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Old 02-21-2012, 10:31 AM   #1
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Pain following 5-level spinal fusion

I found this board shortly after I had my most recent surgery but this is my first post. At the end of November I had surgery to repair spinal stenosis. I had previously had L4-5/S1 fused in 2005 so the doctor was going to fuse up another level. (A CT myelogram had shown major blockage at the site of the previous fusion). Surgery went great. Doctor informed me the the nerve sac was smashed totally flat but once he was done it popped right back with no damage at all. He did say the nerves to my right side were highly irritated and that it would take "quite a while" to actually heal however within 2 days i was walking the halls of the hospital feeling fantastic. Unfortunately the staff let me fall when they were performing x-rays later. The fall caused a massive bruise and a large hematoma which they had to drain a week later. Turns out it also knocked the screws and a cage loose the doctor had just put in and I had to have another surgery in late December to repair this damage. He ended up having to fuse all the way to L1 to get the screws to hold so now my entire lumbar from L1 to S1 is fused.
I am now about 8 weeks out of surgery and still experiencing enormous pain on right side. It is so bad that I can't step with my right leg without hanging on to something or I'll fall again. X-rays show everything still in place so they say it's muscular but it sure feels like skeletal pain. Home PT says I have to realize I went through a "hell of surgery" and that the fall certainly didn't help at all so it would just take time. I'm actually starting a new rehab program in a pool today and hope everyone is correct and the pain goes away soon.
I guess my question is whether anyone else has had a surgery like this and/or had this kind of pain this long after surgery. If so how long did it take to get over the pain so you could walk.

 
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Old 02-22-2012, 09:35 PM   #2
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Re: Pain following 5-level spinal fusion

You had a very long fusion, and these fusion surgerys are very big surgerys. You can't compare them to having your gallbladder out for example. They (fusions) are more on the level of open heart surgerys. I mean this in pain, recovery and rehab time. You are only two months out, so you are still very early on in your recovery. You should only be walking and resting. I had an 8-level fusion several years ago, and it took me three months to feel more "comfortable". Water therapy is great and may help with the walking. I would stay away from the treadmill; some doctors and PT's don't like them, but some do. But I'm not a doctor, so always ask your doctor first. Welcome to the HealthBoards!!...I'm sure others will chime in too...janiee

 
Old 02-23-2012, 03:09 PM   #3
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Re: Pain following 5-level spinal fusion

I had a lot of pain after surgery. Later I had problems with my sacro which caused much pain. I am never really pain free but I think I have other problems with my back like scar tissue. I'm sure you will be feeling fine but it does take a while.

 
Old 03-04-2012, 04:21 PM   #4
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Re: Pain following 5-level spinal fusion

Thanks everyone who answered my post. I am now 10 weeks since my 2nd surgey and doing a little better. People keep telling me I'm doing great but in my mind I still have a hard time believing it. I still have a lot of pain on my lower right side and have to use crutches to walk. Does beat the wheelchair and the walker I was using. I started rehab in a pool and find it extremely tiring but I can tell it is building muscles in my legs. Today I was able to walk 1800 feet. First 1000 was in a parking lot with my wife following me and telling me when I started sticking out my butt instead of standing straight. Nobody told me to only walk on flat areas so the last 800 feet were up and down steep street. I really want to ditch te crutches but I still get too much pain when I try. What I really wanted to do today was ride my motorcycle but figure that is a long time off right now.

 
Old 03-04-2012, 05:16 PM   #5
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Re: Pain following 5-level spinal fusion

Particularly with such a long fusion, you are well-advised to stay on a flat, level surface. Going up or down an incline tips the spine and puts additional stress on everything. You have to remember that a fusion is just like a series of man-created broken bones. If it were your arm, the doctor would put it in a cast to immobilize it so that the new bone cells would have an easier time knitting together without some movement jarring the line of cell growth. Think about when you are gluing a broken dish together. The pieces have to be held together without movement until the glue sets. Otherwise they will not stick together.

