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Dr. Andrew Rynne

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Getting tingling sensation in lower legs and pain in buttock after spinal fusion surgery. Is this normal?

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Dr. Rahul D Chaudhari

Spine Surgeon

Practicing since :2002

Answered : 322 Questions

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Posted on Fri, 8 Feb 2013 in Osteoporosis
Question: I had spinal fusion surgery on August 15th, 2012, and had to have a second operation because a screw became dislodged. I still have the original pain in my butt and have acute tingling in both lower legs. Is this normal? My GP has checked my lungs and they are clear; my last EKG was normal. My podiatrist has checked me because I have a bunion and a hammer toe on my right foot. I also had three left butt surgeries during 2012 to remove large lipomas (which after the 1st surgery turned into a small basketball sized seroma). I am tired of being in pain. What do you suggest?

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Answered by Dr. Rahul D Chaudhari 2 hours later
Hi,

Thanks for the query.

Pain in the buttock and and legs may be due to pinching of the nerves in the spine. I would like to know few more things as this would help me in suggesting you better.
- How much do you walk pain free?
- Have you got any post operative MRI?
- Are you on any medicines?

It looks like you have spinal stenosis symptoms.

Please get back with above information.

Thanks.
Above answer was peer-reviewed by : Dr. Mohammed Kappan
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Follow up: Dr. Rahul D Chaudhari 11 hours later
Let me try again. In Oct.2010, I had an MRI on my left buttock and thigh which revealed a tumor (they thought malignant). Went to XXXXXXX and it turned out to be a neurofibroma. Several doctors told me to leave it alone. Still had pain - went to the first surgeon who removed the lipoma mass and the seroma and still had pain.
Went for 3 epidurals - no relief. Then came the back surgeries. Still have pain.
Tried physical therapy where they pushed a hard plastic ball into my butt to break up scar tissue. I couldn't walk for two days. Am now heading for a shot in the sacroiliac joint. I'm winded; walk without pain a minimum amount of time; take no pain meds because I can't take narcotics and I have other "old woman" issues.
My legs from the knee down both feel numb and tingly. I had a CT scan after surgery as well as a MRI on my leg. The CT scan showed the dislodged screw and the MRI showed no change in the neurofibroma. I realize that I have been sedentary for over a year and I am trying to at least walk slowly on a treadmill for 10 minutes a day. I get exhausted easily and never have been a person who exercises. The MRI in the very beginning showed stenosis. In the words of my
surgeon: "your back is a mess".
doctor
Answered by Dr. Rahul D Chaudhari 37 hours later
You have a complex history and I think it would be better to examine you first and need to know whether the pain is from the spine or neurofibroma.

Definitely post op MRI with contrast will tell us the exact situation in the spine and if there is any residual stenosis. In addition, EMG NCV can be performed to get an idea about location of nerve involvement.

It is difficult to tell you for sure about the source of the pain right now.
Thanks.

Above answer was peer-reviewed by : Dr. Shanthi.E
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MRI OF LUMBOSACRAL SPINE: -

PROTOCOL:

-     SE T1W & TSE T2W SEQUENCES IN SAGITTAL PLANE.
-     TSE T2 W SEQUENCE IN AXIAL PLANE.
-     STIR SEQUENCE IN CORONAL PLANE.
-     MR MYELOGRAPHY USING HEAVILY T2W SEQUENCE IN SAGITTAL AND CORONAL PLANES ON A 1.5 TESLA SCANNER.

There is some degree of straightening of lumbar lordotic curvature. Vertebrae are normal in height, alignment and marrow signal intensity.
Dessicative disc changes and anterior osteophytes are noted at multiple levels. Disc height is reduced at L4-5 with degenerative endplate changes at this level.

There is diffuse disc bulge, thickened ligamentum flavum & facet joint arthropathy at L4-5 compressing the thecal sac and causing spinal canal stenosis with bilateral neural canal compromise (L>R). The mid sagittal diameter and area of spinal canal are 0.8cm and 0.75cm² (lower normal limits are 1.0cm and 1.5cm² respectively. Effusion is detected in the facet joints.
Annular tear, diffuse disc bulge and facet joint arthropathy are visualized at L3-4 indenting the thecal sac.
Diffuse disc bulge is observed at L5-S1 mildly compromising the neural canals bilaterally.

Cord ends at L1 vertebral level and shows normal signal intensity. No abnormal pre or paraspinal soft tissue mass is seen. MR myelography confirms the above findings.

Impression      :     MR findings reveal lumbar spondylotic changes with
     -     Diffuse disc bulge, thickened ligamentum flavum and facet joint arthropathy at L4-5 compressing the thecal sac and causing spinal canal stenosis with bilateral neural canal compromise (L>R).
     -     Annular tear, diffuse disc bulge and facet joint arthropathy at L3-4 indenting the thecal sac.
     -     Diffuse disc bulge at L5-S1 mildly compromising the neural canals bilaterally.

-     To be correlated clinically.

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