Can L4-L5 Compression Cause Heel Support Issues After Thoracic Surgery? - Orthopedics

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Yes, L4-L5 compression can indeed cause heel support issues, particularly after thoracic surgery. The relationship between lumbar spine issues and lower extremity function is well established in medical literature. The lumbar spine, particularly the L4 and L5 vertebrae, plays a crucial role in the innervation and function of the lower limbs.
In your case, the inability to support weight on the heel of your left foot while being able to do so on the toes suggests a possible neurological issue. The L4 and L5 nerve roots are responsible for the sensation and motor function of various muscles in the lower leg and foot. Specifically, the L5 nerve root is particularly important for the dorsiflexion of the foot, which is the action of lifting the foot upwards at the ankle. If there is compression at the L4-L5 level, it can lead to weakness in the muscles that control this movement, resulting in difficulty with heel support.

Your symptoms of pain and numbness in the outer calf and weakness in the big toe further support the possibility of L4-L5 nerve root involvement. These symptoms indicate that the nerve roots may be compromised, which can lead to altered motor function and sensory perception in the affected areas. The fact that you have undergone thoracic surgery and have a history of a significant spinal injury adds complexity to your situation.
After thoracic surgery, it is not uncommon for patients to experience changes in their posture and biomechanics, which can place additional stress on the lumbar spine. This stress can exacerbate pre-existing conditions or lead to new issues, such as disc herniation or nerve root compression.
In your case, it would be prudent to follow up with a neurologist or an orthopedic specialist who can evaluate the severity of the nerve root compression. Diagnostic tests such as MRI or CT scans can provide more insight into the condition of your lumbar spine and help determine the best course of action. Electromyography (EMG) and nerve conduction studies can also be useful in assessing the function of the nerves and muscles in your lower extremities.

If the compression is significant and conservative treatments such as physical therapy and medication do not alleviate your symptoms, surgical intervention may be necessary to relieve the pressure on the nerve roots.
In summary, L4-L5 compression can indeed lead to heel support issues, especially in the context of your previous thoracic surgery and current symptoms. It is essential to work closely with your healthcare providers to monitor your condition and explore appropriate treatment options. Early intervention can often lead to better outcomes and a quicker return to normal function.