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Lumbar Fusion, Cold Left Foot and More

Very long story short, had L5/S1 fusion back in Sept. with screws and rods. Ever since then, I do not have full function in my left foot. Instead of drop foot, I kind of have the opposite problem. I cannot stand on my toes, feel my toes properly (though perversely, I can feel plenty of nerve pain) and cannot stand on the left leg independently. I (and several other people) have noticed a big difference in the temp between my normal right foot and my impaired left foot. The left foot always feels cold (and I'm the girl who never wears socks even in below freezing temps) and it is definitely colder to the touch by quite a bit.

I get that there is nerve damage, but how does that affect the temp. of my foot? Wouldn't that be a circulation issue? I plan to ask the NP when I go to get my stitches taken out from my hardware removal surgery 2 weeks ago, but if anyone else is dealing with this or has any insight, I'd love to hear from you. Thanks!
Left leg radiculopathy/sciatic pain
L5/S1 microdiscectomy - May 30, 2014
L5/S1 microdiscectomy - Aug 14, 2014
L5/S1 TLIF - Sept. 24, 2014
Left-side screws/rod removed along with bone fragment Dec. 29, 2014


  • bodolsbbodols Posts: 7
    edited 01/13/2015 - 12:26 PM
    I just wrote my first post about a similar Subject. I had ALIF L5S1 surgery on 12-4-2014 and started noticing temp difference left foot vs tight foot. 79-83degree left vs 97.3 right.
    It is only on bottom of left foot and top and bottom of left toes.
    It seems to be brought on by certain body positions like sitting in bed or sitting on toilet. After I wake up in morning both feet are warm. Nuero Surg PA was unfamiliar with this and Vascular Surg who did entry did not seem too concerned. I do not have the severity of weak keg that you have but
    I have sciatica type pain in left leg, calf and foot. Trying to get answers as well.
    You may see my first post later- not sure where it will show up.
    Good luck to you - post any info you get.
  • You can see my post under surgery recovery for more details about my situation.
  • I've noticed the cold foot as well. No foot drop. I never thought about my foot brig cold having anything to do with the surgery/back issues. I will bring this up to my dr Monday.
  • I rcv'd info that it could be related to swelling in the L5S1 area if a lit if digging into the area is done as major veins run right in front of area. In my case if ALIF revision due to Psuedoarthrosis after TLIF L5S1 in 2012.
    The ALIF I had on 12-4 lasted just under 5 hours as they had great difficulty getting the old spacer out. I still have temp difference in left foot 83 vs 97 right on occasion especially if I am sitting.
  • kevheadkkevhead Posts: 42
    edited 02/08/2015 - 3:21 PM
    I'm having almost the exact same issue except I just had my L5/S1 surgery on Jan. 27th. I go back for a follow up this Thursday and will bring this up, but I assumed this was part of the recovery or nerve inflammation. For me it's on the right side, I originally had severe sciatic nerve pain and before surgery I could barely move my right leg and foot. My foot and rear leg have numbness still, the heel is somewhat bothersome and I can't stand too long yet. My last 3 toes are very sensitive too, just feels like a bad charlie horse in my foot. Very strange...
  • Just an update, when for my second post op today and my concerns about the cold feet/weakness and numbness in the leg and foot are supposedly very common after a few weeks and even a few months. My Ortho didn't seem to be too concerned since we caught it early and had surgery quickly after the diagnosis. I still am worried about the possibility of having nerve damage but I guess time will tell.
  • kevheadkkevhead Posts: 42
    edited 02/19/2015 - 10:54 AM
    Update, so now I'm 3 weeks Post OP and things are getting better each day. Still have the pins/needles and numbness in the foot but it's slowly getting better. The cold sensation is getting better too. I started PT today and the therapist was very familiar with my condition. Everyone says be patient with the nerves, they will eventually heal as long as the compression wasn't prolonged (which I had for about 3 weeks before I had surgery). I still have stiffness and weakness in the right leg but the strength is also slowly coming back. I still can't flex my calf muscle or stand on my tip toes but things are progressing.
  • Kevhead,

