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Fall from ladder, leg weakness and numbness, constant urge to urinate, diarrhea. Surgery best option?

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I recently had a fall from a 10'ladder onto my concrete pool deck. I landed on my side/back. since the fall I have had the following symptoms; leg weakness both legs and numbness down my right leg to my big toe. I have had 2 falls since the accident due to my leg weakness. I have a constant feeling of having to urinate and have noticed i am leaking urine into my underwear. I have not had an erection since the accident, I usually wake up with one. the pain is very intense shooting down both legs to my calves. My job requires me to stand for long periods and I find this almost impossible due to the weakness and pain. I have had back pain before , but nothing like this and I have never lost function before. I have also started having continuous diarrhea for the last 2 days. This fall occurred 6 weeks ago and I have been using pain meds, muscle relaxers, steroids with very minimal relief and I need the assistance of a cane due to an unsteady gait. I have attached my MRI, I am a very athletic person actually a competitive bodybuilder and now I can barely move.
I feel that surgery would be my best option do you agree?
Posted Sun, 23 Sep 2012 in Brain and Spine
Answered by Dr. Piyush Ostwal 3 hours later


Thanks for the providing a detailed account of your problem in addition to providing the MRI report.

Based on what you describe the symptoms are suggestive of involvement of nerves at level L4 and below. Since it has occurred following this significant fall, the most probable cause of it will be compression from the injured / displaced segments of the spine.

However MRI report appears fairly good for the amount of problems that you are having.

This means there is a possibility of cause other than compression contributing to the symptoms. The one that I can think of is chemical arachnoiditis following the disc extrusion. If the contribution of chemical arachnoiditis is significant then surgery is not suggested; because that condition does not improve with surgery.

To make picture little clearer, I would suggest MRI of the spine with contrast followed by a lumbar puncture test (if required). Discuss further about this possibility with your treating physician.

Till than you should manage with strict bed rest, physiotherapy and pain medications.

Hope this answers your query. If you have any further queries, I would be happy to answer.

Good luck!!
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