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Had Canal Stenosis And Bilateral Foraminal Narrowing. L4/l5 Fusion Done. Shouldn't The Foraminal Narrowing Be Repaired?

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Posted on Mon, 6 Aug 2012
Question: i had a l4/l5 fusion done nov 16 2010,i had severe canal stenosis and sever bilateral foraminal narrowing, the surgery went gtreat but now my legs and feet go numb,cant urinate sometimes,tingling and needles in fet and legs,loss of balance etc... Mri done week ago showed no postoperative canal stenosis,but it says the foraminal narrowing that was there during surgey in 2010 is now more severe and now called neuroforminal narrowing. My question is shouldnt the foraminal narrowing been repaired while they wer in back fusing l4 to l5 . I know the laminectomy and removal of dick and putting in medtronics cage and screws,plus he used the synthetic bone promoter
doctor
Answered by Dr. Dr. Praveen Tayal (7 hours later)
Hello,
Thanks for posting your query.
The symptoms you are having are due to neuroforaminal stenosis causing the nerve compression. During the surgery , the decompression of nerve roots is done but this is an age related degenerative process. Re stenosis can occur after the surgery. In your case, it seems that the sacral fibres are affected. Affection of bladder and bowel indicates that the stenosis is severe and surgical correction may be needed again.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Regards.
Dr. Praveen Tayal.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (13 hours later)
Thank you Dr. XXXXXXX Tayal,
i appreciate your time and attention to mt question. I have a follow up question,which is,if that foramin area was enlarged,grinded out some"foraminotomy". Do you feel that 18 montrhs is enough time for the bone in that area to grow back,but even though it was identified on the preop mri and 18 months later same exact area is same,moderate bilaterall neuroforiminal stonosis of the exact same area. Origannally surgeon told me he was going to take bone from my hip to use for the graft,i agrred and understood. When i woke up and after the anestetic wore off i noticed no pain from hip are and no scar,i asked him why and he replied he decided to change his original plan while he was in there and use the medtronic bmp,or bme, the synthetic bone growh stimulator. Is it posible for the bone to grow back that fast around the foramin area of the vertabrae where the fusion filled in and the canal stenosis was gone. Thank You for your time
XXXXXX
doctor
Answered by Dr. Dr. Praveen Tayal (44 minutes later)
Hello.
Thanks for writing again.
The rate of bone growth varies from person to person. Although such a rapid bone growth is not common but not impossible. The other possibility is failure to decompress the nerve roots completely during the surgery and the further osteophyte formation caused the stenosis. Only the surgeon who performed the surgery can tell you the details.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12314 Questions

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Had Canal Stenosis And Bilateral Foraminal Narrowing. L4/l5 Fusion Done. Shouldn't The Foraminal Narrowing Be Repaired?

Hello,
Thanks for posting your query.
The symptoms you are having are due to neuroforaminal stenosis causing the nerve compression. During the surgery , the decompression of nerve roots is done but this is an age related degenerative process. Re stenosis can occur after the surgery. In your case, it seems that the sacral fibres are affected. Affection of bladder and bowel indicates that the stenosis is severe and surgical correction may be needed again.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Regards.
Dr. Praveen Tayal.