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Old 03-08-2012, 10:23 PM   #1
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Unhappy more back surgery or not?

Hi, I'm 30 years old and broke my back at the beginning of Feb. I just had my L4 to L2 fused as my L3 burst which impacted on my spinal column by 80%. I have a 30% compression in my L1 that we decided to let heal on its own. I didn't take it as easy as I could have in the beginning and now a month after surgery have been told the L1 fracture is out of line. I am in a lot of pain and have a raised lump in this area that I've been told on first glance could be the screw. Can anyone share advice and tips? Or at least reassure me that the lump and pain may go away? I understand that sometimes screws are taken out? If not will my spine become crooked? And is the misaligned L1 fracture at 30% something that may need more surgery? So many questions! Sorry , I've been so positive but its time for a reality check I think. I normally take a holistic approach to health so don't want to be on pain meds forever. I can't wait to start physio but cant until my brace comes off in another month. I also lead a very active life so want to know, realistically, how much flexibility I will get back. Thanks in advance!!!

 
Old 03-08-2012, 11:11 PM   #2
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Re: more back surgery or not?

Welcome to the board. Do you have any reason to believe the fracture at L1 is still 30%? I guess I would be concerned that perhaps it has increased due to your activity and increase in pain.

I hope you now understand that you are still very early in your recovery and you will need to be extra-careful for many months to come.

Hardware is removed for a variety of reasons, although it is far from common. Normally it is not done until the fusion has formed solid, unless there is some critical issue that would require removing it sooner. If the hardware is removed prior to fusion, the chance of the spine being unstable is great.

I really couldn't guess whether you might need surgery to repair that L1.

You won't know for awhile if you will need to make some modifications to your lifestyle in order to preserve your back so that when you are in your 70s you will still be mobile. I will tell you right now that the L4-L5 segment will be in danger of developing degenerative disc disease due to the fact that you will be fused from L2 -L4. The L4-L5 already takes the brunt of all motion due to its location. Since you will have little mobility in the segments above it, there will be increased stress on the segments adjacent to the fused area. Even with a normal amount of wear and tear, that L4-L5 segment is going to be at some risk. If you are very active doing movements that stress the spine, you will probably face this "domino effect" sooner rather than later. No crystal ball -- but something that is worth mentioning...something for you to be aware of.

Due to the location of the fusion, I don't think you'll notice much loss of flexibility. When the L4-L5 and L5-S1 are fused, there is loss of ability to twist or bend backward...but I don't think you'll notice a big difference.

I'm sorry you've been through such a difficult injury and hope the L1 clears up soon. You may just have to be patient for a couple weeks and see how things heal.

Last edited by teteri66; 03-08-2012 at 11:14 PM.

 
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Old 03-08-2012, 11:21 PM   #3
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Re: more back surgery or not?

I'm sorry to hear about your unfortunate accident.

Have you had any imaging on the lump/possible screw? It should be close to time for your first X-ray. It also sounds like knowing what that lump is might give you some peace of mind. (I clicked on the post since you didn't have any replies, then saw that Teri had already posted. Hi Teri!)

Kind in mind that L1 is going to have a tough time healing, since sitting on top of or below a fusion causes extra stress for adjoining vertabrae and discs, so be very, very careful and put that active lifestyle on hold so that you can get back to some of the things you enjoy later.

 
Old 03-08-2012, 11:35 PM   #4
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Re: more back surgery or not?

Thank you so much for your honesty, especially to be aware in years to come of the 'domino effect'. I had my first post-op xray today and faxed them straight to my surgeon as I don't live in the city. I should hear from him tomorrow hopefully. Im just kicking myself that I didn't rest as much as I was being told to at the beginning..and youre right, I guess I'm still in early stages. I'm due to fly home in 2 weeks but have been told I need a reclining seat so I can take my brace off regularly, I have another appointment set up with my surgeon just before. Any stretching/flight tips? Its a 10 hour flight I started taking a homeopathy pill called Symphytum Officinale (bone knit) that helps with healing apparently.

 
Old 03-08-2012, 11:51 PM   #5
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Re: more back surgery or not?

Oh boy, that's going to be a tough flight. Here are some ideas: have lots of pain meds and muscle relaxants ready. More than you think you need.

Whenever you get a chance, try to find somewhere to lie down and elevate your feet, if possible.