    I'm glad you're seeing some improvement. That's got to be encouraging. I just re-addressed this with my surgeon at my second post-op and he sent me for a bunch more tests and checked for a blood clot (there wasn't one). Of course, I'm almost 5 months out from my TLIF, so who knows?
    Left leg radiculopathy/sciatic pain
    L5/S1 microdiscectomy - May 30, 2014
    L5/S1 microdiscectomy - Aug 14, 2014
    L5/S1 TLIF - Sept. 24, 2014
    Left-side screws/rod removed along with bone fragment Dec. 29, 2014
  • Coltsfan, any improvement since your last post? I'm now 6 weeks Post Op and the cold foot sensation is almost gone, that's the good news. Bad news is that I still can't stand on my toes and flexing my calf muscle in the right leg is still hard. I've started PT and that seems to be helping a little with the strength, but they are trying to work on my gait and walking. It's hard to explain but it feels like I have something stuck to the bottom of my foot sometimes even though there's nothing there. My heel sometimes hurts but they tell me that's part of the strength loss and compensating when I walk. I'm trying to walk a mile a day, hopefully things still improve but it's still frustrating.
  • Kevhead,

    Thanks for checking on me! I don't really have any changes in my foot/leg weakness. I haven't noticed any improvement at all and it's now been about 5.5 months since my fusion. PT didn't make any difference there either. It did help re-strengthen my hip and upper leg muscles, but as far as the calf and ankle muscles, they are still very weak. I wish I had better news.

    Your news, on the other hand, seems encouraging. I know it's a really slow process towards healing, but the fact that you are seeing any improvements is a good sign. I can confirm what the therapist said about your heel hurting. Mine was really sore when I first started getting more active again. I knew I was compensating for my toe/ankle weakness and after a while that discomfort did lessen. I hope you continue to recover and make good progress!
    Left leg radiculopathy/sciatic pain
    L5/S1 microdiscectomy - May 30, 2014
    L5/S1 microdiscectomy - Aug 14, 2014
    L5/S1 TLIF - Sept. 24, 2014
    Left-side screws/rod removed along with bone fragment Dec. 29, 2014
  • Caper-JimCCaper-Jim Posts: 1
    edited 07/24/2015 - 4:06 AM
    I had an L5-S1 TLIF procedure on May 5th, 2015 for spondylolisthesis aggravating my left leg. The cold toes and extremely sensitive skin on the top of those toes seems to be developing. Since surgery I have pain in my left hip and outer calf - especially in the mornings...seems to get batter with the day. I can't tell if the entire effect is waning although I am taking much less pain meds 2.5 weeks post-op.

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  • SlongSSlong Posts: 9
    edited 07/23/2015 - 11:11 AM
    I had this op on 23/04/15 and had sciatic nerve pain in left leg, back and pain gone however cold and numb feeling foot and calf. Back at work now for 3 weeks and walk loads in my job, foot often feels hot at work but still no strength in foot leaving me unable to drive (can't use clutch) and walking with a limp. Any advice? I'm having EMG/nerve conduction studies (electric shock treatment) next week to see what my sensory nerves are doing. I know it's only 3 months since the op but I'm so deflated by this and often get a dull ache in the whole of my leg when waking up?.

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  • I know how you feel, I had/have some similar symptoms after I herniated my disc. How long were you having weakness/numbness before you had surgery? I had my fusion done in January (started having weakness about a month before surgery), I'm almost 6 months post op and still haven't recovered strength in my foot/leg. I'm still in therapy and I think I'm about 15-20% stronger than I was. My foot is still a little numb on the heel, the cold/hot feeling went away after about 3-4 months. It was mostly a cold feeling. I've been through a bunch of tests since my surgery, my Ortho says that nerves heal VERY slowly and I just have to be patient. There's a chance I may have permanent nerve damage but hopefully that's not the case. Keep us posted on your progress and good luck!
  • Slong,

    Sorry you're dealing with this aggravation as several of us here are. In my case, nothing has really changed and it will be 10 months ago tomorrow since my fusion surgery. My foot is still really cold all the time compared to the other one. I still have the same weakness (unable to raise up on my toes on the left side) and I still walk with a limp. I have often thought how fortunate I was that this didn't affect my right leg/foot as that would make driving so difficult, if not impossible.

