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Had discectomy-laminectomy. Been on physiotherapy. Difficulty in walking and suffer muscle fatigue. Treatment?

Jul 2013
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Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
I had a discectomy-laminectomy at L5-S1 in Dec 2012 required because of loss of strength in my left leg (I could not lift my left heel off the ground). I have been in physiotherapy from March to XXXXXXX 2013 but there has been only a small gain in the muscle mass and strength of my left leg and left butt muscles which are noticeably smaller than my right side. I have difficulty in walking steadily for longer than five minutes before muscle fatigue sets in. What further treatment steps should I consider?
Posted Tue, 23 Jul 2013 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 20 minutes later
Hi, thanks for writing to XXXXXXX

The very fact that you have waited until you have lost muscle strength in your leg before undergoing surgery indicates that the L5-S1 nerve root is so much under compression for a very long time.

Normally the muscle tone and strength should recover within 3-4 months after disc decompression.
When the nerve root is compressed by the inter-vertebral disc for a prolonged period of time, ischemic changes occur in the nerve root leading to neurological disturbances and cause atrophy and weakness in the muscles they supply.

So,when the muscle gets atrophied, it is gradually replaced by "Fibrous tissue" which lacks the elasticity as in normal muscle leading to loss of strength.I suspect this in you.

I suggest you to undergo Nerve conduction studies and EMG (Electromyography) to evaluate the status of both nerves as well as muscles in your leg. You have to consult a neurophysician for these investigations.
Hope, I have answered your query. Happy to help if you need any more clarifications.

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