It is the same process for the spine, only without benefit of a cast that holds everything still. So it is up to the patient to attempt to create as much stillness as possible while the new cells form and grow.

Walking in a warm pool is optimal exercise for any fusion patient. I too was told no treadmills, at least in the early stages of recovery. Anything that has a repetitious movement is harder on the spine. When walking outside, the steps vary more in length, speed; you tend to naturally vary the pace just a tad, etc. It is better than the constant pounding footfall of a treadmill.

You are still very early in your recovery...and it takes longer for multi-levels to heal than a one or two level surgery. You shouldn't really be too concerned about nerve pain for several more months. It will take all the soft tissue and muscles some time to get used to the new structural alignment -- the fascia will readjust, etc. It isn't just a matter of growing bone, even though that's all most of us talk about.

Walking will remain your best exercise. Try to take short walks several times per day as that is what keeps the nerves stretched out and helps to minimize scar tissue from attaching to the nerves as it forms.

Be patient and maintain a positive attitude. You've been through a MAJOR trauma and it will take time for your body to heal.

 
Old 03-11-2012, 12:30 PM   #6
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Re: Pain following 5-level spinal fusion

Quick update: My doctor never said anything about whether I should walk only on level ground but after reading the responses to my last post (and feeling like somebody had beat me with a baseball bat the next day after walking the hills) I am now only walking on level flat surfaces. I am now 11 1/2 weeks out from my 2nd surgery, I've been doing rehab pool therapy for 3 weeks now and while I do see more muscle development in my legs the pain in the right side of my lower back is just as bad as it was just after the 2nd surgery. The pain is still keeping me from walking without crutches which REALLY frustrates the heck out of me! In the pool I can walk just fine however as soon as I get out and try to take a step without crutches the pain hits so fast and hard that it will instantly put me on the floor if I don't grab something to hang onto fast. The therapists still keep telling me that it's muscle pain but sometimes it sure is hard to keep believing them. The pain is to the right of my spine and I swear I can feel a knot there. My chiropractor tells me my pelvis is "locked" and "out of position" and once we started seeing good bone growth happening I did let him adjust it twice. The first time it felt like the pain shifted to my left side for a few days before coming back to the right side. Not sure why. Also after both times the next day the bottoms of my feet would cramp really bad when I walked so I haven't let him adjust it again. I have been getting cold laser treatment on my back three times a week since surgery and have been using a vibrating platform after each session as well as at home. (both are supposed to make the bones heal faster and the vibrating platform is supposed to make muscles stronger faster as well) I am going to see my surgeon for my 12-week check this week and will be quite curious as to what he has to say about my progress (or lack of progress). I know everybody keeps telling me it just takes a lot of time but man do I get frustrated at my lack (or perceived lack) of progress. One interesting note though - last night in a dream I remember getting up with crutches then saying "I don't need no stinking crutches", throwing them away, and walking normally. Maybe this is some sort of subliminal message or sign that I may be about to make a break threw and get better. I just don't know.

 
Old 03-11-2012, 01:38 PM   #7
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Re: Pain following 5-level spinal fusion

Were you told to use the vibrating platform by your surgeon? That certainly runs counter to everything I've been told about growing new cells and getting things to fuse.

 
Old 03-11-2012, 03:38 PM   #8
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Re: Pain following 5-level spinal fusion

Actually yes my doctor has been all for both the cold laser and the vibrating platform. Said he's had really good results from both.

 
Old 03-11-2012, 06:52 PM   #9
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Re: Pain following 5-level spinal fusion

What is this doctor's specialty? Is he your surgeon? He definitely has a different philosophy than any spine surgeon I am familiar with!

Where is your pain located? What is it that keeps you from walking without crutches? Is it the pain or do you feel weakness?

It is a bit unusual to use crutches after fusion. Usually doctors prefer a walker unless that patient needs to keep the weight off the legs.. Would you be able to use a walker or would it be physically impossible?

