx. that made my PM began to realize that my description of my symptoms might have seemed mild to him but when he saw documented evidence of other problems was when he started to talk to me about seeing a surgeon.

I have got to be honest, Carol. I really kept kidding myself about my problem. I even would pray, telling God that I had enough surgery on other parts of my body that I wanted Him to make this problem go away. I must have said, "No surgery" thousands of times. Then the knee buckling began. And I had a serious pain near my S1 vertebrae when I would try to sit on my haunches when I was reaching into low cabinets. I would see stars from the pain.

Now in telling you this, I have to emphasize, spine surgery is not for sissies. I even told Rich that JoeBob sounded so upbeat post op that I was concerned that it made it look like spine surgery could be a breeze...especially if it is done by laser. It takes a real awareness of what is happening to your back to determine if one is jumping the gun because you experience various types of pain. If I had only used JoeBob's reports as to how well he did after his surgery, after mine, I would have been been driving my doctor nuts with calls of insecurity and requesting assurance and asking "is this to be expected." I am now 6 weeks 5 days post op. I still have aching and I can't jog for an hour. I can't even power walk for an hour. I sort of stroll on the treadmill for 15 min. and believe me sometimes I want to go faster; Have done so and had serious pain results. But I am slowly getting better...let me repeat...slowly. This is no rush job.

I know your email was to reassure us, but I still feel concerned. Please don't do as I did. Don't fool yourself and think you can get away with one more reduction in your life style.

Marie B.

Rich, Isn't Kenalog a penicillin...or antibiotic? I have not looked that up. If it is, I don't think that would be a reason for improvement of the pain post an injection as Carol was questioning. Then again, I might not know what I'm talking about either.
Marie B.

Hello Marie,

Kenalog is NOT an antibiotic. It is a corticosteroid. Similar in chemical structure to cortisone, but NOT cortisone. It really BUGS me when doctors say "I'll give you a cortisone injection". THAT is not true in 90+ percent of the cases. What they are giving you is an injection of a corticosteroid, a man made compound.

Kenalog has a much longer life time in the body than the cortisone our bodies make to ward off inflammation.

Enough, the chemist in me is showing I'm afraid. LOL

Take care.

RichT

Rich T:
I'm definitely inquiring about the Kenalog vs. corticosteroid. My doc just called it a cortisone shot. It might be that that it has morphed into the generic name. Ex. Kleenex for tissue . . .

In the short time we've gotten to know each other, I must say you guys are tooooo good at reading between the lines . . . this Taurus may be stubborn, but hopefully not too stupid. I will take care. Waiting till after the first of the year. New insurance, less coverage, changed coverage. Who knows? Anyhow I'm pretty sure I've passed the expiration date on the "otomies." More than likely we've progressed to the "ectomy" level for sure with the possibility of fusion.

My second opinion doctor did do a flex and extension exray. He is the one who decided there was some "slippage." Sherman is basically a three horse town, so I will venture into Dallas, proper for a third opinion. I just hope they don't put me through the routine of physical therapy, "just to make sure." I even know there's more to be done than that. Thanks for the wake up call. I like the advice of staying closer to home. An hour drive is better than state hopping. I know part of the decision is location. I love your direct no frills honesty when you write Marie. You and Fran really tell it like it is. Do we have to go on the other site to get an update on Joebob? Anyone still posting there as well? I wonder how the "Spinazi's" are doing? A little humor never hurt anyone!! Ha!
C

Hello Carol,

"I'm definitely inquiring about the Kenalog vs. corticosteroid." - Whoops, Kenalog IS a corticosteroid. Kenalog is a trade name for the corticosteroid triamcinolone (common name). Other trade names are Aricin, Aristocorf, Cinalog, cinolar, delta-Tritexs, etc. If you want I can give you the chemical name, and its a LOONGGGggg one. LOL

Glad you will be seeking a third opinion.

Regarding Joe - I think he is having just too much fun coaching ice hockey. I did check the other forum/web site and as best as I could determine the last time he posted there was on November 15th. Okay Joe where are you??????

I haven't posted there for ages.

Hope you had an enjoyable Christmas. All ready to roll in the New Year?

RichT

Well my son flew home with no issues. Said he had no problems with the flight back from Florida to Arkansas. It has now been two weeks since surgery at Bonati and he is still pain free.

His family came to my house for Christmas including his two boys and wife and we has a wonderful time. He was in such a good mood and able to already do many things he could not do before such as play with his children.

