Four level lumbar fusion for primarily leg weakness

Hello
I'm sorry for the problems you are having. I have had severe lumbar problems for about 12 years. Had my first surgery 5 years ago L4 to S1 fusion. My legs did get somewhat weaker but I think that was from lack of activity due to severe back and leg pain. Your condition with lack of pain and the degree of weakness is different. I'm glad you're getting a 2nd opinion and cervical/thoracic imaging. My 60 yo sister developed leg weakness like you describe and the issue was myelomalacia in the cervical spine. Best wishes to you

I’ve had a T11 through S1 fusion one year ago. I had to wait 7 months before I could get the surgery. My biggest issue is leg weakness. It is getting better, but, it is a very slow process. Try not to get too discouraged. When they work around nerves, chip away spurs and arthritis, pound in rods and place screws, ( I have two rods and 15 screws) the nerves can take 2 years to recover. Keep up your PT and you will get better.

I second PT if you can. Or at least after for sure (fused T10-S2).but I found my leg weakness was gone after surgery but my back was weak from surgery. Took time to rebuild muscles (had 360 done for mine, open). If they give you a back brace get out as soon as possible and work those back muscles. The first few days were sore but I found the pain after surgery to be nothing remotely close to pre surgery so it was tolerable for me. Just take the meds the give you, do NOT sit too much. Walk as many times as you are told, it really does help. Even if just inside the house if weather not permitting outside. Get up every 30 min and stand for a few minutes or walk around. Helps muscles remember what they were supposed to do. Also reduces pain if you keep moving after surgery. But leg weakness totally depends on how much damage is done. I had caude equina syndrome (three fusions to L4-S1, screws kept loosening) then spine shifted forward, almost obliterated spinal cord, woke up with unreal nerve pain in right leg but it subsided over about 24-46 hours, felt like acid for awhile! They did whole fusion then and third lower lumbar, went thru two ribs, abdomen, other side and back. But I was out in 4 days from hospital.)
Getting ready to have another one, two levels shifted backwards outside of fusion. And fusion revision , some hardware is loose again.) but even with all that as long as I kept moving I felt really good. I think we put up with it so long that the pain after is nothing and we don’t realize how much pain we were in before until it is finally taken care of. Then we wonder how we ever managed the pain before!

Had C3-C6 fusion 4/24 and L3-S1 6/24. All felt good but weak until 3 weeks after lumbar fusion. Started to feel nerves zapping in thighs. Spoke with surgeon as condition just kept getting bit worse. He indicated this was normal from compression of cervical and keep up with core and other exercises. Well after a year my strength was getting better but thighs still had a lot of nerve action and lost flexation . All docs kept indicating lower extremities issues were from cervical. Then from 7/2024 - November lower legs and lumbar just pain just kept getting worse. I did exercises, chiropractor, injections and they barely worked and only masked the pain. Finally had MRI, X-ray and CT of lumbar, SI and found that adjacent L-2,L3 was the issue which I tried to convey for over 6 months. Had fusion completed with new rods to tie in previous fusion on 12/20/24. Within a day pain was gone except incision area. Legs feel much better but still have knee flexation issues and shins/calfs are numb. Hoping exercises good diet will get me back near normal except limitations of the fusion which I sure I can adapt to.
I myself would not wait for surgery as every day is possible long term damage. Just make sure to be prepared to put the work in to get muscles strengthen to support you and limit failure years down the road.

@brhodes202 Welcome to Connect. I'm glad you kept advocating for yourself until you found the real reason you still had pain. I'm glad you're on the mend! That's a good lesson to share. Your doctors should have listened to you sooner, but they are not living with your condition. It is true that leg pain can be caused by cervical spinal cord compression, and I had that. When you have issues both in cervical and lumbar with overlapping symptoms, it gets confusing to figure out an exact cause. Good for you for keeping after the doctors.