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He sort of drags his right foot and uses a walker now. He says its not numb though. He has erectile dysfunction and wondering if this is associated. Yes, we have some great teaching hospitals around here and we will get several opinions before surgery. His orthopedic doc wants him to go to a neurosurgeon and try injections and physical therapy first. I guess it can't hurt?
If he has erectile dysfunction, plus excessive urinating and bowel movements too it may very well be associated as you are wondering. But I would expect that a neurologist would be asking questions about these two functions if your husband mentions the erectile problem.
I am eighty-one and have a long and profoundly lousy spine history. (My sister died at an early age from a spine malformation and other relatives have had major spine problems.) I want to emphatically second those people who have emphasized seeking consultations with several specialists before surgery or radical treatments. I once consulted a very well-known spine surgeon, and quite to my surprise he indicated that he would do something totally unexpected as an operation...and at the last minute he also modified just how he would do this particular surgery. As if I were a total greenhorn, I trusted him because of his big rep. Major mistake.
No surgeon I have ever consulted after has agreed with the route he took, and worse they have even more emphatically taken exception to the his modification of the technique. If this jackass had called a halt and consulted another couple of surgeons I would have encountered major redlights probably and not gone ahead. But, no, I went with his rep....like a jerk. Please sign my autograph book Dr. Famous...pretty please. Turns out he was just on the way to making this his new specialty back then; but by now, a decade or so later, he hosts major conferences on it, and shows up around the world as an expert on it.
So, definitely see at least three specialists. I have had wonderful results from surgery over the years, but from cautious surgeons who believed in "hasten slowly." Unfortunately there are "cowboys" in every profession under the sun and it can be dangerous to just go along with the rodeo.
I hope his problem can be resolved successfully and in an uncomplicated manner.
Just an anecdotal comment -- I had a secretary in my office whose husband had hip pain and some other odd leg and lower back pain and they kept thinking it was a hidden back problem or arthritis. It turned out to be advanced prostate cancer. He was an elderly farmer and assumed some of his issues were just age-related but he didn't seem to have the usual prostate symptoms that would be an obvious clue.
Well, we thought it was hip joint or knee joint. No. We thought it was ligament or some other issue why his right leg is sorta weak and knee not stable. No. So latest place did an MRI on his lower back. Bingo. His spinal cord is getting pinched by the lower discs. Saw it on the MRI myself. So now we go to see a spine doc. Start with injections and therapy. Anyone go through this?
Regardless of WHAT the cause for the 'pinching' of the nerves is, this MUST be addressed IMMEDIATELY of your husband MAY end up with something called Cauda Equina Syndrome which is NOT reversible and is pure HELL to live with.
I speak from 7 yrs experience. It requires immediate surgery to repair. I was BS'd x 88 days from ER to ER and sent to a Community Clinic for evaluation and ALL missed my pinched T12-L1-L2. When they finally surgically repaired it I am left with searing, burning pain going down one hip>>thigh to the knee PLUS horrible daily never-ending pain in my other buttock that radiates to my hip and down that leg to my calf. I was pain controlled fairly well til the "opioid crisis" when my Pain Management MD abruptly stopped ALL 2 of my meds and discharged me for asking questions he was not prepared to answer. Today, I am pretty much home bound now and am killing off my healthy liver with ES Tylenol around the clock. At 66 it is doubtful I will get a new liver when that happens. Cauda Equina Syndrome also affects bowel and bladder function and you don't get to choose what parts are effected not how severe the effects are. Each person with it has different degrees of damage, but the damage, when present, is permanent I hope your husband's pinched nerve gets taken care of quickly and simply.
Another tidbit~both Orthopedic and Neurosurgeon MDs missed my CES and told me, "it is fixed by the surgery." I have learned that surgeons who cannot 'fix' thing with surgery tend to dismiss them afterwards.
Last edited by mooksmom; 06-01-2019 at 11:45 AM..
Reason: spelling
Regardless of WHAT the cause for the 'pinching' of the nerves is, this MUST be addressed IMMEDIATELY of your husband MAY end up with something called Cauda Equina Syndrome which is NOT reversible and is pure HELL to live with.
