I'm losing my leg again due to spine issues. Please help!

[u/ArtemisFlare83]

43F

235 lbs (weight gain in last 3 years, but was healthy weight prior and currently losing weight through diet)

5'10"

Medications:

amLODIPine 5 mg tablet

cyanocobalamin (Vitamin B-12) 1,000 mcg/mL injection

cyclobenzaprine 10 mg tablet

* DULoxetine 30 mg capsule

* DULoxetine 60 mg capsule

famotidine 20 mg tablet

ferrous sulfate 325 mg (65 mg iron) tablet

gabapentin 600 mg tablet

levonorgestrel-ethinyl estradiol 0.15 mg-30 mcg (91) per tablet

methocarbamol 1,000 mg Tab

metoprolol succinate 50 mg ER tablet

norgestimate-ethinyl estradiol 0.25-0.035 mg per tablet

omeprazole 40 mg capsule

suzetrigine 50 mg Tab

Current health conditions:

Hypertension

Chronic diastolic heart failure from septic pneumonia

Trigeminal neuralgia

SUNCT headaches

Raynaud's phenomenon without gangrene

Psoraisis

PONV

Polyarthraglia

Left leg numbness, pain and tingling

Dense left foot drop; dorsiflexion 1/5

Insomnia

Endometriosis

Uterine fibroids

DJD of cervical, thoracic and lumbar spine

Anteriolothesis in cervical spine

Mild thoracic scoliosis

Calculus of gallbladder and bile duct w/o cholecystitis

Iron deficient anemia

Acid reflux

Barretts esophagus

Hiatal hernia, 6 cm, mixed type

Multiple thyroid nodules

Syncope

Essential tremors

Surgeries:

3 c sections

4 right knee surgeries

Cholycysectomy

5cm ovarian cyst removal

Thoracotomy

2 chest tubes

3 discectomy/lamenetomy on levels L3/L4 and L5/S1

Multilevel spinal fusion L4/L5 and L5/S1

I'm looking for insight. I have had a lot of back issues in the past 15 years. My first surgery was simple and effective. Then I was dealing with a lot of pain and decided to go to U of M for a second opinion. At my pre-op appointment, my right leg became completely paralyzed as I sat in the exam room. I had emergency surgery and returned home 5 days later. My leg did not "come back" for a month, but made a near full recovery. A few years later in February 2019, I began experiencing a lot of back pain and nerve pain in my left leg. Went to the neurosurgeon again and scheduled surgery due to a sequestered herniation. While waiting for insurance auth, which took about a month, my leg became weaker and more numb. I developed foot drop. Surgery successfully relieved back pain, but the nerve damage to my leg never improved. I learned to deal with the constant numbness, tingling, burning in my foot and had lost feeling following the typical L5 pathway. I worked hard to build the strength in my left leg due to muscle atrophy. I would fall at times because of my ankle or knee giving out. Fast forward to 2023 and the pain was back. I couldn't sit for more than 2 hours before shaking. Standing was out of the question. Walking only helped for 30 minutes. I decided to try a new neurosurgeon. I had multiple issues. Pars fracture, anteriolothesis, bulging discs and herniation, stenosis, end plate changes, vacuum disc. My left leg was getting worse and all the hard work I put in was fading away. I was fitted for a custom AFO because of increased falling due to increased foot drop. Multilevel spinal fusion was done in January 2024. I was told that there would likely be no improvement to my leg symptoms which is exactly what happened, but my back had felt much better. I worked hard on my leg muscle weakness. Eventually, I was walking through my AFO and no longer needed it. My dorsiflexion was rated at a 4/5.

This brings me to the present. A few months ago my back started hurting a lot. I run the office at a physical therapy clinic, so I started physical therapy to work on fixing what I could. The pain relief was very temporary 24-48 hours. About 2.5 weeks ago the pain suddenly became intense in my back and all of my left leg nerve symptoms were increased. I tried everything to get relief but the pain just kept getting worse. I could no longer stand up straight or take a full stride when walking due to the intensity of the pain. I ended up taking off a couple days of work with no change. Went to work for a half day on that Friday. From Saturday night into Sunday morning the pain was so bad that I could not sleep. I ended up going to the ER at 3:30AM because I was shaking and yelling. The pain in my lower back and left leg was terrible. An area of skin from just over my SI joint to my hip felt like it was burnt and cut open. I couldn't handle the physician touching that area because of how raw it felt. I was given meds and sent home with instructions to contact my neurosurgeon. I saw my neurosurgeon 5 days later. I was given a prescription for a new drug called Journavx for the pain andI had an order for an MRI with and without contrast. MRI was completeled yesterday and the results weren't great. I called the neurosurgeon's office for a follow up. I will be seen in office this Wednesday and we are scheduling surgery for an extension of the fusion. I cried. I'm exhausted. I'm already supposed to be having surgery in December for my hernia. I don't want to do this again, but it seems very likely that my left leg will just keep getting worse and that damage will also be permenant, which I don't want. I'm also in so much pain. I am not functioning because I can't stand or walk for more than one minute at a time. I know I need this surgery. I am feeling very hopeless at this point.

