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Old 06-30-2012, 06:49 PM   #1
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Spinal cord fusion of L4-5 and L5-S1

I would like any info. on spinal fusion i will be having one real soon. Can anyone tell me how long does the surgery take and how long does it take to heal? I had cancer in 2003the and in 2007the i was diagnosed with lupus and rheumatoid arthritis im taking sometimes 23-25 pills a day not including pain pills. Im just ready to stop hurting i know the surgery wont cure the arthritis but hopefully it can stop the pain in my back. About how long does it take for recovery and did anyone have to wear a brace? I would love any information that anyone can give me. Thank u.

 
Old 06-30-2012, 10:09 PM   #2
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Re: Spinal cord fusion of L4-5 and L5-S1

Welcome to the board. There are many older posts on this part of the forum pertaining to lumbar fusions. Also, there is a "stickie note" near the top of the first page of the back board called something like "Post Surgical Must-Haves." It contains much more stuff than any one person would need or want, but it does get you thinking about what life will be like post surgery, and how difficult it is to go for months without bending or twisting at the waist, etc.

I cannot tell you how long the surgery will be. Every surgeon is different. Mine happens to operate very quickly, but he was a trauma surgeon before he decided to take a fellowship in spine surgery. I have had two lumbar fusions. My first surgery was about two hours and my second fusion was just under three hours. I have a friend who had a two level fusion and she was under 7 hours...and there were no complications, supposedly. I can't imagine why it took so long.

If things go without incident and you do not develop complications post surgery, I think the average time of being really laid up is anywhere from eight to twelve weeks. People are usually off work from 2-3 months. I know someone who went back in one month and also have several friends who were out nine months, and two have not been able to return to their jobs at all.

It takes a good year for the new bone growth to become strong and hard, although you may see signs of new bone as early as three weeks post surgery. You will quickly recovery from the surgical incision, but that is the easy part. Recovery is a long, slow process requiring a great deal of patience...and frequently involves taking a couple steps forward followed by one step back. Most people continue to have some pain afterward. If it is caused by a nerve that had been compressed, it can take a long time to calm down or rejuvenate. The surgery itself is often irritating to the nerve and you may even feel more pain for awhile. Recovery can be quite a roller-coaster ride.

The use of a brace is a personal choice of your surgeon. With the advent of "hardware," the brace is not really necessary anymore. Some surgeons continue to use them because it affords the best way to prevent the patient from bending or twisting to the point that it hurts the surgeon's handiwork.

I did not wear a brace with my first fusion. That surgeon used them early in his practice, but no longer sees a point to them. My second fusion was with a different surgeon who almost always uses a brace for all fusions...and he did admit to me that it was just a precautionary thing used to limit the patient's ability to move in the wrong ways. Odd as it may sound, I actually preferred wearing the brace, and I wore it whenever I was out of bed for 11 weeks.

I don't know when you are having surgery, but you might want to take this time prior to surgery to get your home organized -- particularly the kitchen and bathroom. Move things you use frequently to counter height or waist level. Some people make food ahead and freeze it if you don't have someone to cook for you. You will probably want to have someone with you for the first week or two after you get home from hospital. You might be able to get along without any help, but it is very handy to have someone available to help you.

I would have been OK on my own. I could take myself to the bathroom, could dress myself, etc. but some people have difficult with these tasks right after surgery.

Be sure to get some stool softeners, laxatives and stock up on fruit juices, prune juice is good if you can tolerate it...The pain medications and anesthesia are very constipating so you want to try to keep ahead of this issue and don't let it become a big problem.

They will have you up walking the first day. You will most likely have a catheter for the first day or so and will have an IV pain pump that you can control yourself. But as soon as they can, they will switch you to oral medications. They will teach you how to move so you won't hurt your surgical area, how to dress, put on socks, etc. and will have you walking and climbing stairs, and generally taking care of yourself before you leave the hospital.

