Leg/buttock pain after L4/5 kyphoplasty

@asianangler Welcome to Connect. I'm sorry about your pain, and with several issues at the same time, it may be hard for a surgeon to determine exactly where your pain is coming from. Often surgeons won't promise to cure pain with surgery because it can have several different sources. You fractured L4 and L5, but that disc between those vertebrae is also allowing one vertebrae to slip past another (called spondylolisthesis) and that may potentially cause contact or compression of nerves because of that movement. With scoliosis, there can be uneven pressure in your spine too. Has your specialist showed you how your vertebrae have healed from the fracture? That also may potentially be another way a nerve could be compressed if the bone healing is pressing into something or the bones changed shape.

Yours is a complex situation, and it may be worth it to get some other opinions from some good spine surgeons who are well respected. With spine issues, when there is radiculopathy that is when the nerve roots (between the vertebrae) are compressed by extra arthritic bone growth taking up space, a ruptured disc, or vertebrae that shift closing down that space. It can also happen when a disc collapses because the space gets shortened because the vertebrae get closer together. Discs act like cushions. Imagine it is like a water balloon, and then some of the water leaks out and then there is less of a cushion remaining.

I understand why they did Piriformis muscle stretching because that can present symptoms just like a spine issue. There can also be Psoas muscle issues and hip flexor issues that can play into back pain.

Here is a link that explains Lumbar Plexus Compression Syndrome. You do have spine issues, and it is possible to also have issues generating pain unrelated to the spine.
https://mskneurology.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/
It may also be worth trying Myofascial Release which is a hands on therapy to release tight tissue in your body done by a physical therapist. This MFR work can help a lot of tissue physical issues that generate pain and help the body align better. It can't over come major spine misalignment, but it may help if muscle spasms are causing pain or slight shifting of the spine. That would be a question for a therapist to answer. I have done a lot of MFR work and it has benefited me and also before and after my cervical spine surgery. There is a provider search at http://mfrtherapists.com/. My PT also did neurostimulation to block pain signals with a Dolphin Neurostimulator.

Here is our discussion on MFR where you can learn more.
Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

The description of your different diagnosis are almost exactly as mine. I feel lost, like no one is listening to me. My pain in the morning when I put weight on my right foot the pain shoots up the outside of my thigh. As the day progresses the pain is in my groin and my inner thigh. By evening the pain feels like my hip area and buttocks are on fire. My buttocks are sensitive to touch.

I do have a spinal stimulator that isn't doing a thing. I now have a new neurosurgeon that is sending me for an injection in my SI joint. It will be interesting to see if this works. If it gives me relief I will have surgery for placing some kind of spacer.

The arthritis in my back I have learned to live with but nerve pain is awful.

@kburt911 If your pelvis has shifted out of shape, it may cause symptoms like you describe. Surgeons tend to look at SI joint issues. A physical therapist can help with pelvis alignment. Of course there may be more involved, but seeing a PT may help. I have some things I do when my pelvis gets out of alignment and it stops the discomfort. If you look at the link in my prior post about Lumbar Plexus Compression Syndrome, it explains these issues. It produces symptoms similar to spine problems and it’s positive have both issues at the same time. Have you seen a physical therapist for an evaluation?

Sounds like I have a similar issue. 4/5 exposed nerve. Pain in my butt and lower back. hurts so much today two steroid shots next Friday. I really have no idea what to do. I live in Charlotte, NC. Medical system is very slow to get specialist appointments.

I have tried PT twice and the pain was sombad when they just started to bring my leg up that the therapist said she didn't want to keep hurting me as I was crying uncontrollably. I was hoping it would be something that PT could help.

@kburt911 You may want to look at this discussion about Myofascial Release. This isn't traditional physical therapy, but instead a hands on technique to stretch overly tight tissue that is restricting movement. It shouldn't hurt, and is gentle like massage. It sounds like your hips and range of leg movement are very tight and I'm guessing that may be limiting your stride. MFR can be like baby steps to get the tight muscles released. You'll need to look for a specialty trained therapist for this and can search at http://mfrtherapists.com/.

Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
In this discussion, you'll find a video showing treatment of a patient with a tight pelvis done by John Barnes who created this kind of therapy and he explains what he is doing.

Thank you for taking the time to respond. I will ask the therapy people about this. It's worth a try before resorting to surgery.