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BY DWIGHT TYNDALL | Sunday, April 06, 2008 | (No comments posted.)
Q: Nine months ago I had major spine surgery because of bad disks, spinal stenosis, and a slipped vertebrae. I had no back pain but experienced electric shocks from the buttocks down to the right knee. Surgery solved the shock problem but caused left buttock pain, left knee numbness and constant back pain.
I also have developed another slipped vertebrae and bad disk up above the surgery site. (I have bad knees but was told to have back surgery first.) I was told by my physician that I was not a candidate for spinal decompression.
I have tried aqua and physical therapy without any help. Now I am trying an epidural but so far no luck.
What can I do other than more surgery on the spine to relieve the constant back pain and left knee numbness? -- Beverly
A: From your description of your condition, it seems that you had a lumbar fusion and decompression initially for a spondylolisthesis and lumbar stenosis. This is often done to stabilize the slipped vertebrae while at the same time relieving the pressure off the nerves. By your description, it now appears that you might have developed the same condition above the initial surgery area.
Your treatment, so far, seems to have been reasonable with both aqua and physical therapy as well as the epidural injection.
Since these have failed, your next option might be medication. There are now medications on the market that might help. These include Elavil, Lyrica and Neurontin. These medications, which can be very helpful in relieving the pain and numbness that you have in your legs, can also be variable in their effects. Therefore, your doctor might have to try various dosages to see what will work.
If these medications don't work, it is very important that a thorough examination is done to truly identify the source of your pain.
Since you have "bad" knees, it is important that the knee is eliminated as a source of your pain. This can be done by a physical exam with the proper diagnostic study on your spine.
For your knees, weight bearing x-rays are helpful to see how much osteoarthritis is present and for your spine, a CT myelogram is helpful to see if there is any residual nerve root compression.
In addition, your hip should be evaluated by both physical examination and radiographs since osteoarthritic hips can present either back or leg pain or both.
The opinions expressed are solely those of the writer. Dr. Dwight Tyndall is a practicing Spine Surgeon. He can be reached at dstyndall@yahoo.com (use the subject line "bone doctor column"), www.spinecarespecialists.com or at Dr. Dwight Tyndall, 730 45th St., Munster, IN 46321. This column is intended for informational purposes only. Readers should seek specific medical advice from their own physician.
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