This is a big surgery and you will find that you are tired for quite awhile afterward. People always seem surprised that it takes so long to get their strength and energy back.

Feel free to ask questions that are of particular interest to you. I try to be realistic in telling people how long the whole recovery process actually is, as I think too many patients have been told they'll be feeling great in six weeks, and then they think something is wrong when this does not happen.
But I don't want to scare you. The process is manageable and most people do just fine. The first week is tough, but the staff will keep you comfortable.

Just remember that what you read on forums online is just a small minority of patients who end up with complications. You do not get a representative cross-sample of the whole population of patients who have lumbar fusion. Those who are no longer in pain are out enjoying life, not posting on a board.

My first fusion was technically "successful" but it did not resolve my issues. After nine months of recovery, PT, etc. I didn't notice any difference from the way I was prior to surgery. I then had two tough years trying to convince people that there was still something wrong that could be fixed. Finally I was operated on again, and the doctor was able to see what was wrong with me...and it was a problem that had not been apparent from any testing or imaging I'd had. I am now 2 years out of that second fusion and I am pleased with the results. I would repeat the experience in a heartbeat.

Hope I've answered a few of your concerns. Let us know when you are scheduled for surgery.

 
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Old 07-02-2012, 03:39 PM   #3
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Re: Spinal cord fusion of L4-5 and L5-S1

I am 9 weeks out of my lumbar fusion. My surgery was minimally invasive, but it took 5 hours, mostly because I am very thick from years of powerlifting and the surgeon underestimated my size and had to get larger instruments during surgery.

So far, I have been pleased. I was back to work part time at 3.5 weeks, full time at 5 weeks. I went into the surgery in very good shape though, and I think how strong you are going in dictates how well you heal coming out. I think 6-8 weeks is a realistic goal for most people.

It is scary and painful, but honestly, my ACL and MCL knee surgery was more painful. The worst part has been the mental game. YOu will be very restricted (no bending lifting or twisting) for at least 12 weeks.

Just talking at work, there are LOTS of folks who have this surgery. I think that there are so many negative stories because most people have no idea what this is about, have their surgery, recover and move on. It is the chronic folks that are out there looking for ideas. God bless them.

For me, the pain relief has been incredible, and I am so thankful I had this done. I did not wear a brace and never felt "unstable".

 
Old 07-02-2012, 05:39 PM   #4
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Re: Spinal cord fusion of L4-5 and L5-S1

Unless you have to drag yourself to move around, DON'T.!!!! I don't feel operations will do much for pain.

 
Old 07-02-2012, 06:25 PM   #5
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Re: Spinal cord fusion of L4-5 and L5-S1

Hi Sissy ~

Just so you know before talking further with your doctor, you are thinking about having a lumbar spinal fusion. The spinal cord ends around the Lumbar 1 segment of the spine. Beyond that termination point, the spinal nerves bundle together in what is called the "cauda equina." It is called this because hundreds of years ago, when doctors began the practice of dissecting a cadaver, they thought this mass of nerves that were all twisted together looked like the tail of a horse. The nerves which exit the spinal cord in the upper section, the neck, control breathing and the arms. The nerves which exit the spinal "cord" in the mid and lower section of the back, control the trunk and legs, as well as bladder, bowel and sexual function.

The spinal cord and the cauda equina nerves are protected by the bony vertebral column. The cushiony discs separate the vertebrae and it is this part of the spinal anatomy that are affected by the fusion. The disc is often removed, and replaced with a bone graft material with the idea that the two vertebrae and the disc space will all grow together into one solid block. If more than one level is done, then these levels will become one solid block. You can find videotapes of the procedure online if you are curious...but I would just recommend the short animated ones that explain the surgery rather than seeing the actual live surgery!!

 
Old 07-02-2012, 06:40 PM   #6
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Re: Spinal cord fusion of L4-5 and L5-S1

I think the main difference between spinal fusion and most other surgeries is the length of the recovery....The initial pain may be the equivalent to other surgeries, but for most people, it takes months to recover. The person may be over the healing from the surgerical process in a matter of weeks, but if the person has had any nerve compression or instability, it generally takes months before he/she even has any idea if the surgery has "worked."

