Motor Weakness 10 Days Post-Op?

[Eldon]

My daughter Brittany (13) had a posterior spinal fusion w/instrumentation surgery 10 days ago. She is recovery rapidly in every way except that she has significant motor weakness in her left leg.

Because of this, the hospital sent her home with a walker, which she is still very much dependant on while walking. This is not paralysis, because feels our touch. She can also wiggle her toes, flex her foot, and ultimately move her left leg w/great effort.

Does anyone have any experience with complication? She said yesterday that her leg feels like it is dead. When trying to walk, she gets frustrated with her leg, because it is not reponding like she is used to. Prior to the surgery, she seemed healthy in every way. We only discovered her scoliosis when she hurt her back high jumping during a track meet.

Please share any insight you may have.

[jc3]

hi eldon
glad to hear your daughter is doing well. My daughter had surgery in november and is now 9 months post op and i do remember her complaining of one of her legs feeling like it was asleep and also she had complaints like that with one of her arms in the beginning. I remember i was worried because one of her arms would just dangle a little sometimes and she would say it felt limp. I think it was just from all the muscles in her back being cut and her's never turned out to be anything and it did go away that feeling. If you are worried i would definitely give a call to the dr.
Jennifer

[Alison]

Just thinking out loud......could they perhaps have aggrevated/shoved not quite right one of the nerves in her lower back. And which is now having to wake up, repair itself and--getting back to where it was.

Alison

[Eldon]

I spoke with her surgeon today on the phone, and he suggested it would improve with time. Since her follow up appt. is a week away, I just wanted to hear from someone else who might be familiar with this complication.

Thanks Jennifer and Alison for you feedback. The prospect of nerve damage makes me well...nervous. I am encouraged that both of you suggest she can overcome this.

Eldon

[Theresa]

Eldon, I'm not a young teen, but I had left leg weakness after my surgery. It eventually got better. Sometimes getting into the car or bed, I would lift my leg into the car or bed. From my first surgery I'm now 16 months post-op and only every so often do I still need to help my leg. Just remember complete recovery is almost a year or two.

[Eldon]

Brittany had a checkup the other day with her surgeon. She is now 19 days post-op and still using a walker, but her left leg motor weakness is improving slowly. Her Dr (Dr. Barry) said she is not recieving "positional feedback" from her left leg's nerve system.

Apparently, when her brain tells her left leg to move, it's supposed to recieve constant real-time feedback confirming the position of her leg. The absence of this feedback is quite literally affecting her coordination. This is because she is not sure where her leg is at any given moment, which hampers her ability to send appropriate continued muscle movement commands.

Since my original post, we have also learned that she is 100% numb over a large portion of her left side. Specifically, her front left & left side from her knee cap to her arm pit.

Dr. Barry said the improving stability in her left leg, suggests that her positional feedback is slowly returning. He is optimistic that her sensation will follow.

I would love to hear from anyone else with insight this this complication, as I am still quite concerned about how fast and how much she will ultimately recover. Dr. Barry said the only thing to be done is to give her time to recover.

[phaden]

While certainly not as severe as what you report, my daughter had numbness after her surgery across the right side of her chest and under her arm. She is 15 weeks post-op and has only recently completely recovered the feeling under her arm. Her chest is still slightly numb.

Patricia

[Eldon]

Thanks Patricia. Your daughter's experience gives us more reason to be optimistic for Brittany's recovery. It was interesting to note that your daughter had the same vertebrea fused as my daughter (T3-L1).

_____________________________

Eldon

Scoli Dad from Nevada, USA
Daughter Brittany's surgery 26 July
Posterior Spinal Fusion T3-L1

[Analyzing Anne]

Me Too!

Hey!
Just wanted to tell you that I have had weakness in my RIGHT leg since my surgery. It was on July 14, 2005. During the surgery, the doctor had to abort my surgery before doing any instrumentation but after doing the incision because I lost all movement in my right leg. The doctors and neurologists were all baffled as to who this happened. They think that because of my curves, (mid to high 40s, 2 of them) a blood vessel got kinked and I lost blood supply to my legs (for better details from my mom, see the thread posted by Analyzing Anne on kinked blood vessels). I had to use a walker while I was in the hospital, but now I have a cane, which I don't really even use, I ditch it a lot. I spent a week in the hospital and then was transfered to a Children's Rehabilitation Hospital. I am 15 years old and was healthy before the surgery. I had to regain EVERYTHING in my right leg. An EMG showed that I have no muscle or nerve death, only weakness. I had slight left leg weakness after the surgery as well, but not anything like my right and now my left is fine. I have only JUST been able to begin to pick up my ankle and still can't raise my big toe. I also have a lot of pain in my right shin. I'm curious if this is anything similar to your daughters?????? Does she have pain????? Mine is also somewhat nerve damage because I cannot feel temperature (hot, cold) on my LEFT thigh and pain shoots up my leg when water touches my foot/right leg. Makes getting into a pool an interesting experience!
I also had slight numbness under my right arm and on my chest, but that has gone away now except when I raise my arms over my head when lying down.