I feel blessed that this has happened for him and would go back to Bonati again if the need arises and this includes myself.

Just wanted to share a success story with you.

I did talk to a lot of people at either Bonati or Gulf Island Resort and Tennis Club who had their own stories. I did ask several to post here but have not seen any yet.

Hopefully they will post their stories here for more to see.

Norm

Hello Norm,

Thanks so much for you update.

WOW, so GREAT to read that your son is doing so very well. I can only imagine the joy that your son, his children and wife now have because of your most unselfish gift. What an incredible example of true giving you have given to all of us this Christmas.

Thanks!

And thank you for inviting those who you spoke with at Bonati to share their experiences with us. I truly hope some will do so.

RichT

I'm so glad to read that you are planning for 3rd opinion over the next few weeks and that you are beginning to realize that your situation may be more serious than you realize.

How true that there are others that are in worse shape than yourself or any one of us, but that does not make your situation or anyone else's situation serious as well. It is just different degrees of seriousness as well as how an individual's body responds to different circumstances.
It also has a lot to do with an individual's body structure. I've been told that those that are short, like myself and Marie, not only have shorter spinal columns because of our height but also have less space within our vertebrae.
If we assume for a minute that that is true, then, a mild to moderate stenosis in, say the lumbar part of the spine, could feel worse on a person that is short than a person who is taller.

So it all becomes relative in degrees of how severe or not severe a person's spine problems are.

A good spinal surgeon will us and MRI or any other tests done as a tool for assisting in diagnosing a patient, but utilize the patient and the patient's symptoms as a guide to how severe the spinal problem is.

I smiled when I read your statement "I'm literally not doing anything but getting myself to and from work, which entails more sitting than standing (I don't have a classroom full of kids). My wonderful family has taken on my previous household chores. I do what I can, and what is left over allows me time to write. So, I'm thinking I'm living a very charmed, and spoiled life right now. I know in my heart of hearts, I could be doing much worse. I’m sorry I set everyone off worrying about me."

It reminded me of my 24 year old daughter. The "queen" as her big brother used to call her when she was a baby.

My kids where 5 years apart and big brother loved that little sister so much, that he waited on her hand and foot. Sounds wonderful doesn't it? But, in reality, it was the worst thing he could do for her. It prevented her from developing and learning to do for herself.
Big brother did everything for her, so much so, that she never had to learn to turn over, sit up, crawl or stand.
He would sit her up, stand her up to hold on to things, get everything for her. and it looked so cute.
By the time she was 15 months old, she still hadn't done any of those things, but had the vocabulary of a 2 year old and was smart as a whip. Too smart for her own good, because she had turned her brother into her personal slave. Worst of all, big brother and his friends loved every minute of it.
At 18 months the pediatrician had us take her to specialists at Children's Hospital in Boston with fear that she might have muscular dystrophy.

The long and short of it was this. Our sweet angelic daughter was diagnosed as "one of the biggest. spoiled little girls we have ever seen. Totally spoiled by her wonderful loving brother. She has no reason to do anything for herself because all she has to do is yell her big brothers name and he will come running and do everything for her."
Treatment consists of breaking this habit and forcing her to do for herself and once it is broken she will be running, not walking around the house.

We went through 2 months of literal hell keeping big brother from doing anything for her and hearing temper tantrums all the time from that angelic little girl.

Sure enough by 20 months she was rolling around on the floor, using that butt of hers to "walk". She thought her feet came out from that part of her body and boy could she move fast that way.

Then one day when she was exactly 20 months old, I gave in and let big brother have his best friend over to play. They promised to do nothing to help little sister to do anything.

Funny how 2 months of non anything for little sister turned into being a pain to do for her. After what seemed like the millionth time she asked big brother and his friend to help her, the friend turned around and said, "shut up already, you lazy creep. Stand up and walk already."

I just froze and watched what was going to happen. and what I saw was this "OK" my daughter said. Then smack in the middle of the living room she stood up, holding on to nothing. With a grin on her face to toddled across the room and said. "this OK".

You could have knocked me over with a feather as I stood there with my mouth hanging open.

Big brother turned and said "NO, you are supposed to be walking all over the place by now, not just a few stupid steps".

Well 4 hours later, she was all over the house and has never stopped going since.