Your situation is so different from most fusion patients that I don't feel comfortable trying to offer any tips or comments....

Last edited by teteri66; 03-11-2012 at 07:00 PM.

 
Old 03-12-2012, 08:19 AM   #10
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Re: Pain following 5-level spinal fusion

Yes, this doctor is considered to be one of the best orthopedic spine surgeons in the country. He has performed over 10,000 spine surgeries and one thing that impressed me was the fact that he considers new therapies and treatments instead of just automatically rejecting them. I used a walker and wore a "clam shell" hard brace until he saw good bone growthat which time he approved going to a softer brace and crutches. He also had to see that I was standing up using my legs and not my back before I was allowed to use crutches.

 
Old 03-12-2012, 08:21 AM   #11
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Re: Pain following 5-level spinal fusion

In what country is the surgeon located? I am just curious because the vibrating platform seems to contrary to anything I know about how bone cells begin to form. I know that there have been studies to see if it affects osteoporosis (which were inconclusive) but it just makes no sense to me.

If you were trying to glue together a china teacup, if you set it on a vibrating table for the glue to set, you would never have a tight bond. Any movement between the two pieces will keep it from being able to set up so the glue can set. Since broken bones set and heal the same way as a fusion, I don't see how keeping the surfaces continually mobile allows the cells to knit together. Particularly with so many levels that need to fuse, knowing the additional problems this creates, I do not understand how this is supposed to help.

I will be very interested to hear how you are doing, if you are still posting in another year or so.

Why does the surgeon have you using crutches?

Last edited by teteri66; 03-12-2012 at 08:59 AM.

 
Old 03-12-2012, 09:18 AM   #12
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Re: Pain following 5-level spinal fusion

He is in the US and is director of the spine clinic at the hospital the surgery was done at. The vibrating platform was not used until good bone growth was seen, not from right after surgery. Cold laser was used from right after surgery. I've looked at a lot of research on both and both have shown they stimulate bone growth.

 
Old 03-12-2012, 11:06 AM   #13
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Re: Pain following 5-level spinal fusion

That's great. I really am interested in learning about this. You must have had BMP to have already had lots of bone growth prior to your 12 week checkup.

I hope you'll be cleared to walk without crutches at that time.

 
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Old 04-07-2012, 11:27 AM   #14
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Re: Pain following 5-level spinal fusion

Well, I am now 15 weeks since surgery. I have also finished several weeks of intensive pool rehab therapy and I still have just as much pain as I did right after surgery. In fact I believe my pain is worse now than it was before I had the surgery. I admit it's a different pain than before surgery but it's still pain. I still can't walk without crutches (or a walker although I don't do as well with a walker so I prefer crutches). At my last check up the doctor said he saw good bone growth and that I could start weaning out of the soft brace. Told me the nerves were so inflamed when he did the surgery that it might take a year for them to heal. He did tell me I could start riding my Honda Goldwing trike again though. Of course I ran right home and went for a ride. BIG MISTAKE! First I couldn't swing my leg up and over the seat like I used to but I was determined to ride. Every time I tried to swing up my leg I just kicked the side of the bike because I couldn't get it high enough. Ended up grabbing my foot and throwing it over to mount up. Riding didn't increase my pain but when I went to dismount I found I had a hell of problem. Didn't think I was ever going to be able to get off the beast. I was home alone and I just sat there for a while thinking, "this is another fine mess you've gotten yourself into". Finally through shear willpower I was able to drag myself off without falling. I then waited a couple of weeks and tried again. Found that while I still couldn't get on like I could before surgery it was a lot easier than the last time I tried. Still hard enough getting on and off that I put it back in the garage and don't plan to try again for a few months. Thought it was funny that the doctor also told me I could ride my Suzuki Burgman 650 scooter until my wife piped up and said, "Do you realize his scooter goes 120mph" and which point he said, "whoa, whoa, you're not riding the scooter yet then but you can ride your wife's moped". He seems to think I have a death wish sometimes. I remember when I was still in the clamshell brace that went from my waist to my neck (I called it my ninja turtle suit) I told him I needed to get out of it because it was screwing up my aerodynamics when I was ski jumping. He looked shocked for a moment then shook his head and said, "You know, you scare the hell out of me sometimes".

