Post-Spinal Surgery Leg Weakness: Can Laser Therapy Help?

Postoperative leg weakness after spinal surgery?

Hello, Director Yin! I am a patient with rheumatoid arthritis who underwent surgery for L4-L5 lumbar spondylolisthesis (and had a second surgery due to recurrence) over 10 months ago.
My right foot remains stiff and I still cannot lift it.
I have a few questions:
1.
Is venous laser therapy effective in repairing nerve damage after surgery? Is it typically recommended to undergo three treatment courses, with each course consisting of 10 sessions? How many courses are generally needed to see results?
2.
Given that it has been so long after surgery and my lower limbs still lack strength, is there a possibility that the nerves cannot be repaired?
3.
Are there any cases where patients with lower limb weakness after spinal surgery have shown improvement from venous laser therapy?

Amin, 50~59 year old female. Ask Date: 2023/08/16

Dr. Yin Xinbei reply Rehabilitation

1.
Lower limb weakness caused by spondylolisthesis is classified as a central nervous system injury.
Modern medicine still lacks a definitive effective treatment.
Endovenous laser therapy is considered an energy-based treatment, and its effectiveness varies from person to person.
It may improve abnormal muscle tone and stiffness or numbness caused by central nervous system injuries.
A trial treatment course can be undertaken, but if there is no improvement, further sessions are not recommended.
However, muscle weakness still requires rehabilitation training to enhance strength and endurance for progress.

2.
Once nerve damage reaches a certain severity, complete recovery may not be possible even after decompression.
Nevertheless, ongoing rehabilitation focusing on strength and endurance can still improve daily functional abilities.
3.
As mentioned in point 1, muscle weakness still relies on strength training.

Reply Date: 2023/08/16

More Info

Post-spinal surgery complications, such as leg weakness and stiffness, can be particularly challenging for patients. Your situation, involving L4-L5 spondylolisthesis and subsequent surgeries, is not uncommon, and many patients experience similar issues. Let’s address your questions regarding the potential benefits of laser therapy and the overall prognosis for your condition.

1. Effectiveness of Laser Therapy: Laser therapy, particularly low-level laser therapy (LLLT), has been studied for its potential to promote healing and reduce pain. While some evidence suggests that laser therapy can help improve nerve function and reduce inflammation, results can vary significantly from person to person. The therapy is thought to stimulate cellular activity, enhance blood flow, and promote tissue repair, which may be beneficial for nerve recovery.
Typically, a course of treatment might involve multiple sessions, often around 10, with recommendations for 3 cycles depending on the severity of the condition and the individual’s response. However, it’s essential to have realistic expectations; while some patients report improvements in pain and function, others may not experience significant changes. The exact number of sessions required to see results can vary widely, and it’s advisable to discuss this with your healthcare provider to tailor a plan that suits your specific needs.

2. Long-term Nerve Recovery: After more than 10 months of post-surgical recovery, it’s understandable to be concerned about the potential for nerve repair. Nerve healing can be a slow process, and while some patients do regain function over time, others may experience persistent weakness or stiffness. Factors influencing recovery include the extent of nerve damage, the type of surgery performed, and individual healing responses.
If significant time has passed without improvement, it may be prudent to undergo further evaluation, such as nerve conduction studies or electromyography (EMG), to assess the current state of nerve function. This can provide valuable insights into whether there is still potential for recovery or if alternative treatments should be considered.

3. Case Studies of Improvement: There are anecdotal reports and some clinical studies indicating that patients with post-surgical leg weakness have experienced improvements after undergoing laser therapy. However, these cases often highlight the variability in patient responses. Some individuals may find relief from pain and an increase in mobility, while others may not see substantial changes.
It’s crucial to approach laser therapy as part of a comprehensive rehabilitation plan that may include physical therapy, medication management, and possibly other interventions. Engaging with a multidisciplinary team can help optimize your recovery strategy.

In summary, while laser therapy may offer some benefits for nerve repair and pain relief, its effectiveness can vary. Given your prolonged symptoms, further evaluation of your nerve function may be necessary to determine the best course of action. Always consult with your healthcare provider to discuss the potential benefits and limitations of any treatment options, including laser therapy, in the context of your overall recovery plan.

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