S1 Nerve damage.

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S1 Nerve damage.

Postby LostLenore_74 » Wed Apr 08, 2009 7:43 pm

I underwent a minimally invasive laminotomy in January for right leg pain. Upon waking up I discovered that my right leg was more numb that ever before. I was expecting to have a microdiscectomy, but the surgeon stated that he only had to lightly push the disc back in place, but he had to "move" my nerve so he wasn't surprised by my symptoms. However, I could barely walk to the bathroom the first time up because of right leg weakness. Well, after weeks at home with a funny walk, I finally discovered that I was not able to stand tippie toe anymore or walk tippie toe, which was one test the had me perform pre-op that I did fine. I have seen the NP and surgeon twice now, have attended therapy, and I am still having life changing weakness. I am a nurse and to walk with a weak and sore leg in a big hospital is exhausting. While my surgeon is sympathetic, I am a little concerned that he has never performed a quick exam of my neuro function after the surgery. I realize that this is slow recovery, but I am concerned that there is a chance of this being permanent. Is there any advice you can give or websites that explain how long of a process there is with this nerve palsy. I am not worried about lawsuits, I actually work with this MD and respect him, however I want maybe a fresh look at this and wonder if this is "normal" and "fixable". As far as a second MD, should I be asking for a neurosurgeon or neurologist?

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Tom Plamondon PA-C
Physician Assistant
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Re: S1 Nerve damage.

Postby Tom Plamondon PA-C » Wed Oct 21, 2009 10:07 pm

I find in my medical practice that treating my colleagues can be most challenging. I believe it takes a level of detachment (which may be hard to do when you work with someone everyday) to view them objectively and to do a thorough job.

Regarding the nerve, moving the nerve back may have caused some damage or inflammation. Maybe.

It is generally accepted that post op inflammation and scar tissue develop is the normal but should resolve over time. How much time is the question.

The loss of standing on the toes likely means S1 nerve root is damaged and is concerning. If this was not the level worked on in surgery then another MRI is needed. Nevertheless, a neurosurgeon's thorough evaluation is needed at this point.
Nerve conduction study and EMG will add information on extent of nerve damage.

Take care and keep in touch.
Tom Plamondon PA-C, PT

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