I speak from 7 yrs experience. It requires immediate surgery to repair. I was BS'd x 88 days from ER to ER and sent to a Community Clinic for evaluation and ALL missed my pinched T12-L1-L2. When they finally surgically repaired it I am left with searing, burning pain going down one hip>>thigh to the knee PLUS horrible daily never-ending pain in my other buttock that radiates to my hip and down that leg to my calf. I was pain controlled fairly well til the "opioid crisis" when my Pain Management MD abruptly stopped ALL 2 of my meds and discharged me for asking questions he was not prepared to answer. Today, I am pretty much home bound now and am killing off my healthy liver with ES Tylenol around the clock. At 66 it is doubtful I will get a new liver when that happens. Cauda Equina Syndrome also affects bowel and bladder function and you don't get to choose what parts are effected not how severe the effects are. Each person with it has different degrees of damage, but the damage, when present, is permanent I hope your husband's pinched nerve gets taken care of quickly and simply.
Another tidbit~both Orthopedic and Neurosurgeon MDs missed my CES and told me, "it is fixed by the surgery." I have learned that surgeons who cannot 'fix' thing with surgery tend to dismiss them afterwards.
I am so, so sorry. There's really no excuse for what happened to you.
When I presented to my PCP with pain radiating down my left leg and inability to climb stairs, he sent me to physical therapy. With NO dx. Of course PT did not help in the least, so one Sunday I went to Urgent Care and told a kind woman doctor what was going on.
The very FIRST thing she checked for was Cauda Equina. Then she ordered an MRI, and that set me on the right path to a dx, which was not CES.
But dang, it's a simple test to check for CES. It should be Emergency Medicine 101.
Also note that spine surgery has changed dramatically over the years.... thankfully.
My spouse had his fusion done at Stanford and he had three incisions - two in the back and they actually went in to do his fusion from the left side - actually going in anteriorly (from the front of the spine) That way they would not have to retract his nerve in the surgery to do the work.. Retraction has often caused more damage.
Actually, going in from the left side is an XLIF. It is a lateral incision not an anterior incision. I have had spinal fusion surgeries with both types of incisions. The benefit of the lateral approach is that you can avoid moving the great vessels which you have to do with the anterior approach. You need a vascular surgeon to do that for the neurosurgeon to do his/her work.
He sort of drags his right foot and uses a walker now. He says its not numb though. He has erectile dysfunction and wondering if this is associated. Yes, we have some great teaching hospitals around here and we will get several opinions before surgery. His orthopedic doc wants him to go to a neurosurgeon and try injections and physical therapy first. I guess it can't hurt?
If he needs steroid injections, please find a board-certified pain management specialist to perform them. They are usually anesthesiologists and are the experts for doing this. I have had many injections over the years as well as spine surgeries so I am very familiar with this process.
And yes, if surgery involves the nerves, go to a neurosurgeon. Orthopedic = bones, Neurosurgeon = Nerves, brain.
He sort of drags his right foot and uses a walker now. He says its not numb though. He has erectile dysfunction and wondering if this is associated. Yes, we have some great teaching hospitals around here and we will get several opinions before surgery. His orthopedic doc wants him to go to a neurosurgeon and try injections and physical therapy first. I guess it can't hurt?
The person who should decide is your husband. What does he want to do?
Erectile dysfunction comes generally with age, but it could be worse due to the spine problem. Before my surgery, I lost some bowel control and urinary function. Luckily for me, both functions got better after my surgery.
Good luck. I hope that if he has the surgery, he improves. As far as the injections, they may give relief from the pain and therefore give some added mobility due to the fact that it won't hurt as bad to walk. This masking of the pain does not make the condition in the spine better, but it may help. If it is not almost completely blocked like mine was, maybe it will be a good thing. He should be speaking to a really good neurologist and neurosurgeon. Sometimes, the deficit (dragging of the foot) is permanent if left too long. Be very aggressive with his care.
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With NO dx. 