Carol, what yo sound like is you have gotten yourself caught in the middle of a vicious circle, similar to what my daughter was in.
She couldn't do for herself because she was too young to do so, so big brother did it for her, then it became such habit and love that it never stopped and she couldn't learn to do the things for herself because she never had to and it was fine with her and big brother.
It wasn't until she was forced to do them on her own that she finally learned and she learned real quick how to do them.

In your case you have slowly been able to do less and less and your family has automatically filled in for you. It makes your life easier for you and you settle into doing things this way.
Yes it's a charmed life, being waited on, others doing what you did and you able to do what you want to do.
Then you don't realize how much you can't do, because you don't have to do it.

If you stop and think what life would be like for you, if you couldn't do these things and no one could do them for you, you will find a very different picture and I don't think you will see it as a pretty one.

I'm one of the ones that answered the question of when to have surgery with "when you can't take the pain anymore, when there is no life to live and you can't function anymore at all. that all there is in life is pain and no quality of life."

My situation was really different and as my doc said "I've never seen it in 20 years of practice."
I went to bed on Sunday night fine and couldn't get up on Monday morning. By Wednesday morning I was already thinking if this doesn't end, suicide is looking good.
By the following weak,I was close to a wheelchair, the pain was so bad.

Carol, my life went from a $25,000 a year income from a home craft business, doing 20 craft shows a year between Sept and Dec., coaching soccer in the fall and spring, basketball in the winter, guest speaking at 2 boston colleges during the winter months in a political science class on life growing up in the 60's, working for rape crisis center and on call for the crisis intervention team to schools in the area for emergency psyche help, to not being able to move over night.

My life has not returned to all of the above, since having my spinal surgery and this past few months has been a real mess because of that disc, but it has nothing to do with the prior surgery, but rather the pleasures of being in the wrong place at the wrong time and a car and driver that shouldn't have been driving. That's for another post.

I don't think most people who have spinal surgery ever return to the full life they had before any spinal issues, let alone after surgery. It's unfortunate that that does happen. I suspect, personally, that there are many reasons too. Reasons are many and include bad doctors, just the way people heal, more than one problem in the spine, waiting to long to correct the problem and the simple fact that when we do have the surgery, we aren't as young as we would like either, for starters.

And, oh yes, getting the head wrapped around spinal surgery is not easy either. I'm also the one with the famous last words to the pain doc who was going to do the first ESI for me. "It better work, because it will be a cold day in hell, before I let anyone put a knife into my spine."

Both the pain doc and my surgeon have yet to let me forget those famous last words. If the 3 of us live to be a million, I'm sure they will still be reminding them of those words too.

No one can tell you what the right thing is to do, other than get that 3rd opinion and new tests to update the old ones and compare them to the new ones. Doctors can advise you, tell you what they think you should do, but the final decision is up to you.

We can be here and listen to what you tell us the doc says and give you opinions, make suggestions, but in the end, you have to make that decision yourself.

I do think surgery is in your very near future, but I wouldn't even begin to venture what kind.

I also agree that being close to home an doctors to follow up with you near home is a good idea.

So girl, after the first of the year, get busy with the 3rd opinion and get the answers you need. Your symptoms are not good, even if they are not as bad as we thought they where. That problem going up the stairs, as Rich said, is not good. The last thing you want is to fall and break a bone. You have enough problems already, don't make them worse, please.

Then let us know what the doc says and we can all sort it out with you and go from there.

And please, please, please, don't worry about me and the L3 disc. So far the nerve block is doing well, the disc started to leak a little, but it is sealing over fine. The PT is helping and if that works, then it's just another one of those "partial laminotomies" that I've already had. In and out of the hospital the same day, less than 12 hours. Walk in in pain, walk out feeling fine. Do the PT and get on with life.
I have full trust in my spinal surgeon and trust me, he isn't going to screw up anything cause he doesn't want to suffer the consequences. LOL.

He knows the rules, he screws up on surgery with me and he no longer gets "the best tomato seedlings I've ever had in his life, with the best tomatoes I've ever had, with the rarest kinds of tomatoes, and my 2 kids will "kill me and never speak to me again".

That's right, Carol. He fixed me once and he'll do it again. I grow from seed, killer size tomato seedlings that produce hundreds of tomato plants that have tomatoes growing and ripening into early Nov. even in MA.

Fran

Norm,

What wonderful news you have been posting about your son. I'm so glad that things have turned around for him and he is doing so well.

You couldn't have had a better Christmas present than that, nor could he.

Fran

As promised, here is the story of why I now have a problem with my L3 disc.

