Nerve pain after L4/5 decompression/fusion

I would ask for CT imaging. Lets just acertain that something hasn't gone awry. Anyway, how can you sleep.

I had L4/5 fused a year ago and still have pain in my lower back down through my toes. I am constantly told it can take up to 2 yrs for the nerves to wake up…after being compressed for so long.

The nerves in this leg were never compromised prior to surgery. That’s why I’m concerned that they are now.

@kwolverton62
I have cervical/lumbar congenital spinal stenosis, degenerative disc disease, cervical myelopathy (spinal cord compression injury) neurogenic claudication and residual symptoms following ACDF surgery (C5-C6). I met with my surgeon yesterday to talk about my lumbar spine surgery. I have disc bulges, stenosis, etc. causing pain/numbness/weakness lower back/hips/buttocks/legs/feet. He will get a new MRI to check current status (last MRI was from September 2023) and said that he would check/confirm levels needing decompression/fusion and hardware to support. My older MRI shows I would need L4-L5 for sure but possibly L3-L4 and L5-S1 done, too. He did say that nerves take longer to fully recover/heal which could be months/years depending on how long they have been compressed/pinched. My pain symptoms started over 12 years ago and I’m expecting full recovery will take a while.

You may have new nerve pain following surgery due to irritated nerves during surgery. Your surgeon needed to move things around a bit to do the surgical work which may have irritated new nerves. Three weeks is too soon to expect full recovery/healing of nerves after surgery. You may want to take the additional nerve pain medication recommended plus see if there is anything else you can do/take for nerve pain (like pain patches/supplements like alpha Lipoic acid/acetyl l carnitine which I take for small fiber neuropathy). If you feel better when standing/walking/sitting but not when lying down, see if you can adjust your sleeping positions to be more upright (use lots of pillows). I read that after lumbar surgery you only want to sleep on your back or side with pillows propped under/in-between legs.

Are you able to take melatonin to help you sleep?

Thank you for your reply but I’ve done all that you suggested. The part of my story that doesn’t add up for me is that I was totally pain free for the first 10 days post op and my current pain is in my leg that was normal prior to surgery and it’s actually more painful than the other leg was prior to surgery. I understand all of the nerves were irritated during the surgery but why did it take 10 days to start the flare up?

I had a similar experience after an L3/L4 decompression a few years ago. I know you probably don’t want to hear this, but I still have that nerve pain which I did not have before my surgery. I’ve had many tests, MRI, EMG, etc. but nobody has found the cause for the new nerve pain. I had L5/S1 fusion and decompression surgeries after the nerve pain occurred, but the surgeries had no effect good or bad. I know this is not helpful, but just wanted to share that I had this similar experience. Now I live with the new nerve pain.

Thank you

Wolverton
Sorry for your worries.
I had hemilamenotomy
7 days ago.
Have been told you must give the nerves time to adjust to the decompression and that can take time.
I have had a very good experience with a bad time the 3 rd day.
Give it some time I will pray for you.’
Tony

Thank you! Prayers appreciated. Unfortunately I don’t think this applies in my case. The affected leg now had no deficit prior to surgery and now is only having problems when I lay down. I can walk for miles with no pain or nerve issues in this leg. My worry is that my hardware is shifting when I lay down and compressing the nerves.

You can have the perfect surgeon the most precise surgery, but sometimes our bones don't hold the hardware. It shouldn't be shifting. One loose screw