This patient had an unfortunate complication of spine surgery leaving her with a foot drop and chronic pain in the leg. When her foot drop never resolved, she opted to have a partial ankle fusion to allow her to walk a little easier without having to wear a brace. She required two operations to help with this. She had a second unfortunate complication in the fact that she had worsening chronic pain in the ankle after the second ankle fusion that she did not have prior to the operation. This pain she described as “an electric shock” or “electrocution” feeling shooting into the great toe and top of the foot and outside of the heel 24/7. In addition to this, the patient also complained of symptoms of pins and needles in the sole of the foot.
The patient did not want to try a spinal cord stimulator, and we felt that there was evidence of entrapment of the common peroneal nerve at the fibular head, the proximal tibial nerve at the soleal sling, and injuries of the superficial peroneal and deep peroneal nerves. Nerve blocks that were performed in the office supported these suspicions.
The patient underwent a decompression of the common peroneal nerve on the outside of the knee, the proximal tibial nerve in the back of the calf, and resection or removal of the superficial and deep peroneal nerves that provided painful sensations to the top of the foot and ankle.
At 3.5 months after surgery, we are celebrating with this patient who is reporting 80% improvement in the severe ankle and foot pain that she had prior to surgery. She reported that 80% of the shooting, electrical, shocking pain is gone from the top of the foot and her previous ankle surgery scars, the deep aching in the back of her calf cured from the proximal tibial nerve was gone completely, and she reported that the sensation to the sole of the foot was “much improved.” The pins and needles were gone and the hypersensitivity to light touch was dramatically improved. She could touch the sole of the foot without recoiling. The common peroneal nerve decompression resolved much of the pain that she had that was starting at the knee and radiating up into the posterior buttock and the pain that radiated down to the top of the foot.
We are very excited for her. She had a complex case and we are glad that she was able to get some of the relief we were expecting.
V.E.