Just minding my own business. I was doing quite well, out and about, did an hour workout on the independent program at the PT facility and went to pay the property taxes as the town hall.

So outside, bottom of the stairs in the parking lot and just going to head to my car, when out of the corner of my eye, I notice a car going to pull into the parking space. At least that's what I thought.

In an instant the car races towards me and I had just enough time to jump into the garden bed and get out of the way of these speeding car. The car hits the front stairs and this huge cement planter on the landing of the stairs.

You guessed. planter shatters and huge pieces are down on my back, on the left side, and my surgery was for the right side.

Police and ambulance called. someone helps get the cement pieces off my back and I go to stand up and well, I new it wasn't a problem with the prior surgery. The left side of the bum hurts and the left hip and left thigh.

So lucky that the ambulance guys get to see me, looking like I'm about to cry in pain. Such wonderful luck to have the 2 of them, friends of my, almost 30 year old son and these 2 grew up in my house.

One look at me and they turn white as snow and want to know which of 3 hospitals I want and are saying OMG Mrs. your back and surgery and OMG< what do you want us to do.

I told them go take care of the little old lady that did this and leave me alone, I am not going to any hospital. Well if looks could kill, I'd dead with the looks these 2 "kids" are giving me.

The little old lady, of course she's fine, why wouldn't she be? She caused all this to happen and she didn't have any cement on her back, right.

So the EMT's are back with me and I just said to them "cut the crap and stop being pests." and they say "Mrs. we need to help you, don't you trust us?" I look at them and burst out laughing and say "trust you 2, are you crazy. You want me to trust 2 of the biggest pain in the butts I've ever known, 2 whiny kids, that drove me nuts, ate me out of house and home and weren't even my own kids, all but lived in my house every day after school, where deaf as a doornail in listening to me, where famous for making a total disaster mess in my house and giving me grief in cleaning it up, and to top it all off, you are the 2 pain in the you know what, that taught my daughter to climb trees, climb the chain link fence and get stuck up there and then you 2 and my son would come running to tell me "she did it again", and you want me to trust you?"

OK, so I was a little mean, but crap guys, I hurt.

In the end, I told them I did trust them, but I was going home not to the hospital of any kind, I have my own spine surgeon, and will call him when I get home. I signed the release papers and these sweet EMT guys, help me to the passenger side of my car, one gets in and drives me home and the other drives the ambulance to the house.

So now the neighborhood is having hysteria cause there's an ambulance in my driveway and I'm barely able to get into the house.

Neighbors come running and they explain what happened and settle that. Then they stand there and wait for me to call the doctor. I ask what they are doing here still and get told, "waiting for you to call the doctor." So I said "don't you trust me?" and get "Hell, no. We grew up here, we know you and you will wait and see if you need to. So we don't leave till we see you call and WE hear what the doctors says you are supposed to do."
So I look at them and say "See I told you both, that you where the biggest pains in the you no what, and I suppose I should take comfort in knowing that some things never change and you chalk another one up to I was right. And by the way if you think I am or was going to let either of you examine me, well, let me know when hell has frozen over."

I called as my hubby was walking in the door and I gave those 2 kids the evilest eyes you've ever seen. they had called my hubby at work.

Doc had me come in right away, and OMG, that was one of the worst rides I have ever had. All I could think of an see was those 2 grown kids looking at me and evil eyed back at me about calling my hubby.

Lucky for me, the doc has xray and MRI facilities right there. I was xrayed and then tubed in the MRI. Luckily nothing was broken, but I was already bruising away, and the MRI showed a "very pretty" L3 disc that may or may not be protruding. If it was, it didn't appear to be much, but then again, it might be, only time would tell and it didn't look any different than the follow up MRI I had had done several months prior.

He gave me some percocet for the pain and ice, ice,ice and wait a bit to see how it goes.

3 weeks later, the bruising was gone, but the pain in the butt, down the him and the front of the thigh became horrible and had spread to the right knee and could only stand for about 5 minutes before the leg just gave out and I was on the floor.

Since the MRI didn't match all the symptoms, we decided to do a selective nerve block to the nerves of the L3 disc and see if with lidocaine and kenalog the pain would go. If it did, we would know that the nerve to disc was probably being compressed.
Nerve block ended all pain, so we know that the nerve is involved. The question now is was it part of the accident or did the accident activate a problem that was there and causing no problem.