    You are still much earlier in the recovery process than I am, so hopefully you will see improvements in the coming weeks and months. Don't give up hope!!
    Left leg radiculopathy/sciatic pain
    L5/S1 microdiscectomy - May 30, 2014
    L5/S1 microdiscectomy - Aug 14, 2014
    L5/S1 TLIF - Sept. 24, 2014
    Left-side screws/rod removed along with bone fragment Dec. 29, 2014
  • I have the same problem as you and several others who have posted. The back pain. foot feeling like its wrapped in barbed wire and sciatica have gone. I am left with an icy cold foot , which is painful at night , weak leg muscles , a limp, fatigue and terrible balance issues. I am having physio but it doesn't seem to be helping much. I am 12 weeks out from L5 S1 fusion so early days I know. I was not told that I could have these issues. I am grateful to be out of the horrific pain. My G.P. was clueless when I saw her this week and was puzzled as to why I was still using a cane. Yet another case of the patients having to educate themselves. Thanks for all your reassuring and helpful posts though I wish you were not suffering.
  • Just chiming in with my experience. Also have a cold leg/foot - right one for me - especially when lying in bed. Emergency microdiscectomy L4L5 on April 21 due to sudden loss of all strength and feeling in my right leg and urine retention (cauda equina). Immediately after surgery a good part of the strength and feeling came back. I'm left with right leg numbness of the foot, calf and upper back of the thigh. I can't raise my toes and my foot will not turn out at all - a zero on that test. I've had physical therapy since day 3 - was lucky to go to a week of inpatient PT straight from the recovery floor. Re-learned how to walk and climb stairs. I've been in out-patient therapy since. I walk without the cane but need to be very careful my right foot is on even surfaces or my ankle will just turn out. I walk with a limp as well. I'm trying to find out if there is something that can be done to keep the muscles from atrophying even if I don't get the use of them back. Anyone explored this? I can drive despite the right foot weakness and numbness. I took it really slowly and just now started getting back on the interstate. It's worth trying in a parking lot if any one is hesitant.

    I'm getting conflicting info on if I just need to wait and see about the weakness and numbness or if I should pursue anything (whatever that would be). Also wondering if the lingering weakness which is related to the S1 nerve could be a sign of further compression on the S1 nerve form the L5S1 level which I know has some issues and I wasn't operated on that level.

    Thanks everyone for sharing..it's so helpful.

    Susan (age 42)
    L4L5 micro with cauda equina 4/21/15
  • Hi,

    Yes I had numbness but not coldness in the left foot for a month before the op. Today in work, (not sure if my desk is set up wrong) but I had severe numbers in the back of my left thigh which is new. Am wondering if there is still something pinching on a nerve causing this. Cannot go on toes (on left foot) and therefore not got the strength to use the clutch in my car. Feeling exhausted and am putting pressure on my back due to the limp and silly walk I have at the moment. Contemplating getting a walking stick just to take a bit of the pressure off. EMG/nerve conduction tests next Monday so fingers crossed, if nothing found they may even do another MRI for me to rule anything else out. Fingers crossed as can't cope with this for much longer.
  • Slong, keep us posted on your progress. After my fusion I had all sorts of strange feelings/sensations in my leg/foot/bum area. I'm 6 months post op but still have a little numbness in the back of my thigh and in the heel of my foot. It doesn't bother me too much, the cold sensation was awful at first but that went away (thank goodness). What does worry me is the weakness I still have in the leg/foot. I had another MRI and EMG, the MRI showed no further compression the nerve just some scar tissue that my ortho didn't think was a big deal. The EMG tests confirmed S1 nerve issues at the root (which is where the compression was). So far I've been told it just takes a long time for this to heal, and hopefully it's not perm. nerve damage. I'm still in therapy 3 days a week and that seems to help, they are focusing on my strength more than anything now. I keep telling myself not to give up and be patient, but it's hard to just accept this as "normal" for now.
  • kevhead said:
    So far I've been told it just takes a long time for this to heal, and hopefully it's not perm. nerve damage. I'm still in therapy 3 days a week and that seems to help, they are focusing on my strength more than anything now. I keep telling myself not to give up and be patient, but it's hard to just accept this as "normal" for now.
    I just wanted to say I am at the same point - therapy is going well to help me compensate for the S1 nerve damage but I'm having zero response to stimulating the muscles that won't work. I'm 3 months out and my PT says that she thinks it is unlikely I will have a return of function and feeling. I have definitely gained strength but I think there is a limit to it. I can get down on the floor now and back up with the use of a chair/couch and walk with a limp. I torn between accepting my current state, which is livable as I can drive and walk, and the urging of others that I should leave no stone unturned but if the muscle won't even be stimualted I'm not sure what other options are out there.
  • I have now had nerve conduction studies and EMG and co sultans said definitely no circulatory problems a, he even think
    S I may still have something pushing on L5/S1 so is requesting my spinal consultant sends me for an MRI. Still no difference in strength in my foot even though I walk (limp) all day long in my job, have even bought a walking stick now to help as when tired I can be clumsy and fall. Still can't drive and it's getting me down, I don't want to accept this is how it's going to be, no one understands the pain that has now become the norm for me and the tiredness I get in simple walking,..... Hoping there is a light at the end of the tunnell
  • Hi Slong, is this your first MRI since your operation in April? Maybe there's still something there that's compressing the S1 nerve root and hopefully an MRI will show that. I had an MRI done last month and my ortho said for the most part everything looked ok, however scar tissue was building up around the S1 nerve root. He said it's hard to tell whether or not that's contributing to my S1 issues still, only way to tell would be to go in for another surgery and try to remove the scar tissue.

