Pinned Post
Annual General Body Meeting
Which date would you like for the annual General Body Meeting (10 AM EDT)?
0%April 11
0%April 18
0%April 25
You can vote for more than one answer.
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General Discussion
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Cases (1)
Opinions wanted!
Relatively healthy 81M with history of right L3/4, L4/5 open far lateral discectomies done in 2006 in NJ. Apparently this was complicated by nerve injury causing a period of profound RLE weakness. This eventually largely recovered, though he does have mild permanent deficits.
He presents now with progressive right low back/glute pain, as well as medial leg pain that radiates into the arch of the foot. This has been ongoing for several years (the foot pain being the most recent development), with the back and foot pain being most severe. He's undergone right L3/4 and L4/5 TFIs with about 50% improvement for several days. Podiatry has evaluated the foot and did not identify any intrinsic pathology. An EMG reported a chronic L4 radiculopathy, without evidence of tarsal tunnel syndrome. He was referred for minimally invasive decompression and is not very keen on a fusion. He does state that even if…
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What would you do?
Tough one
Young. Myeloradic
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Tough case! For me it would be a two level lateral. I know you said he is not keen to get it but I think that’s the only option that is safe and has a chance to be effective in my hands. Someone already tried the far lateral decompression and it didn’t work. As you said I worry about the scar tissue in an already previously injured nerve. Curious to see what others think!