Possible femoral nerve damage after disc replacement surgery

by Chris
(Houston tx)

Possible femoral nerve damage after disc replacement surgery

After total disc replacement in my lower back (L3-L4) I believe, I was still in hospital recovery, when I experienced an extremely painful burning sensation in my lower abdomen near the end of my incision. It was extremely painful to the touch. I was heavily sedated and also had the push button morphine drip that I could give myself a shot every ten minutes if needed for pain.

I was discharged the following day and the pain had subsided some and/or lost amidst all the other pains that come with the surgery. Incision pain, back pain, etc.

During the week at home after surgery I noticed that I have pain/numbness in my groin, inner thigh and front of thigh. I don't know what it's from. Possible damage to a nerve, a nerve that was compressed then relieved after procedure or injury from my catheter . My surgeon says it might be a muscle tear and has no idea how I got it. I know this isn't the case. I remember the branding iron type pain when I was laying in my hospital bed and now almost two weeks after surgery my incision and back pain are getting better but my pain and numbness in my groin and inner and front thigh still remains the same.

Any answers would be greatly appreciated.

Dear Mr Smith
You make no mention of what leg pain you may, or may not, have had pre-surgery. This groin and inner/ anterior thigh pain is presumably new, reading between the lines.

And yes, it is the distribution of the Femoral nerve ... I find it surprising that you had such major surgery with no pain in this very region. That is the indication for major lumbar surgery: Unrelenting leg pain despite conservative treatment.

Look, you went into this surgery knowing it wouldn't be a walk in the park. It never is. Give time a chance. Be careful, follow your surgeon's instructions, tell him about your leg pain, and wait a few weeks before any rash decisions.

The things to look out for are a sensory change in the leg, remembering you may have had such changes pre-surgery. Take a pin and prick your leg. Is there a difference right vs left?

More important, is there progressive weakness of the quadriceps muscle, the big muscle in the front of the thigh. Is it beginning "to give" when walking, especially on stairs? Are you getting little tremors called fasciculations in the muscle?

These may be of a temporary nature and simply a warning to be very careful for the next six to eight weeks, or yes, they could be signs that the Femoral nerve was damaged/ bruised in the surgery.

I have no particular advice, that's not my role, but you might like to ask if these Slipped disc rules might be pertinent to your case. After all, the responsibilty lies with him that you recover completely. YOUR responsibility is to be careful, follow your surgeon's instructions and give time and nature a chance.

IF you notice progressive sensory and motor changes (weakness at the knee) then you MUST bring it to the attention of the surgeon, and expect a cogent answer.

But meantime, be careful, you've had major spinal surgery and this isn't the time for "playing silly buggers!" Be sensible, follow your doctor's advice and above all use your own common sense.

Incidently, cold hot therapy is the best pain killer.

Best wishes, and I hope you end up with a good result. Let us know in a month's time how you are getting on.

Dr B

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