    I understand your frustration, I'm a little over 6 month post op and working hard every day to try and regain strength in my foot/leg. I still can't do a calf raise and am scheduled to see another specialist next month. I refuse to accept this as "normal" until I've exhausted all my options, so don't give up and keep us informed of your progress!
  • Yes this wil be first MRI since op on 23/04/15. Although nerve conduction tests also state no motor or sensory use in lower left leg and foot. I'm such a positive strong person but about to go on holiday in a week and already anxious...need to be at the shallow end of the pool so I can heave myself out as can't use the steps due to no feeling in left foot and can't push up, will sunbathing/lying down for long periods be good or not for me, what shoes do I wear as can't wear flip flops due to lack of grip between the toes, should I have got a seat on the plane with extra leg room, and the list goes on. No one sees what goes on in my head every second of every day, just can't believe how much this has affected my everyday life, the pain being normal now is also bothering me. Thank god for a loving and supportive family and friends
  • Slong, how long did you have symptoms before you went in for your surgery?

    I completely understand what you are going through. I had a Micro-D three years ago and that was nothing compared to what I went through this past winter. In hindsight I should of gone to the emergency room and maybe I would have had a better chance of recovery, I waited a few weeks after the symptoms became unbearable and that may have been too long. I have 2 young kids and am active with them and their activities so it's been a big adjustment for me. Luckily I'm not in too much pain, just periodic back soreness if I do too much. Hopefully the MRI comes back negative and it's just inflammation and the nerves are still in recovery.
  • I went into the Emergancy hospital by ambulance on 01/03/15 as was in so much pain with my back, had an MRI ON 02/03/15 and before they did surgery they wanted to try a spinal block which didn't achieve anything, it was during this time my leg and foot felt comfortable led and numb, it's just progressed from there. I had a lumbar microdyscectomy on 23/04/15 and funnily enough a microdyscectomy on 04/09/08 which I recovered from really well with no after pain or numbness. Part of me hopes as the nerve studies suggest that I may still have something on my L5/S1 that I may need further surgery, not keen to go through it all again, but if I have a chance of my leg and foot going back to normal I will try anything. I have even applied for disability to see if I can get it then get an automatic mobility car, but I don't expect to get it due to still being under investigation. Just suck not driving since 01/03/15
  • A third of my left foot, towards all toes, is not only cold, but I could walk on hot coals and feel nothing. It is spreading now, and I am 5 months post op, from a 3 level lumbar fusion with  2 artificial discs implanted.
    They went through the front and then the back.
    Overall, my low back pain is way better, but what a trade off.
    I have to still use my cane, because my balance is off.
    I cannot stand on my toes on the left foot either.
    I cannot walk more than 30 feet and then my leg just refuses to continue on.
    I stop, wait and then walk 30 more feet.
    The airport is a pain in the ass because the airlines are not paying attention to "ticketed all the way through with a wheel chair". Its like a mile between concourses.
    I even paid for FIRST CLASS but was bumped to seat 15  in the middle when we missed our connection due to no driver for the electric car they plunked me in, then walked away and left me.

    My neurosurgeon has yet to order me ANY PHYSICAL THERAPY, so we flew to Jamaica, so I could get in warm sea water, for a month.
    I feel like my legs are toned, but those same problems continue.
    My husband was massaging my feet, and he noticed the huge difference in the temp of my left foot compared to the right.
    The bottom is also red and puffy, compared to the right.

    I see one of two neurosurgeons tomorrow. I will bring it up then, but I imagine he will say, "it takes a year to heal."
    No CT SCAN to see if I have fused. He is waiting until 9 months post op.
    Must be good old WORKERS COMP being cheap skates.

    I am happiest in the sea.
    "For we walk by faith, not by sight"~ Corinthians
  • hvillshhvills Suzhou, ChinaPosts: 728


    It could be that you have some kind of nerve damage... maybe permanent maybe not.   In my case I have permanent nerve damage that causes the bottom surface of my right foot in the toe area to feel numb 24/7.  My doctor says there is nothing that can be done about it... and I will just have to learn how to live with it.   Even if your doctor has not given you specific PT exercises hopefully you are doing some walking every day. Yes? No? Maybe?  It's very important for your recovery.  I also really like swimming... and do it 4-5 times a week in addition to walking.

    Harry - 63 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
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