Remember this, if you did an MRI of the spine on 100 random people, at least 50% would show some compressed or herniated discs and have no symptoms. Just because the "problem" is there doesn't mean you do anything about it. This is the kind of problem that you ignore, unless there are symptoms.

So the plan was to see if the pain returned, and if it did, they would do one more nerve block just to be safe before doing any decompression.

Anyway, about 2 weeks ago, I woke up to find no feeling in the little toe on my left foot and an occasional sharp nerve burn in my big toe all on the left foot. New what that meant and called the doc to let him know we know have a slight leak of the disc.

So he ordered PT and keep an eye on it. Many times with some good PT, and exercise, the leak will heal and nothing needs to be done.

So Christmas Eve and Christmas Day I worked 12 hour shifts in the ER of one of the local hospitals and was fine. Then the day after Xmas noticed that I was getting some feeling back in the little toe. Sign that the disc is sealing.

Now we wait to see if any of the original pain returns. Knowing my luck, it will and I will have surgery for the compression. Just has to be done in time for me to be able to sow those tomato seeds for the doctor. (see previous post to Carol about the tomato seedlings and my spine surgeon).

Oh and the sweet little old lady. Well, I thought she was in her 80's. I find out that she is 92. has not had a drivers license since she was 70, when it was permanently revoked after a 5th drunk driving charge. She was drunk this time too, driving without a license and had stolen the car from her grandson, who had driven his car to school. She paid a taxi $15 to drive her to the school and then proceeded to splice the wires to get the car to start. Then she drove around the corner to the town hall and no one knows why.

And wouldn't you know, good old me was right smack in the way of this crazy lady driving.

Maybe I should never go out of my house again, what do you think? And I thought all i would have to worry about was falling on the snow and ice and breaking something.

Fran

Don't you just love to read Fran's posts? They can be better then reading a book.

I just want to ask a question, Rich. Can you get the monitors of this Forum to start numbering each posts? I recall reading somewhere on either this Forum or the old one about the Lumbar nerve pathways that some one posted. I recall wanting to print the information out because it would help to know which lumbar vertebra and nerves affected the hips...outer leg/ankle pain, etc. It would be like diagnosing oneself.
If our posts were numbered and I wondered which poster that was, someone might know and post me the number to look at for the information.

What do you think?

Meanwhile, Fran did you ever post the nerve pathways of the lumbar region?

Marie B.

Hello Marie,

That is an EXCELLENT idea. Just today I recalled something that Fran said a few (several) pages back, and I can't remember which page it was on or the post. BRAVO!!!!! for a SUPER idea!!!

Marie, I will forward your excellent idea on to the Admin.

Thank you.

RichT

Marie,

Not sure if this is the post you where looking for but this I one I posted a while back in answer to a question on nerve pain

I should add this too having just learned it since the run in with the car and the little old lady.

If the nerves to the L3 disc are compressed, the then pain and nerve pain is on the left lower back (the butt) go to the outside of the hip, then travel to the front of the thigh and lodge in the knee. That pain and nerve pain in the knee can cripple you so badly in pain that the leg and knee buckle right under you and if you aren't holding on to something you will land on the floor.

Post you may be looking for

littleonefb
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Experienced User , Rather EHEALTHy
Joined: 11 Aug 2007
Posts: 81
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Re: Nerve Studies
Posted: 09-21-07 20:59pm
mj57 wrote:
Hi everyone,

I have a question....

Regarding a nerve study that was done....what does it mean ''suggestive of a lesion along the somatosensory pathway between the right posterior tibial nerve and the left cortex"? Clinical correlation is required.

I've tried to search this one .........but way to much comes up that is all greek to me. Just wondered if any of you may have had a nerve study done and had experienced any of the similar results or possiliby close to this..........
Always.........mj


MJ,

I'll take a stab at this one for you, but remember, I'm not a doctor, just going on "some medical knowledge and anatomy and physiology.

First of all the word lesion is a funny word when it come to medical terminology. It has several meanings from a tumor, plaque in your arteries and damage or nerve compression.

In your case, if I remember correctly, we are talking about spinal stenosis stuff, so that the "lesion" no doupt refers to how the nerves are functioning or not functioning well.

So here goes with what "I think this means".

The tibial nerve is a branch of the sciatic nerve that comes through the spinal canal through the L4,L5,S1,S2 vertebrae. The sciatic nerve goes along the butt and goes down your thigh, where it branches into the tibial nerve that goes along behind your lower leg. It brances further down again at the ankle into the plantar nerves of the bottom of the foot.

