Foot numbness and pain after L5-S1 fusion: anyone dealing with this?

Posted by pauldandurand @pauldandurand, Mar 27 5:35am

Has anyone had a failed L5-S1 fusion that introduced foot problems that didn't exist before surgery?

I had the surgery to address lower back pain and a burning sensation in my right calf. The surgery resolved the calf burn but introduced new numbness in the ball of the foot and pain when bearing weight while walking. What my surgeon didn't know beforehand is that I have a conjoined L5-S1 nerve root, an anatomical variant where two nerve roots share a single exit point, which made the nerve more vulnerable and harder to identify during surgery. He most likely injured it in the process. The MRI radiologist missed it. After the surgery a different radiologist had a look and he clearly identified the conjoined nerves. Post-surgery scar tissue has since encased and tethered the L5 root.

A second surgery 6 months later removed bone, replaced the disc with a spacer, and added rods. This made my foot symptoms worse, probably due to further nerve aggravation and additional fibrosis around the root. Too add to the frustration, the second surgery hardware is failing with screw loosening and the L5/S1 space is not fusing (pseudarthrosis). So, I also have constant back pain.

Every neurosurgeon I have consulted has said there is nothing surgically correctable and that I should either live with it or consider DRG stimulation. I looked into the latter carefully: DRG stimulation targets the dorsal root ganglion, but my injury is too far upstream at the nerve root itself for that mechanism to help.

I am now doing home self-therapy which includes neuropathic foot exercises and sensory re-education using vibration, brushes, texture discrimination, etc.

I am looking for others in a similar situation, particularly anyone who has been told the same thing by their surgeons and is actively trying rehabilitation rather than just pain management. I know stem cell solutions are probably years from now, but I'm not giving up in finding ways to regain my normal foot.

Please share. Thanks!

Interested in more discussions like this? Go to the Neuropathy Support Group.

Profile picture for philnob @philnob

As far as I could understand, the Surgeon was giving me a general read of the MRI. Several times he referred to the Nerve Roots as being normal. I have been trying to contact the Radiologist, but I haven't been able to reach her yet.
I am very disappointed in the outcome, and the attitude of a surgeon who won't acknowledge that I inherited these problems as a result of the surgery he performed.

Philnob

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@philnob You should be able to get a radiology report along with access to the images. You paid for them 🙂

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Your are right Paul. I plan to do exactly that, and search for another Doctor.
Thank you,

Philnob

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Profile picture for philnob @philnob

Your are right Paul. I plan to do exactly that, and search for another Doctor.
Thank you,

Philnob

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@philnob I don't know if you use AI, such as claude.ai, but consider doing research. If you don't use it, find a friend who's very good with advanced AI LLMs to help. I use the paid version (Claude Pro) to leverage the higher models such as Opus 5. Just keep in mind to always ask the LLM to search only credible sources and to double check itself. It won't have the answers, but could give you direction and may also help you find which docs to see.

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Hi, I am going through this exact thing at the moment. I am 9 weeks post L5 S1 laminectomy and fixation surgery and I have horrific nerve pain in my left foot! It's affecting the top of my foot and big toe mostly but sometimes the outer edge and ball of the foot. It's debilitating and it's affecting my mental health and physical recovery. I think my nerves were injured during surgery but I am under the NHS In Scotland and doctors are downplaying my symptoms and my surgeon is nowhere to be seen. I was told by a whistle blower in the hospital that he has been suspended from duties due to bad practice. I have no idea if I will improve and I'm about to make a complaint against the hospital for negligence.

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One year ago I had back surgery on my L5/S1 to remove a fibroma and relive back pain. After the surgery I developed numbness in my left leg from the knee to my ankle, and extreme pain in my left foot. I also get these random jolts in my foot, that take the pain from a 10 to a 20. Of course this was not present before the surgery. I have also been told that " I may have to learn to live with it", by several doctors. I have tried several medications, most of which have done nothing. Lyrica helps a little. I had a sympathitic nerve block, which didn't do anything. Now they want to implant a Dorsal Column Stimulator in my back, which I really do not want to do. I sympathize with you pauldandurand. Good luck.

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Profile picture for Dziewanna @dziewanna

Hi, I am going through this exact thing at the moment. I am 9 weeks post L5 S1 laminectomy and fixation surgery and I have horrific nerve pain in my left foot! It's affecting the top of my foot and big toe mostly but sometimes the outer edge and ball of the foot. It's debilitating and it's affecting my mental health and physical recovery. I think my nerves were injured during surgery but I am under the NHS In Scotland and doctors are downplaying my symptoms and my surgeon is nowhere to be seen. I was told by a whistle blower in the hospital that he has been suspended from duties due to bad practice. I have no idea if I will improve and I'm about to make a complaint against the hospital for negligence.