-Sarah

[Eldon]

Sarah,

I read the thread posted by your mom that you referred me to for details. In that thread, you mentioned that an emergency MRI showed a lesion from T10 - L1. It sounds like there are definite similarities between your's and Brittany's post-operative condition even though they aborted your procedure.

For starters, she also sustained an apparent tear in her spinal cord during surgery. I say this because she had classic CSF leak symptoms during the first week of her recovery. These symptoms were 1) severe headaches whenever her head was elevated (when sitting up, her head hurt 3X worse than her back), and 2) strong nausea for an extended period of time.

Her Dr ordered an MRI to check for a leak on the 5th day post-op. The metal in her back rendered the results inconclusive, but the tear apparently healed itself, because the symptoms went away after day 7.

You asked if she was experiencing pain. Yes, but it is difficult to characterize, because we are still managing it with Lortab. We tried to wean her off of it a few days ago. It seemed like all was going well 12 hours after her last dose. Then, after raising her right arm above her head, it suddenly started burning. She said it felt like her right arm was about to burn off and quickly got hysterical. We gave her an immediate dose of Lortab and her pain was under control 30 minutes later.

We are now giving her a Lortab dose once in the morning and once at night with Motrin in between. She has felt the return of her right arm pain at times, but not as severe. Her back hurts about as much as would be expected post-op. Her left side doesn't hurt, but then again she can't feel anything in much of her left side, including temperature. She does not have the water sensitivity you mentioned on either side.

I'll keep monitoring this forum for a while, and will post any specific improvements in Brittany's condition. Thanks for sharing your experience. I hope you are able to recover soon to a point where surgery can be considered again (with success this time).
_____________________________

Eldon

Scoli Dad from Nevada, USA
Daughter Brittany's surgery 26 July
Posterior Spinal Fusion T3-L1

[jc3]

i was just reading your post and noticed that you said that you are giving your daughter motrin in between pain meds. Our dr. said no motrin or advil for 1 year post op. Just curious.
Jennifer

[Eldon]

Hi Jennifer,

Dr. Barry specifically recommended Advil or Aleve instead of Tylenol because she is already getting acetaminopen in her Lortab. Brittany much prefers chewables, so I purchased Motrin chewables since they share the same active ingredient (Ibuprofen).

If not for the nerve complications, she would probably be off pain relievers all together by now. The reality, however, is that she will probably be using Motrin for some time. Do I need to be concerned about Motrin?

Eldon

[jc3]

hi eldon
My dr. said no to anything with ibuprofen for at least a year because they feel it isn't good for the healing of the fusion. So i was just curious when i read your post about her taking it. I'm sure every dr. is different and if your dr. said for her to take it then he obviously feels it's safe.
Glad to hear she is doing better.
Jennifer

[Analyzing Anne]

Eldon,

This is Anne. Sarah's mom - she is away enjoying the comraderie (sp?) of her cross country team at camp. Sarah had very bad headaches in the hospital -ones that never seemed to go away even with pain meds. She experienced much dizziness and definitely lots of nausea. She did not eat for days as nothing would stay down. She even experienced this when she was at the rehab hospital.

How is her walking coming? Is she going to physical therapy? Sarah goes twice a week but was prescribed for 3x but we lack more visits per the insurance. We are working on an appeal and her therapists are OK with 2x per week.

Thanks for sharing.

Anne

[Eldon]

Hi Anne,

Her walking continues to improve slowly. Today she has been getting around the house w/o her walker, tenatively and cautiously with a definite limp. Last Friday she had an appt. w/ her surgeon. I specifically asked him if we should take her to a neurologist, and if she should be recieving PT. He said no on both counts. He said a neurologist would just do a bunch of tests to create a baseline of her current nerve functionality, and then wait to see how she progresses. He said PT would not help her specific nerve problem any more than not having PT.

Do you think Sarah's right leg weakness has improved faster due to continued PT? If so, I will check into it with my insurance company. Also, was she assessed by a neurologist after the aborted operation? If so, I'm curious to learn what they thought about this from a recovery stand point.

It's good to hear from you Anne. My wife Paula and I feel like the vast majority of our family and friends can't really understand how emotionally exhausting these post-op complications have been for Brittany and us. It must be even more so for you and Sarah, because you didn't even get the benefit of an otherwise successful surgery to offset these nerve complications. I thank you (and others in this forum) for sharing your experiences.

Eldon