It was interesting that during pool therapy I noticed that I did have a few days where my pain wasn't very bad when I was out of the pool however as soon as I started walking in the pool I instantly got severe pain in the middle of my low back. Even though I mentioned it every time to the therapist she acted like that was normal. Pool therapy KICKED MY BUTT but I do have to say the pool therapy and the vibrating platform were quite effective in rebuilding the muscle size in my legs. (20 days in the hospital had left my legs quite small in size). Strange things is though that although the muscles got bigger my strength doesn't seem to be any better than before the therapy.

Doctor says he still expects me to have a full recovery but that it's going to just take a long long time. I think this waiting for the pain to go away and my body to start working correctly are the most frustrating thing I've ever been through. Every morning I wake up hoping this will be the day but every day I am disappointed. Now it's going to be interesting because I have to take an 8 hour flight soon. Have to get up and walk every 15 - 30 minutes or my back really locks up but have to use crutches to walk and of course the airline seats are too small for me since I'm quite tall.

OK enough whining for now. Does feel good to get it off my chest at least.

 
Old 10-22-2012, 07:38 PM   #15
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Re: Pain following 5-level spinal fusion

[QUOTE=teteri66;4938952]Particularly with such a long fusion, you are well-advised to stay on a flat, level surface. Going up or down an incline tips the spine and puts additional stress on everything. You have to remember that a fusion is just like a series of man-created broken bones. If it were your arm, the doctor would put it in a cast to immobilize it so that the new bone cells would have an easier time knitting together without some movement jarring the line of cell growth. Think about when you are gluing a broken dish together. The pieces have to be held together without movement until the glue sets. Otherwise they will not stick together.

It is the same process for the spine, only without benefit of a cast that holds everything still. So it is up to the patient to attempt to create as much stillness as possible while the new cells form and grow.

Walking in a warm pool is optimal exercise for any fusion patient. I too was told no treadmills, at least in the early stages of recovery. Anything that has a repetitious movement is harder on the spine. When walking outside, the steps vary more in length, speed; you tend to naturally vary the pace just a tad, etc. It is better than the constant pounding footfall of a treadmill.

You are still very early in your recovery...and it takes longer for multi-levels to heal than a one or two level surgery. You shouldn't really be too concerned about nerve pain for several more months. It will take all the soft tissue and muscles some time to get used to the new structural alignment -- the fascia will readjust, etc. It isn't just a matter of growing bone, even though that's all most of us talk about.

Walking will remain your best exercise. Try to take short walks several times per day as that is what keeps the nerves stretched out and helps to minimize scar tissue from attaching to the nerves as it forms.

Be patient and maintain a positive attitude. You've been through a MAJOR trauma and it will take time for your body to heal.[/QUOTE]
I just wanted to thank everyone for the wonderful post.. I am almost 3 weeks out of my 8 level spinal fusion and I am always trying to figure out if I am on track. I had the surgery Oct. 4Th and I don't go back to the Dr. until Nov. 5Th. I just waited way too long before I HAD to go see a Ortho surgeon. I thought they were going to work on T-10 to L5 but the morning of the surg. the Dr came in and said they looked at some of my old scans that I brought them from a year ago and decided they better include T-9. He had said he had been doing this for a lot of years and had never seen such a bad back. So I said OK. After 7 hrs the Dr. came out and told my husband it was 10 times worse than he was expecting. I was given 14 Oxycontin, 82 Percacets and 30 Soma.. I am off all of them except the Soma. Save those for walking. Well I am doing everything as before except for bending. I hope I continue to do well, or at least I feel like I am.. Again thanks for all the post...

 
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