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Back Surgery Created Nerve/Ankle Damage - help

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BillDSampson · · Unknown Hometown · Joined Jul 2014 · Points: 0

I had lumbar surgery to correct excruciatingly painful disc ruptures. Surgeon bruised a nerve that eventually died. Now have 40% slow nerve response below knee and most of ankle. No longer any side to side ankle control and can only pull foot upwards 25%. Has anyone had something similar, and do you know of any options - surgery, brace, stay horizontal... Thanks - sickeningly frustrated.

J. Serpico · · Saratoga County, NY · Joined Dec 2009 · Points: 140

Are you sure the surgeon was the cause? If it was, this is why I'm a big fan of actually researching your Dr. M.D. and board certified mean they at least graduated last and then passed a test, doesn't imply high levels of competence.

FYI, when the disc compresses the nerve, it causes damage. The severity and length of the compression determines long term disability. Some people, even with crushed nerves recover fully and quickly. My first surgery the MRI and the surgeon confirmed I had essentially a crushed root at one level and significant compression at the other, yet I regained 95% sensory back with no appreciable motor loss. This was 7 years after the initial injury.

Second time, the acute phase was just 3 weeks before surgery (incompetence locally despite me not once asking for pain meds -which just make them assume you are seeking drugs- and handing them a diagnosis and laying out what I needed them to do to get me into surgery ASAP). Anyway, 12 months later the lateral aspect of my foot, my entire heel, and the lateral aspect of my calf all have significant sensory loss, as well as significant motor loss all the way up to the buttocks.

To me it sounds like it was the L4-L5 nerve root that was compressed on you.

Can you recover? Yes, but it's not going to be overnight, it might take a year or even two. First thing to do is go to a physical therapist and do what they tell you. In the mean time. Unless you can't walk without a brace, don't brace it. Get in the pool and do what you would do on land but with less weight. And walk a lot. I gave 5 Fingers a shot to increase sensory and small muscle strengthening in my feet/calves, I also wore them in the pool so I didn't tear my feet up. Then continue on land. Sensory actually can come back faster if you rub and touch it. Convince your wife/GF to give you massages. The motor aspect will just be hard work and some luck.

You can also buy a TENS/EMS unit. Insurance might cover it, but they aren't expensive. The EMS portion of it basically activates the muscles. I used this quite a bit early on for my calf. I can't say it did or didn't help, and my surgeon (highly respected nationally) was indifferent on it. he said early on it might be of benefit, down the line recovery is identical with or without EMS.

This might sound weird, but I was convinced I'd never climb again, and yet climbing is was I feel made the most difference. I started out on ice because of the rigid platform (like a brace) and things went ok. At that point I could barely do 1 single leg body weight calf raise, after 6 months post surgery and 6 months of rehabbing. It went well enough, I followed all winter and even led quite a few pitches at the end. Both sensory and motor improved drastically with climbing. Then with rock I made another quantum leap forward in both aspects.

Strength is now 70% of the right leg, and sensory feels like I have made improvements but I'm expecting it to never have feeling, at least not fully. I do think I'll get close to 100% motor back. Which is good enough for me.

Good luck.

john strand · · southern colo · Joined May 2008 · Points: 1,640

I'm not a Doc but, I would say for sure NO staying in bed !

Where was this ? i know a couple of good ankle guys in the Denver area

BillDSampson · · Unknown Hometown · Joined Jul 2014 · Points: 0

Thanks for both of your responses. I had the back surgery done at the Cleveland Clinic by one of the top back surgeons in the country. A lot of the issue was that because I have extremely narrow facet openings the nerves don't have much space to move in. The surgery requires moving the nerves a little to get to the bulging discs, however mine were so pinched one stretched too far and got bruised. I had two other spine doctors and surgeons do spaced out post-surgery MRIs and EMGs. They all agreed that if the nerve didn't regenerate after 18 months that my status would be predominantly permanent.

My surgery was in March 2011 so it's not good. My strength is definitely better and I am ever so slowly able to pull my toes up more over time so I have some hope. The big issue is the lateral ankle movement. I can't move it left or right - it's pretty much stuck in the middle. Also, there is no control as if trying to push off on the inside or outside of it. So if I step on a rock on the left side of the bottom of my foot the right side of the ankle doesn't know to stabilize my ankle/foot so it just collapses and I easily fall. I can push straight up very well with no problems. So when my calf is heavily involved upwards I am solid. If it is heavily involved at a sideways angle the ankle stability is nowhere to be found.

I hate the thought of fusing the ankle so it will only hinge up and down. I do at least get some lateral balance from it hinging sideways. I think I may be pimped in thinking I will ever boulder/route again. I guess there are always big mountains with my skinny carbon fiber brace and boots...

J. Serpico · · Saratoga County, NY · Joined Dec 2009 · Points: 140

Sounds like you did your homework, had a good surgeon, and are just looking for a hail mary answer.

Ice climbing might be your ticket back into climbing, but it sounds like even that might be difficult. Good luck whatever you decide.

BillDSampson · · Unknown Hometown · Joined Jul 2014 · Points: 0

Thanks Serpico (I always wanted to say that but never had the chance!). I think you're right. I can't tell you how hard it has been facing this issue and going through all of my options. The last to go heavy into is the ankle fusion. Wish me luck.

If anyone from this point (7-30-2014) forward has any idea, regardless of how hair-brained or fuzzy logic it is, PLEASE don't hesitate to contact me. I will try just about anything...

Thanks,
Bill

john strand · · southern colo · Joined May 2008 · Points: 1,640

Shit..from the Cleveland clinic ? That's a suprise, but maybe not i guess.

I had a Doc who insisted on ankle fusion..I thought long and hard about it and am really thinking better of the In Bone replacement now. I know ankles don't yet equal hips/knees but a fusion is forever.

I know a guy in LA who did a replacement and thinks it's great. much better for rehab as well.

good luck

Guideline #1: Don't be a jerk.

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