Failed Back Surgery Leads to Nerve Surgery Success

Thomas came to see Dr. Tollestrup after he endured failed back surgery six times. His chief complaint is pain and paresthesia involving the left lower extremity.

Pain and Numbness

Thomas’s pain starts in the left knee and radiates down into the lateral leg and over the dorsum of the foot. He also has pain in the calf muscle and the plantar surface of the foot. He states that he gets a lot of cramping in the toes and the arch of the foot.

Sitting makes the pain worse. When he sits, he also has pain in the left buttock and thigh.

He has a strange sensation that is kind of like a tingling from the knee down into the foot. He describes his pain as a “hard ache” most of the time with occasional intermittent painful electric shocks.

Thomas takes a sleeping aid otherwise he doesn’t sleep very well due to the pain. His wife says that he tries to sleep most of the day just to try to get away from the pain.

He has had a thorough workup with imaging of the spine from both his spine surgeon and his pain management physician. Neither of them can find any ongoing pathology at the spine level.

Sciatic Nerve Compression

On physical examination, Thomas shows evidence of compression of the large sciatic nerve at the level of the piriformis muscle in the deep buttock. This is called piriformis syndrome.

He also has compression of the common peroneal nerve just below the outside of the knee.

To confirm this, Thomas had a diagnostic injection of the left piriformis muscle which totally relieved his usual sciatica pain for about 48 hours.

With the diagnosis confirmed, Dr. Tollestrup took Thomas to the operating room and performed a surgery he developed where the piriformis muscle is removed and the pressure on the sciatic nerve completely relieved.

Surgical Success Times Two

After this surgery, Thomas has complete relief of the sciatic pain from the buttock to the knee level but persisted in having radiating pain down the outside of the lower leg and over the top of the left foot.

He went back to the operating room a second time for surgical decompression of the common peroneal nerve, a nerve that can become pinched just below the outside of the knee. After this procedure, Thomas is now completely pain-free of the original pain in his left leg.

Thomas is not being evaluated by Dr. Tollestrup for his chronic low back pain. Back surgery was supposed to relieve this pain but only made it worse.

Stay tuned for an update on Thomas’s low back pain.

“He has provided me with a quality of life that I thought I lost forever. I now have absolutely no pain in my legs. I am able to walk without pain again.”

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