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Old 03-28-2012, 05:43 PM   #1
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Fusion in Nov, in pain and depressed

I dont even know where to begin..In nov I had a 2level TLIF. L4-S1 with 2 discs replaced. Besides post op pain I thought I was starting to do better. My surgeon pushed me back to work (I'm a medical assistant) at 6wks and since my pain has only been increasing. I feel so frustrated. I orginally have spina bifida occulta-closed and a spondylolithesis at L5 that was grade 1-2. Its a good thing I had surgery cuz my imaging showed it was stable but when I had surgey NOTHING was holding my vertabrae in place. I also had DDD in l4 and l5 discs and l4/5 was herinated behind l5 vertabrae and l5/s1 was up behind it. I definitely needed to have surgery but I cannot understand or fathom why my pain is getting worse?? Over the last few wks I have been getting this grinding and clicking near my S1 vertabrae and an increase in muscle spasms that I thought I was working through. I gained a 1/2 in in height after surgery so I understand everything is in new order and getting stretched out to accomidate but I feel so frustrated and am almost to the point where I regret having surgery and not just deal with the pain I was having. Everyone keeps telling me to give it a yr and I called my surgeon about the grinding and his staff says it has nothing to do with the hardware. (I didnt realize they have ESP or Xray through the phone.) I go tomorrow to have some steroid injections but they have never given me much relief. I have been in PT since a wk after surgery and they are talking about a Tens unit to try, but I did not sign up for surgery to be more miserable and in more pain!!! Please tell me this is going to get better and just the healing process, cuz trying to find out other peoples stories from this kind of surgery is difficult and I just dont know what to do anymore. Sorry for the long post!

 
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Old 03-28-2012, 07:51 PM   #2
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Re: Fusion in Nov, in pain and depressed

[B]I had a 2level TLIF. L4-S1 with 2 discs replaced[/B] Did you have artificial discs or are you talking about having some sort of spacers put in? I am assuming you had the discs removed. What type of hardware do you have?

Do you have screws? Sometimes TLIF is done without screws -- as a matter of fact, the original surgery was designed without the use of screws and they found out that in some people, the screws migrated. It is for that reason that I make the inquiry.

It is fairly commo, or, at least not unusual, for people with lower lumbar fusions to develop pain coming from the SI joints. This would be something to ask the PT to check on for you. When you have a solid block that now cannot move when previously it absorbed most of the spine's movement, the next movable segment now absorbs all that energy....the SI joints are structured so that they move a very tiny amount...and now suddenly they may be moving more than that, and it can cause problems.

When an SI joint is affected, it can pull on the piriformis muscle which attaches close to that area. If the piriformis is irritated or swollen, it can then irritate the sciatic nerve which runs directly underneath the piriformis.

Is the pain you are feeling something relatively new, or have you had it ever since the surgery?

 
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Old 03-29-2012, 05:04 AM   #3
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Re: Fusion in Nov, in pain and depressed

A two level fusion and your doc pushed you to go back to work after 6 weeks? I don't know if the fusion procedure has improved since my dad had his 1 level fusion back in the mid-90's, but he wasn't expected to be back at work for at least 4 months. He was actually ready at 12 weeks.

Yes, it can take a full year to fully fuse following that type of surgery, but your pain should mainly be post surgical, with some additional pain as your body adapts to the mechanical changes that have happened. Based on my dad's experience, his pain was much lower following his fusion, once he got past the initial post surgical pain. Unfortunately, I don't remember how long that took, but he was able to go back to driving semi after 12 weeks post surgery.

As teteri mentioned, the SI joints can develop problems following spinal fusion. I'm curious to know what your current symptoms are too, and to know if they are different than what you had before. Women are also more susceptible to SI joint problems.

Being one who has been dealing with SI joint problems (among other things) for a while, that popping that you experienced is an interesting one. Does your pain level increase after that popping? If so, where is the pain? It can be difficult to focus on where the pain is located sometimes.

I can tell you that my SI joint pain is usually deep in the pelvis, but does also appear at the top of my pelvis, into the outer part of my upper thing right near the hip bone, and even into the back of my thigh (quads). The upper thigh and quad stuff is usually tight muscles . . . very tight.

 
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Old 03-29-2012, 01:07 PM   #4
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Re: Fusion in Nov, in pain and depressed

I have 6 screws, two per vertabrae, 4 titanium rods and 2 plasic type spacers. Most of my pain before surgery was in my back, left hip and leg with numbness, tingling burning ugh pain. For 6wks after surgery my left leg stuff was gone almost and I had mainly surgical pain. I awoke from surgery with right leg pain, sciatic pain and hip pain. That was starting to get better until I returned to work. I only returned to 12hrs a wk for almost a month and am not working 16 and next month April, Im working 24. The grinding/popping is between my upper si joint and spine, though it feels more in my spine on the right side. It only occurs with slight shifting of my pelvis like when I am taking a pts BP or standing still. Yes it most increases my pain and since it started happening on and off almost 2 wks ago my pain has steadily increased. Im at the point where I am crying almost everyday due to it. I have pain going down the inside and back of my right leg all the way to ankle with "inside numbness" (like when u get novacaine and u can feel ur cheek but its numb too) and burning pain. I also have pain in my hip joint and sciatic in the right leg with tingle in my rt foot. I have burning across both hips at waist band area. I did have problems with my piriformis for wks after surgery in both sides but I have gotten them stretched pretty well. This is different than that. I have manipulation done also and just about every 3 wks my legs are between a 1/2" to 1in off in length. My pelvis definitelt doesnt want to stay in alignment. I just went today and had 3 injections into my rt SI joint at pain mangement and he is going to send me for another MRI or CT scan as he is concerned something might be off.

