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2014-12-14
Case Sharing
In May 2014, 57-year-old Miss Yang suffered from severe herniation of the fourth and fifth intervertebral discs of the lumbar spine, spinal canal stenosis compressed the cauda equina. This affected both hips and foot pain, although the symptoms did not cause weakness in the feet or affect urinary incontinence, due to fear of worsening of the disease, she finally received minimally invasive surgery and performed the fourth/fifth lumbar spine laminectomy.
However, on the third day after the operation, there was severe pain and numbness in the right leg, which extended to the sole of the foot. No matter sitting, standing, walking or lying down, there was no position that could relieve the pain. The MRI scans showed that the operation did not completely remove the stenosis of the right spinal canal. It is recommended that the patient undergo a second minimally invasive surgery to open the spinal canal on the right side. The patient then accepted the second minimally invasive surgery.
After the second operation, the patient’s leg and foot pain has been greatly reduced, but the feet still feel a little tight. Unfortunately, eight weeks after the second operation, the patient’s feet suddenly feeling burned and became numb again. The pinky toe and sole of her left foot were weak. After taking anti-inflammatory, pain-relieving, and nerve-control drugs, the side effects of the medication trigger her to have nausea and dizziness. The doctor stopped the patient’s medication and referred to me for Cox Decompression Manipulation. After one month of treatment, the patient’s foot burn disappeared, the paralysis has been reduced, but the tightness of the hallux and soles still needs to be improved.
Case Analysis
The possibility of persistent low back and leg pain after lumbar spine surgery is caused by neuralgia, soft tissue injury and muscle spasm due to postoperative spinal instability, which usually occurs 3-6 months after surgery. Many research reports have pointed out that some scar tissue (epidural fibrosis) will appear after spinal surgery. The formation of these scar tissues is caused by fibrous changes in the periosteum and paraspinal muscles that have been traumatized after surgery. Scar tissue is usually attached to the spinal nerve roots, so it forms a compression, causing patients to reappear pain. Recently, other studies have shown that the nerve roots after surgery have caused some painful scars due to their own lesions. New pain nerves formation, these pain nerves may be the cause of postoperative back pain and leg pain.
Treatment
Treating pain after spinal surgery is an extremely challenging task because, in addition to helping patients relieve their pain, they must also accept their emotional behavior. They often think surgery will end their pain but the side effect from operation they might not able to accept at once.
The purpose of treatment is to help patients relieve pain and numbness. Since some nerves in the spine may have been damaged after surgery, permanent damage such as numbness and tension cannot be completely eliminated.
Cox® Decompression Manipulation, clinically evident base and validated research (www.coxtechnic.com), can help patients with herniated disc or postoperative back pain to improve their symptoms. Generally, patients can receive Cox® decompression manipulation 6-12 weeks after surgery. If the patient has undergone spinal fusion surgery, treatment can be started 12-16 weeks after surgery.
