Lumbar Laminectomy Causes Foot Drop and Chronic Pain Disorder

Case Overview

This case involves a 44-year-old male with a past medical history of bi-polar disorder, type II diabetes, sciatica, chronic back pain, insomnia, and obesity. He was on a myriad of medications, including Onglyza. Major surgical history includes a plate placed in his right leg following a motorcycle crash in the late 1980’s, right elbow surgery in 1996, a lumbar laminectomy for L5 in 1996, and an appendectomy in 2001. Patient has a significant family history of chronic back issues. The patient was aggressively treated with medical management for his chronic back pain but responded poorly to treatment and surgery was recommended as the only remedy. Minimally invasive left-sided transforaminal inter-body fusion, L5-S1, with radical discectomy, placement of biomechanical spacer (CD Horizon Legacy Spinal System, and arthrodesis with allograft and bone morphogenetic protein, pedicle screw placement and segmental instrumentation, L5-S1, and posterolateral fusion with local autograft and allograft. Immediately following the surgery, the patient began to feel a burning sensation down his left leg. The surgeon did not seem to consider this to be a problem and the patient was discharged home on with prescriptions for Carisoprodol, Gabapentin, Hydrocodone, Oxycodone, Tramadol, and Zolpidem. A follow-up MRI showed no problems but further EMG testing displayed, electro-diagnostic evidence of severe, advanced sensorimotor polyneuropathy evidenced in both lower extremities, as well as superimposed left L5 radiculopathy with extensive denervation changes. The patient now experiences foot drop, chronic pain, and a significant reduction in his mobility after undergoing this procedure.