Start practicing ab setting, essentially stabilizing your ab muscles. You will want to hold your abs tight during turbulence/take-off/landing. I had an encounter with a bumpy bus today and used my abs to stabilize my back. I felt like I was almost hovering a millimeter above the chair.

I didn't have a brace, so I don't know if it would help you, but I always put a pillow in the small of my back when I have to sit for longer than I would like.

Make friends with the flight attendant and ice as much as you can. Fifteen minutes on, at least fifteen minutes off.

As far as stretching, I would be very careful and you probably shouldn't stretch your back, but you should be able to stretch your calves and also flex/point your feet while seated. If you have any TED (compression) stockings, you might want to wear them under your pants. This will help with your leg circulation.

One of my favorite things is self-massage with tennis balls. This is not appropriate for the area where you had surgery, but can help with tightness between the shoulder blades, for example. Just place the tennis ball between yourself and a wall and apply GENTLE pressure to get a comfortable massage.

 
Old 03-08-2012, 11:55 PM   #6
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Re: more back surgery or not?

And, of course, get up and walk, stand, march in place, as much as possible.

 
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Old 03-09-2012, 11:27 AM   #7
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Re: more back surgery or not?

I don't know what type of brace you might have, but I would think you wouldn't need to remove it if you can get up and stand or move around. To me, that is more important than sitting and removing the brace.

Will you have a spine surgeon at home who will take over the management of your case? With that L1 segment kind of being in limbo, I would think you would want someone following your case quite closely and advising you.

I don't mean to be nosy, but were you just visiting when you broke your back?

I'm wondering if a hemangioma has formed at L1 since the fusion? This is not uncommon, as "things" don't drain as well as they should post surgery in some people. Usually the patient isn't aware of the hemangioma and it is pointed out on X-ray, but sometimes they are large enough to create a bump that is seen through the skin.

Regarding the trip -- ugh. Flying is bad enough without a back brace on. Other than what SweetPea mentioned, I would just add drinking lots of fluids. ..preferably water...and standing and walking every 30-40 minutes if possible. You might want to buy some of those icy hot patch things to use on the trip. I think they have long-acting ones. It might help a little bit. Also, wear loose-fitting clothes -- don't try to wear jeans. Keep to something with an elastic waist and kind of baggy like yoga pants or similar. Also depending on your height, you may want something to put your feet on, so you can kind of adjust the height and angle while trying to recline, so they are supported.

I really do not envy you this trip. I don't suppose you could postpone it? Do you have to go home?

 
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Old 03-09-2012, 04:49 PM   #8
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Re: more back surgery or not?

Great advice, thank you again. Yes I was visiting when this happened and am trying to use the return flight I have already paid for. I would stay as it makes sense but due to the size of my medical bills Im forced to go home.

I havent heard back about results from my xray yet and dont have an appointment until the 22nd (day before I fly home). I would assume if there was anything serious he would be in touch? (re:the lump or possible increased compression) Im hoping to go see a surgeon asap when I get home who can take on my case. Im dreading the flight already. I am on hydramorphone right now, my valium just ran out and think my new prescription might be for T3s instead. I have been buying methocarbomol (anti back spasm pills) that seem to help. If you have advice on what might be good for the flight let me know and I can ask my surgeon for a prescription.

I really appreciate this advice, its good to hear from people with personal experience.

 
Old 03-09-2012, 08:23 PM   #9
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Re: more back surgery or not?

If you have the means -- either monetarily or through frequent flier miles -- to upgrade your flight, even to an emergency exit row, I would recommend doing so. Even if the money isn't what you would normally spend, it could be worthwhile to avoid any further setbacks. In the past, airlines would upgrade folks if there are extra seats in business or first class if there were vacancies. My tall dad (6'6") was often able to get a free upgrade on trans-Atlantic flights, so be really nice to the person who checks you in.

Also, call the airline ahead of time regarding luggage porting and a medical cart. You might not be able to get yourself to a gate very quickly. You might want to request a wheelchair at touchdown, too. You may end up not needing it, but at least it would be there if you can't walk after the flight. Don't load anything into an overhead bin.

As far as anti-spasmodics, I have taken Soma, flexeril, and skelaxin. The skelaxin isn't very strong. The flexeril worked better for my lumbar issues and the Soma (carisoprodol) worked better for my cervical problems.

 
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back lower spine, compression fracture, fusion surgery, recovery from spinal fusion, recovery help



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