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Permanent L5 nerve root damage

jes3287jjes3287 Posts: 3
edited 06/11/2012 - 7:59 AM in Back Surgery and Neck Surgery
I've been having ongoing toe drop and foot numbness in my left foot since my L4/L5 surgery in July 2009.

Went and had an EMG done today and found out that unfortunately the damage is permanent. Physician believes that damage was done at the time of the herniation due to the severity of the ruptured disc.

Not to be the bearer of bad news, but there are times when the herniation is so severe even immediate surgery won't help. I had my surgery within 2 days of the herniation.

I'm pretty bummed out. At 37 years old, I literally have a disability that won't allow me to participate in sports anymore, even with an orthotic. Oh well, it could always be worse I guess.



  • Hi. I'm hesitant to get the EMG b/c I still believe the nerves can surprise us. I didn't think the test was a definitive test but rather one that shows, based on similarly situated patients, that it statistically is right.

    Well, I guess it's the same thing.
    Anyhow, I dropped in to say that I ruptured my disc at 40 (back in August 2009) and had the surgery within a week of the injury. It failed. I had a revision in Feb 2010 in which I did a little better. I got some leg strength back and my limp is gone (I had to work hard on body mechanics) but never got any feeling back in my buttocks, groin, back thigh, or foot.

    Much like you, I'm done with the sports I loved - like running & biking. I won't say running is gone forever but it's only there if someone is chasing me.

    I walk a lot now, I hike but have to be careful, and I still go out on our boat but not during peak hours.

    Many people don't realize everything I had to give up but I try not to dwell on it and am still looking for new things to try.

    I hear ya....sometimes, the initial injury is SO bad that surgery can only help so much. For me, I'm pleased to see at least some of my pain go away b/c that was keeping me from the basics like walking and going out with friends.

    Stick around...sometimes, we need each other for support!
  • Thanks for the support DNice. As I read through these forums I realize that many people suffer with similar injuries.
    I made some early mistakes in my life, like deciding to work hard labor rather than attend college right away. Never thought those 3 years would've come back to haunt me, but unfortunately they have.

    I wish you the best in your recovery. Hopefully down the road there will be some stem cell treatments to help regenerate the nerves and we can all feel better.
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  • I hear ya. I guess I can't complain because I have a desk job and can work remotely occasionally. I hope you find some relief.
  • Hello,

    I've had EMGs, but the selective nerve root injections I've had seemed to be very clear in diagnosing the affected levels. There are similar to an epidural only no steroids, just a local anesthetic. The dr. injects the local around the base of the nerve root. You wait a few minutes and then rate your pain. If it is the correct level for the pain originator, your pain should remarkably improve. That effect will wear off in 30min-1 hour or so.

    As far as permanent, EMGs can be subjective on the dr.'s part and I personally do not believe they can always say it is permanent. Lots of stuff could be going on in there: loose hardware, ectopic bone growth(bony tunnels around nerve roots, especially if you had BMP during surgery), or instability of spine above or below the fusion site. Sure would be nice if the dr. would open up the site and explore the fusion mass so he can see it with his own two eyes!

    If you have nerve pain and all other avenues have been explored, as a last resort you might consider talking to your doctor about a spinal cord stimulator for the pain in butt/hips/legs/feet. You talk about foot drop and numb areas, so I guess I was assuming nerve pain, too.

    So what plan of care is your doctor suggesting?
  • Sadly there really isn't a plan of care at this point. My neurosurgeon tells me I am in pain "because you've had 2 back surgeries at the same level". However, I am not a candidate for another surgery as the outcome would likely make things worse. The damage to the L5 nerve root was caused 2 years ago when I had a severe herniation at L4/L5 and according to the EMG there is very little if any hope of recovery of the nerve. I also had flexion/extension x-Rays and they've ruled out lumbar instability.

    My neuro wants me to get an AFO because he thinks my incorrect gait may be causing my low back muscles to spasm and to follow up in 6 months. My PCP finally gave me Tramadol for the pain, but it works for about the first two weeks, then you build tolerance and I refuse to take more because the crap is quite addictive. I honestly wish the nerve was totally dead at this point, because it still fires on occasion and I get darting pains in my foot that you'd swear were bee stings.

    I guess I'll just continue with my stretching, walking and strengthening in hopes the pain improves. If it doesn't improve in a month or so, I'll ask my PCP to refer me to a pain clinic.
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  • I thought they can cauterize the nerve but maybe I am confusing that with the nerve root block.

    Has the doctor offered other nerve pain meds? I know neurontin and lyrica are options. But they have side effects too.

    I opted for OTC and try to stretch. Also, I have learned to ignore the daily pain or at least try to so that I only take OTC when I cannot ignore it. It is not easy to do though.

    You sound like your rupture was quite similar to mine. It was excruciating when it happened and despite catching it fast, I lost another piece. Much like you, the surgeon told me that the feeling will not likely come back because of how hard/big the hit was both times to the nerve. Luckily my pain has become manageable (except at night and first thing in am) through exercise.
  • I had two surgeries and the thigh pain was becoming disabling so I had a third surgery. As soon as I woke up I knew the problem wasn't fixed. I went out of state for another opinion and this doctor ordered an EMG. It showed permanent nerve damage of the L5 nerve root. You cannot have those burnt or you will become wheelchair bound. The only MRI compatible DCS is for the brain. I traveled around the world helping Spine Surgeons with research. Now I cannot even drive a half hour, so it has been very hard to adjust to not doing anything. Please keep I'm touch and has anyone tried homiopathic such as infrared heat Diana's? I have looking at them with hope. Thanks Lisamarie

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