Are leg pain and feet numbness normal after fusion surgery?

Question

Hello doctor,

Four months post fusion surgery, I am having bilateral leg pain, burning sensations in legs down to feet, and nerve-like jolts in the left leg and numbness in toes and bottom feet. Wondering possibly arachnoiditis?

Answer 1

Hello,

Welcome to icliniq.com.

Spine and lower back surgery is a procedure that can have variable post operative outcomes. It is found that in approximately 40 percent of patients, the symptoms are completely relieved after surgery. In another 40 percent, the symptoms might show mild improvement. In 20 percent of patients, there is a minimal improvement and the pain might even worsen after surgery. The above is only an estimation and does not question the surgical skills of the surgeon in any way.

The problems with pain after surgery can be due to many reasons. It is possible that there is granulation tissue formed in the surgery area which is causing pressure on the nerve. Arachnoiditis is a less common complication and is likely only if there is a dural tear during the surgery. If your surgical notes do not mention any dural tear then arachnoiditis is unlikely. Usually, a repeat MRI (magnetic resonance imaging) spine of the involved area is required to know the cause of pain and burning in your case.

Answer 2

Hello,

Welcome back to icliniq.com.

Thanks for sharing your images. (attachment removed to protect patient identity).

Images were not available to me earlier when I sent the previous reply. I can see that there are screws inserted in your lower back spine at levels L4, L5 and S1. There are post-surgery changes visualized in the paravertebral soft tissue in the area. A small fluid collection is visualized posterior to the thecal sac in the L5 vertebra level.

However, inside the dural sac, there is no clumping of nerves or any empty space which is typical of arachnoiditis. In the L5-S1 level there is a persisting mild bulging of the disc.