Last edited by pookieheart16; 03-29-2012 at 01:09 PM.

 
Old 03-29-2012, 01:35 PM   #5
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Re: Fusion in Nov, in pain and depressed

At least he is looking at the SI joint, and planning an MRI or CT scan. It does sound like there could be something not right in that SI joint.

How is it feeling since he did the injections? What did he use for the injections?

 
Old 03-29-2012, 01:45 PM   #6
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Re: Fusion in Nov, in pain and depressed

I believe he used Marcaine, Lido, Depomedrol. I know he put in 120cc between the 3 shots. He was quite frustrated that my surgeon is not following me about all of this. Thank GOD for pain management! Right now my hip is numb but I had injections at 2p so numbing meds will be wearing off soon . My sciatic nerve feels numb and cool. Injections dont typically last me long but I LOVE having atleast a few hrs of relief. I've tried to get him to leave an epidural in so I can add lido as needed but its too risky to do. I can always dream though. I just feel so frustrated with everything, I turn 30 on saturday and right now I feel as though I am 60. I so do not like this pain. I get I will probably have pain forever but I cant deal with it at this level!! Sorry

 
Old 03-29-2012, 01:46 PM   #7
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Re: Fusion in Nov, in pain and depressed

I believe he used Marcaine, Lido, Depomedrol. I know he put in 120cc between the 3 shots. He was quite frustrated that my surgeon is not following me about all of this. Thank GOD for pain management! Right now my hip is numb but I had injections at 2p so numbing meds will be wearing off soon . My sciatic nerve feels numb and cool. Injections dont typically last me long but I LOVE having atleast a few hrs of relief. I've tried to get him to leave an epidural in so I can add lido as needed but its too risky to do. I can always dream though. I just feel so frustrated with everything, I turn 30 on saturday the 7th and right now I feel as though I am 60. I so do not like this pain. I get I will probably have pain forever but I cant deal with it at this level!! Sorry

 
Old 03-29-2012, 02:05 PM   #8
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Re: Fusion in Nov, in pain and depressed

[QUOTE=pookieheart16;4952723]I believe he used Marcaine, Lido, Depomedrol. I know he put in 120cc between the 3 shots. He was quite frustrated that my surgeon is not following me about all of this. Thank GOD for pain management! Right now my hip is numb but I had injections at 2p so numbing meds will be wearing off soon . My sciatic nerve feels numb and cool. Injections dont typically last me long but I LOVE having atleast a few hrs of relief. I've tried to get him to leave an epidural in so I can add lido as needed but its too risky to do. I can always dream though. I just feel so frustrated with everything, I turn 30 on saturday and right now I feel as though I am 60. I so do not like this pain. I get I will probably have pain forever but I cant deal with it at this level!! Sorry[/QUOTE]

I know the feeling. The SI joint pain can actually be worse than the pain in the back. I've had both. Sitting, standing, and walking are miserable. I realize that SI joint fusion is probably not going to get rid of all of my pain, but I can deal with it at a constant 2. Take it above 5 and that's just not happening. I've been living with this for over 6 years. It will sometimes mellow out for a week, but that never lasts long. All it takes is stepping wrong, moving wrong, or something else stupid and minor like that and the pain level goes way up again.

My back pain at the moment is on a leash after three level bilateral RF Ablation because of my facet joints. The numbing meds are great, even if you do end up with a numb tush! I just had a similar injection on Monday, and the first 8 hours were wonderful! Don't know if the steroids are going to do me any good, but at least the diagnostic part (numbing) is conclusive. Will have to have another.

There are fusion surgeries they can do on the SI joints. I am facing that myself, since nothing else has worked. I don't know if they will be able to or which they will do if we can, since I am not symmetrical. I have a transitional vertebra that is half lumbar and half sacral, but the sacral half didn't fuse. That bone sits right over my SI joint on the right. I actually have 6 lumbar vertebra and only 4 sacral. My SI joints do not look the same on the x-rays or CT scans. There may be some spinal fusion in my future at some point too, but not yet.

At least your pain management doc is on the right path for you, and he can maybe recommend someone to handle the problem for you other than your current doc. Not all docs take the SI joint seriously.

 
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Old 04-23-2012, 10:12 AM   #9
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Re: Fusion in Nov, in pain and depressed

Hello im sorry for your pain i to have fusion they say failed i wont have more surgery for back 2 is to many the doctores tell you all this good results but after they are done cutting then there done go to your PCP or Pain management i have had so many shots and spinlal cord stimulater and tense unit i live in pain so bad every day i wish i never let them do the surgery but they said i was goi ng to end up in wheel chair if i do nothing funny thing there are not saying anything like that and spine mri and xrays look the same as before except for the screws and other metal they left . I know how your feeling if the wont do xrays or mri go to another doctor 6 weeks you would have some relief unless there is a new problem pain is a symtem that there might be a problem. I prasy it gets better for you . It is so bad to be in pain people do not understand it consumes your whole life see another doctor because every day you are walking it could be getting worse . Sorry so long just saying i can relate and see 2 more doctors if you have .

 
Old 04-23-2012, 10:19 AM   #10
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Re: Fusion in Nov, in pain and depressed

Also im done with shots last one hurt so bad i could not walk for 15 min just layed there burned doc said it was because he put it under one of the screws none of the shots have helped except as i read others the numbing for a few hours is great i run to store and get all i can done before it wears off ....they should beable to give us that to use every day..

 
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