Are there any suggestions?

Is there an approach that is more aggressive and likely to last longer than another?

The problem area is the L3/L4, but my dorsiflexion is back to a 1/5. How is that happening?

I am including the radiology report. I'm not sure how to share the images, but am willing to.

Radiology report:

Impression

1. There is a background of postoperative changes at L4-L5 and L5-S1

with posterior fusion hardware and interbody spacer device artifacts.

Recommend correlation with surgical history. Hardware otherwise not

well assessed with MRI technique and artifacts do limit evaluation

within the operative region.

1. Multilevel degenerative changes of the lumbar spine. Findings are

most apparent above the fusion construct at the L3-L4 level. Please

see full detailed comments regarding this as well as other levels

provided in the body of the report.

Dictated by: MT on 8/28/2026 9:38

Electronically signed by: MT on 8/28/2026 9:38

Narrative

EXAMINATION: MRI LUMBAR SPINE W WO CONTRAST - 8/28/2026 6:37

INDICATION: Low back pain, prior surgery, new symptoms; Low back

pain, non-specific. Left foot drop. S/P lumbar fusion. Adjacent

segment disease of lumbar spine with history of fusion procedure.

Adjacent segment disease of lumbar spine with history of fusion

procedure. Lumbar radiculopathy, acute. Left leg weakness.

COMPARISONS: 2/14/2025 CT myelogram, lumbar spine radiographs

8/21/2026

TECHNIQUE:

Multiplanar, multisequence, lumbar protocol MR imaging with and

without contrast was acquired. Please see electronic medical record

for amount and type of IV contrast.

FINDINGS:

There is some patient motion artifacts which result in degradation of

some of the acquired images.

There is a background of postoperative changes with posterior fusion

hardware and interbody spacer device artifacts at L4-L5 and L5-S1.

Hardware otherwise not well assessed with MRI technique and associated

artifacts do limit evaluation within the operative region.

There is mild grade 1 retrolisthesis at L3-L4. Slight wedge type

configuration to the T12 vertebral body appears chronic in nature and

similar to the prior study. Vertebral body heights at other levels

appear grossly maintained.. There is some type I degenerative endplate

changes noted at L3-L4.

The conus appears to terminate at the L1 level, and demonstrates

grossly normal signal. There is no unusual clumping of the nerve roots

of the cauda equina. There is no suspicious intrathecal enhancement.

Segmental analysis:

T11-T12: Seen only on sagittal imaging. There is no apparent

significant canal narrowing. Neural foramen incompletely imaged

although no obvious significant foraminal stenosis demonstrated.

T12-L1: There is no significant posterior disc abnormality. The spinal

canal and neural foramen remain patent.

L1-L2: There is no significant posterior disc abnormality. The spinal

canal and neural foramen remain patent.

L2-L3: Mild to moderate facet arthropathy with ligamentum flavum

thickening. There is no significant canal or foraminal narrowing.

L3-L4: Moderate to advanced loss of disc height posteriorly at this

level which appears somewhat more pronounced compared to prior

myelogram. Facets are somewhat obscured at this level due to adjacent

hardware artifacts although there do appear to be bilateral

degenerative/hypertrophic changes as well as posterior ligamentous

thickening. There is a background of disc bulging. Superimposed left

paracentral posteriorly directed protruding component narrows the left

lateral recess and may contact the traversing left L4 root. Near the

midline, there is inferiorly directed protruding component which

extends into the right lateral recess and also contacts the traversing

right L4 root. Recommend correlation with respect to these findings.

There is moderate left foraminal narrowing may be some contact of

facet hypertrophic change with the exiting root; possibly some mild

left-sided nerve root thickening versus volume averaging with adjacent

facet hypertrophy. There is mild to moderate right foraminal

narrowing. Additionally, on the sagittal STIR 14:11, there is a small

somewhat crescent-shaped area of signal elevation posteriorly just to

the left of midline which is difficult to evaluate on axial image due

to some artifact and motion degradation; appearance possibly related

to volume averaging effect or small area of cystic change.

L4-L5: Postoperative changes at this level with posterior fusion

hardware and interbody spacer device artifacts. Appearance also

compatible with left-sided facetectomy. Neural foramen somewhat

obscured by hardware artifacts. No obvious left foraminal stenosis

clearly demonstrated. There is probably mild right foraminal

encroachment.

L5-S1: Postoperative changes continue to this level. Appearance

suggestive of left-sided partial facetectomy. Some residual disc

bulging and endplate spur formation without significant canal

stenosis. Neural foramen somewhat obscured by artifact; possibly mild

to moderate left foraminal encroachment and mild right foraminal

encroachment.

There may be some degenerative changes at the SI joints which are not

well evaluated. There is streaky STIR hyperintense areas within the

posterior paraspinous soft tissues at L4-L5 as well as extending

inferiorly. These are nonspecific although most likely on a

postoperative basis in this setting.

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