Compression of the nerves in the L4,L5,S1,S2 causes the pain of spinal stenosis, that horrible pain in the butt, going down the thigh, leg, ankle and into the foot. When the compression is released with surgery, or the spinal injections relieve some of the inflammation, the nerves have a chance to start to heal.
Depending on how long and how bad the compression has been, there can be damage to the nerves that just can't be healed.

The tibial nerve, itself, is responsible for supplying movement and sensation to the calf and as it branches to the plantar to the ankle and foot.
What's called "messages" are sent between the nerve to the brain, the cortex part of the brain, that tells the brain to respond to various sensations and movement. Things like pain, burning feeling, tingling, feeling in that part of the leg, ankle and foot.
If there is "damage" to the nerve, then the messages are not getting through to the brain correctly and that part of the leg, foot, ankle doesn't respond correctly.
That could mean reflexes are off or not there at all, pain is felt from compression of the nerves, only deep pain is felt and gentle touch is not, etc.

"''suggestive of a lesion along the somatosensory pathway between the right posterior tibial nerve and the left cortex"? Clinical correlation is required."

This probably means that the tests where not conclusive but suggest that the "nerve messages" may not be getting to the brain correctly along the pathway that it is supposed to from the right tibial nerve to the cortex of the brain. A physical examination of the patient and the patients response to the area of the body in question would help to confirm what the EMG possibly showed.

I hope that helps, but as I said, I'm not a doctor, but do have some medical knowledge and anatomy and physiology knowledge.

Fran
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Fran, That was the information that I wanted. I wanted it because with my fusion, I know I am having adjustments in the vertebrae above and below the L4 &L5 because of the different sensations (some might describe it as pain) in areas of the hip, but and leg. But I knew this to be the expected slow recovering of the nerves which then the surrounding muscles respond to the nerves struggling sensations of recovery.

I have this odd ache on the inner aspect of my left ankle that comes and goes. I'm not even sure that this has anything to do with my Lunbar region. I just know that it appeared when I started walking regularly on my tredmill. It could be that my Nike shoes are now fitting a bit snugly around that ankle (a wee bit swollen) and are aggravating the nerve and muscle found there. After sitting for a year and a half my ankle might be protesting to having to function regularly again with exercise. I am trying to determine if it is enough to mention this to my surgeon. Not that I expect to have him through me back on the Jackson Frame for surgery again, but it will let him know what is happening to me.
Thanks for finding the info for me. This time I am going to print it off and put it in my Spine surgery file right away.

Rich, Glad you liked the idea. I hope the administers of the Forum will agree.

Marie B.

Marie, glad that was the post you where looking for.

It's doubtful that the ankle pain is something that would require surgery. More likely, as you said, some very angry ankle muscles telling you exactly what they think of you for having this surgery, and they aren't being very nice about it.

Don't ever be afraid to mention anything to your surgeon, no matter how insignificant you may think it might be. It's always, better safe, than sorry.

In the mean time, I was told by my spine surgeon, PT, and ortho foot doc, that you should always get new shoes after any kind of spine surgery. They said that the shoes you where wearing prior to surgery and stretched and conformed to the way you where walking prior to surgery and you will not be walking that way afterwards.

They said the only shoes you should wear with spine issues, pre and post op are walking shoes and the best ones to get are the New Balance model 626. top of the line, best support, cushioning etc.

Trust me, Marie. I got a pair and it was like walking on clouds and the support I got from them is like nothing I ever had before in my life.

They are the most highly recommended style of shoes for spine problems.

Some of the worst sport shoes to wear are running shoes. They bend far to much in the sole for walking and cause strain on the back muscles and the muscles of the ankle and feet. They are not meant for walking, as the shoe says running.

The second best to walking are cross trainers and they are not recommended either for spines either, but are better than running shoes.

You might find that seeing an ortho foot doc would suggest a pair of custom orthotics for you as well, but I'd get me those NB walking shoes 626 first and give those a try.

Your feet and ankles along with your back deserve the best for your feet, and so do you.

Fran

Fran, I'll check out the NB 626. But the problem with me and shoes are the manufactureres do not make very many size 5 in a lot of shoes. New Balance is one of them. Sometimes I have had to buy a size 6 and put in thos great sport innersoles.

Thank for the infor.

Marie B.

Funny, one of the first things I said to my daughter as I began to walk with my walker with wheels was that my feet felt like my weight on them was somewhat redistributed.