Post-op dysesthesia is an unavoidable phenomenon that is a risk of nay transforaminal decompression, especially stenosis. It can be a result of the decompression itself or due to anomalous anatomy not known to surgeons.
Operating with the patient awake is the best way to avoid dysesthesia as the patient will have pain during the surgery that will alert the surgeon. Pain is a warning sign. The surgeon must know how to manipulate his instruments and recognize patho-anatomy.
Post-op dysesthesia is a common side effect of decompression adjacent to the diagnosis-related group (DRG). It can be a concern of patients if this is not explained. It is best treated early with TFESI and sympathetic blocks. It may take three blocks to resolve.
This can occur even after a perfectly performed foraminoplasty with the patient awake and no pain is encountered during surgery. The likely cause is due to vascular changes next to the DRG following foraminal decompression.
The patient should be aware of the phenomenon before consenting to decompression. It is unavoidable and usually temporary and is treated with TFESI.