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Post op facet incidents escalating to cauda equina syndrome

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:25 AM in Back Surgery and Neck Surgery
I'm wondering if anyone else has heard of such a thing. I had a discectomy about a year ago (L3 L4), and it has succeeded in solving my back problems almost complete.

The only issue, though, has been that I have episodes of some kind of structural destabilization after my muscles grow tired from periods of intense activity. Activities, for example, would be several days in a row of strenuous hiking, or going surfing many times in a week, or doing any kind of running more than once a week, or swimming strenuously several times in a week.

The structural destabilization I'm talking about was diagnosed by a PT as being 'facet locking'. He taught me how to do a stretch that would cause my back to pop and usually would relieve the pain symptoms.

The pain symptoms have typically been things like sciatica in my left leg, occasional shooting pain to my tailbone, and pain in my lower back itself (especially if I lean forward or sit without lumbar support).

Another thing I have noticed over the year about this structural instability is that I could sometimes instantly correct it by pushing on my lower back in the area of my right facet joints. I would feel something move inside there, and then the pain would be instantly gone.

Sounds like a dislocation, right?

Well recently, I have noticed that the episodes have grown more frequent. And just yesterday I had one that ended up in an emergency room visit because I was (and still am) experiencing symptoms of cauda equina syndrome (numbness of saddle, constipation, feeling like I have to pee but difficult initiating, poor stream, etc). So the doctors heard me out and did an MRI right away. They assumed they would see a disc herniation on the MRI, but they saw absolutely nothing. They said they were looking at a healthy back.

So today things seem to be calming down a little bit. I'm still experiencing some of the CES symptoms, but they might be calming, and earlier today as I was icing my back, I felt something shift inside there that brought immediate relief of most of the pain.

So my question is, does this ring a bell for anyone? If so, am I having dislocation issues as I expect that I am? And if so, do you have any strenghtening exercise suggestions? I do several exercises that were perscribed by my PT for this, but they don't seem to be enough. Perhaps I should do more reps or more of them? (obviously I won't start strengthening until current episode is completely gone and I'm strong again).

Thoughts and feedback will be appreciated.


  • Spondylolisthesis??

    Your description saounded like me in the early days.

    I am thinking perhaps in the ER, the docs did MRI and see only no obvious trauma or reasons for your symtoms. Lying down is possibly putting your spine an an un-natural (for you) position and so, produces an unrealstic view. I am not explaining this very well, bear with me. And because they are looking for the mind numbingly obvious, are in fact missing the sublaxing vertebra?

    My spondy was unstable - all over place, the joint were so hypermobile and ligaments lax with bilateral pars fractures (nothing holding it down, basically).

    I wonder if you should get referred to an ortho, have lateral and flexion xrays which would show the slippage if present.

    Be really careful with the hands on practitiioners until you have been thoroughly checked out, each and every single one I have seen "thinks" they have cracked my case and I am sure a good few well intentioned ones, have made me worse.

    Finally, if you get the CES symptoms again, pls go back to ER again, don't be put off by the fact they never saw anything this time.

    Take Care

  • Hi,

    I checked out Spondylolisthesis. That's what I like about these forums. The chance to find out about new things that I hadn't considered.

    If anyone else has any idea, please let me know. I'd like to get a range of people's input to think about an mull over.
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