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@dziewanna I'm sorry to hear this has happened to you too. Keep pushing them. Sounds like nerve damage if you didn't have these symptoms before the surgery.

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Profile picture for insanepain @insanepain

One year ago I had back surgery on my L5/S1 to remove a fibroma and relive back pain. After the surgery I developed numbness in my left leg from the knee to my ankle, and extreme pain in my left foot. I also get these random jolts in my foot, that take the pain from a 10 to a 20. Of course this was not present before the surgery. I have also been told that " I may have to learn to live with it", by several doctors. I have tried several medications, most of which have done nothing. Lyrica helps a little. I had a sympathitic nerve block, which didn't do anything. Now they want to implant a Dorsal Column Stimulator in my back, which I really do not want to do. I sympathize with you pauldandurand. Good luck.

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@insanepain I understand what you're going through. When I speak with doctors they say the same thing, which is "live with it". No one in the spine surgery field is taking responsibility to make spine surgery safer. For example, one thing they should do for starters is to tell patients in advance that spine surgery is very risky. Secondly, they should have everyone go through PT for six months and after that it gets worse, then surgery is last resort. But, it's a money making business for both the surgeon and the hospital. They all refuse to track results. I don't know why, but I would guess it has something to do with not sharing failed surgery data.

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I am glad to read your comment, I am in the same situation. I am a 80 years old man. My right foot is dropped and without pain. My left feet is affected by pain, numbness and tingling. My legs are so weak that it 8s difficult for me standing. My neurologist ordered a surgery but I have seen many people complaining about the results of the surgery that I asked the oncologist team leader to reevaluate my situation. We are on that now, one neurologist proposes the surgery while other doesn't because she said my nerves are damaged beyond repair.
I do appreciate your extense explanation.

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Profile picture for pauldandurand @pauldandurand

@insanepain I understand what you're going through. When I speak with doctors they say the same thing, which is "live with it". No one in the spine surgery field is taking responsibility to make spine surgery safer. For example, one thing they should do for starters is to tell patients in advance that spine surgery is very risky. Secondly, they should have everyone go through PT for six months and after that it gets worse, then surgery is last resort. But, it's a money making business for both the surgeon and the hospital. They all refuse to track results. I don't know why, but I would guess it has something to do with not sharing failed surgery data.

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@pauldandurand You are absolutely right. The surgeon could have, SHOULD have explained what could go wrong and what could happen that could/would effect me the rest of my life, as could ALL of our surgeons and doctors. I am in constant pain 24/7, can't walk or put preasure on my foot at all. Can't work or do anything around the house. I used to be an active person, but not anymore. Had I know this was going to happen I never would have done the surgery. I used to walk my dog and we would play chase in the backyard. I can't do that anymore, and it sucks. Pain meds don't work or make me sick, and I don't want opiods anyway. There is no 'undoing' this for any of us, so unless there is some miracle out there, it would seem like we are stuck like this the rest of our lives. That being said, I do not give up, I am in my 60's so I try not to get depressed, and also like you, I do my own physical therapy at home. Pain Management, Neurologists just don't get it. Also I am trying to get on disability, but that is a whole nother mess.

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Profile picture for pauldandurand @pauldandurand

@insanepain I understand what you're going through. When I speak with doctors they say the same thing, which is "live with it". No one in the spine surgery field is taking responsibility to make spine surgery safer. For example, one thing they should do for starters is to tell patients in advance that spine surgery is very risky. Secondly, they should have everyone go through PT for six months and after that it gets worse, then surgery is last resort. But, it's a money making business for both the surgeon and the hospital. They all refuse to track results. I don't know why, but I would guess it has something to do with not sharing failed surgery data.

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@pauldandurand
I’m glad to see you’re so pessimistic about the outcomes of surgeries on backs and spines. The reality is it’s very tough to have totally successful surgeries in those areas. Furthermore I see that neuropathy appears to be fairly untreatable unless it’s with narcotics. The best I do is maintain good posture try to lift everything correctly don’t over Lyft and stay in shape. That’s about the only way I can handle neuropathy in my left calf and foot. Along with an occasional old opiate I’ve been sitting on my dresser for six or seven or eight years to help me get through the night. It sucks but that’s where we’re at good luck everybody. I’ve been on the site for about a week and I realized through everybody’s contributions that in the end were pretty much stuck with neuropathy

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