Hello,
Thank you for asking your query at DoctorSpring.
I know how it feels to go-through two surgeries and then when your neurologist recommends another surgery.
I believe that all your complaints till recent were pertaining only to you legs. Because all the effects of your compression fracture of L4 and also the fracture of T12, L1, L2, L3 can affect only your lower limbs. Since your present complaints are not only involving your legs but also your hands as well, I suspect that the pathology is higher up, probably in your neck (cervical spine) or your head.
You need a detailed neurological re-evaluation by your neurologist and probably an MRI of the cervical spine/brain. I presume that the current problem may not be related to your previous lumbar spine injury which is 3 years old.
The hand twitching, numbness and tingling are signs of nerve damage or compression affecting the muscles. They are infact said to be 'cry' of nerves for help. It might be difficult to stop. You can different sleeping or sitting positions. Instead of varying the arm / leg position try to modify the position of spine (safely and slowly). I am afraid beyond this medications or exercise will not help you. Suggesting any trial therapy will be unjust as it might delay the definitive treatment, which might involve surgery
Hope this helps
Please feel free to ask followup questions.
Thank you
Dr Goutham Cugati
Consultant Neurosurgeon
Patient replied :
I have seen my neurologist, there will be a surgery from my L2-S1. two rods, screws, a graph from my hip and corpse bone graphs. Now I am waiting on insurance approval to receive the surgery. I have lost all use of my leg and control of my foot and bladder. But I am stuck at home until I get the approval. Do you have any suggestions on how to relieve the pain until that time? I cannot see the pain specialist for another week. I know pain management isn't your field of study. But I could use any suggestions I can get. Currently I am on Dilaudid 2mg and it is doing nothing to help. Also, are there any warning signs that I need to look for that will require immediate medical attention?
I am glad that you could see your neurologist/neurosurgeon without wasting much time. Its good that they have already decided what is best for you. You will be requiring neuralgic pain relieving drugs like gabapentin or pregabalin. This has to be taken under medical supervision. If your pain specialist feels that the pain is worse, he may advice injection to your spine.
At home what you can do to reduce pain is to be in absolute bed rest. NSAID pain medication can help (OTC ones like Ibuprofen 400mg 2-3 times a day). Try mild hot compress. You might be tolerant to Dialudid by now. So that dose need to be titrated up (increased) , which is better done by your GP.
Having bladder incontinence is already a major warning sign. You have already reached a point where the treatment has to be done ASAP.
Wish you speedy recovery and the very best. If you have any more queries, please feel free to ask.
Thank you