Suggest Treatment For Numbness And Tingling In Both Legs And Feet

Posted on Mon, 14 Jul 2014

Question: Had a fusion of L4/5 two years ago with donor bone. It's been called a failed fusion. A year after the fusion I fell. I received some PT and Epidurals. I started having numbness and tingling in both legs and feet from the knees down. My feet become ice cold at times, whic causes me to use a heating pad. The numbness becomes horrendous when reclining, especially with my head and shoulders are propped up and sitting. I stopped driving to much due to the numbness in my feet. An EMG was done in May H reflex was prolonged and I had no reflexes in knees or ankles. MD said it looked ok. It seems to be getting worse. My surgeon wants to take the screws out. I don't want surgery again if it's not helpful Any ideas what could possibly going on?

Answered by Dr. Sudhir Kumar (11 hours later)

Brief Answer:
Need to exclude peripheral neuropathy.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your past details and current symptoms.

Based on that, we need to exclude a disease of peripheral nerves of legs/feet, called as peripheral neuropathy.

A nerve conduction study would help in that.

If the nerve conduction study rules out peripheral neuropathy, then, it would be worthwhile removing the screws, as these symptoms could also occur due to compression of nerves in the lower back (lumbar) region.

As of now, you can try pregabalin capsules for symptom relief, if not already tried.

I hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.

Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (5 hours later)

I had a EMG in May as stated in my prior question. Would it be smart to have the fusion redone using my bone; as the cadaver bone failed. Would it be hard to remove screws from bone that had two years to grow? Could a fall cause this problem? Thank you.

Answered by Dr. Sudhir Kumar (47 minutes later)

Brief Answer:
Thank you for getting back.

Detailed Answer:
I presume that nerve conduction tests were also done along with EMG and they were normal.

Fusion may be redone using your bone, if there is canal stenosis and nerve compression on the MRI now.

Technically it is difficult to remove screws, but can be done by experienced surgeons.

Fall usually would not cause these problems.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar