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Spinal fusions, stenosis, grade 2 spondylolisthesis, degenerative discs, nerve pain, second fusion not stable. Treatment ?

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Neurologist, Surgical
Practicing since : 1996
Answered : 146 Questions
6 weeks ago I had 2 spinal fusions for a grade 2 spondylolisthesis L5/S1 & severe bilateral foraminal stenosis. I also have degenerative discs further up the spine. I was asymptomatic until after a work accident 12 months ago. I had one ALIF followed by a PLIF. Some bone broke off accidently during the first surgery damaging the nerve, hence the second fusion as the first fusion "was not stable". I suffer terrible nerve pain & numbness as a consequence from the first surgery. The pain in the back of my thigh, side of my calf & foot is excruitiating. My ankle & the top of my foot feels heavy, I really have to focus hard on making each step. Sometimes I can't rest a sheet over my leg the pain is so bad. I can't feel my big toe & have numbness in my foot, toes & the side of my leg. I've stressed my concerns via fax to my neurosurgeon but I've been told by the receptionist to "be patient". I'm unclear as to what exactly happened during the first surgery. I have my first face to face follow up consult since my surgery with my surgeon tomorrow & was wondering what questions I should be asking. He seems to be so aloof when I attempt to talk to him, so I need really clear questions & answers. Also, will this pain & numbness ever go away? I seem to be getting very little by the the way of answers & I need to know what I should do? Or if I need further surgery? What are my rights? I just don't know what I should be saying to my neurosurgeon for him to hear me, or whether he's being distant because he did something wrong? Please can you give me your professional advice?
Posted Sun, 22 Apr 2012 in Brain and Spine
Answered by Dr. Praveen K Nath 24 hours later
Dear madam ,
Thanks for the follow up.

I have gone through your history in detail .You are suffering from spondylolisthesis L5 S1
post traumatic spondylolisthesis is at times difficult to treat .

You already had 2 surgeries for spinal stabilization .

Your pain & numbness may be secondary to original trauma or may be secondary to surgical insult . But it is highly unlikely to be due to surgical damage . As in spinal fixations we go away from exiting nerves .

Numbness & pain may be controlled by your current medications ,by increasing lyrica dose & adding some regular analgesic after discussing your doctor .

You can ask about any persistent pressure on nerves from your neurosurgeon .

Alternatively you can send your MRI SPINE images to me , so that i can guide you in a better way .
Feel free to contact me any time .

Hope i have answered your query.I will be available for follow up.
dr XXXXXXX k XXXXXXX XXXXXXX consultant neurosurgeon
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