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SPINAL FUSION AND
FOOT DROP
Ross A. Hauser, M.D.
A patient came to
Caring Medical with a long history of back pain complaints.
He had a discectomy and subsequent
spinal fusion.
He has
had to wear an AFO (ankle foot orthosis) because of foot drop in the year
following spinal fusion. He had an electromyographic/nerve conduction
study which showed evidence of nerve damage. On physical examination there
was slight movement of dorsiflexion of the foot. There was palpable muscle
contraction in the muscles that raise the foot toward the head. The
muscles strength could only be appreciated when gravity was eliminated.
The patient was given a comprehensive natural medicine evaluation. He was
placed on anabolic
hormones that help get the body into the healing mode. The
hormones included
Human Growth Hormone,
Testosterone, and
DHEA. He was
placed on a hypoallergenic diet. He was given
exercises to do with gravity
eliminated. He was told to do electrical stimulation to the dorsiflexors
and other muscles that move the foot (the ones that were weak). He was
also placed on supplements, and had vitamin B shots,
Prolotherapy to the lower
back, and
Neural Therapy administered to the nerves involved.
The patient continued to make improvements to the point that after 6 months he
was able to discontinue wearing his orthotic. He still has some foot
weakness but walks normally without an orthotic.
I want to now explain why natural medicine doesn't help some people with foot
drop. There are some cases in which people have nerve injury to muscles of
their foot, and the muscles atrophy and are replaced by scar tissue. In some of these cases the nerve repairs, but unfortunately the person
still has foot drop because there is no muscle tissue left. The important
point to make is that if you get nerve injury you have to stimulate the muscles
so when the nerve is regenerated there is some muscle tissue left to stimulate.
In other words, anyone who has nerve injury has to use an electrical
muscle stimulator everyday, sometimes for the rest of their life. If I am not
sure if someone has any muscle tissue left, I will order
physical therapy for
electrical muscle stimulation and ask the physical therapist to see if there is
any muscle contraction in the muscles that are stimulated. If there is no contraction, then nothing can be done to help the person
regain muscle contraction because there is no muscle. If there is, then we continue to use electrical muscle stimulation to
strengthen the muscle. |
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