Often people start to feel reasonably good for awhile, only to get struck down with nerve pain when they start to try to resume "normal" activities. If they have remaining nerve pain from the beginning of the post-surgical process, recovery can be a frustrating and disappointing experience. Nerves are notorously slow to heal and it is not uncommon to have to wait a year to find out if you're going to be in a better place than you were prior to surgery.

It is partially due to this unpredictable nature of the outcome that spine surgery is considered a last resort. You want to have exhausted all conservative treatment methods before even thinking about surgery. It is also extremely important to pick you surgeon with great care. They are not all equal and you will want to find the most experienced and well-trained one that is available to you. No decision will be as important as the choice of the spine surgeon.

Taking all this into consideration, there comes a point where it seems there are no other options....then we are all faced with that big decision.

 
Old 07-03-2012, 09:02 AM   #7
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Re: Spinal cord fusion of L4-5 and L5-S1

What type of fusion are you having? I had ALIF on May 12, 2012. With my surgery they went through the abdomen to get to the spine, then made an incision in the back to insert the screws. L4/L5, and L5/S1 were involved. From my own experience, I can tell you, there is a lot of pain involved. I have also had issues with bowels and appetite. I am scheduled to be off work for 3 months. It is also important that you have someone at home to help you when you leave the hospital, to help you.

 
Old 07-05-2012, 03:57 PM   #8
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Re: Spinal cord fusion of L4-5 and L5-S1

I found everyone's responses very interesting... I had a spinal fusion in my neck back in Sept. 2010, and yes, I had my restrictions, and physical therapy, but no pain... I had fallen down two, yes 2 steps and the buldged disk in my neck started to paralyze me slowly...With that surgery they told me it can take up to two years for everything to come back, but I'm doing fairly well from that surgery, and still am walking with a walker.............

Now, just on May 22 of this year, I had a pinched nerve fixed, and also a Lumbar Spinal Fusion... Now this surgery did cause a bit of pain for me, but nothing I couldn't handle, I'm not saying I never took a pain pill, but compared to my neck, yes, I had pain...............

I'm only 6 weeks post-op and going out of my mind with the fact I can't do this or that, even the simple things you are not to do, like bending to put on your socks and shoes.............They stress over, and over to you NO BLT'S which is NO BENDING, NO LIFTING, NO TWISTING, NO STRETCHING...I can now lift up to 8 - 10 lbs which is approx how much a gallon of milk weighs. .
This might sound a bit gross, but you have to be very careful even when you have to wipe your butt...

I have about 3 grabbers in my home, in case I drop something, and have to pick it up.............I must say I have NO pain where I did before the surgery, unless I over do something.......They tell you once you come home, don't just sit or lie down, get up and walk every so often, and everyday try to walk a bit more..........

I am doing 'some' laundry, but if I have to bend too far to get it out of the washer, I use one of my grabbers, same goes for the dryer............I have also started to do some light dusting on top, and then I take a long handle swifter to do sides, etc, so I do not have to bend....

And yes, definetly have stool softners on hand, I left the hospital with RX's for Muscle Relaxers, Pain Pills, Iron Pills (which I only had to take for 4 weeks), and was told to get stool softners or Miralax........

So that's my story for now !!

 
Old 07-05-2012, 04:09 PM   #9
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Re: Spinal cord fusion of L4-5 and L5-S1

Welcome on board !
I can understand your worries, it not an easy decision for sure.

Nobody can tell you how many hours your surgery may take; only your DR may know and not always.
I was suppose to have 6hr surgery only but ended up to have 10 hr surgery. Before the surgery I had all possible testing, Myelogram and discogram included. I thought they now know exactly what is happening in that area, but when surgeon went in, he saw the damages were more severe than he thought, at SIJ area especially. He said that no accurate testing may be done in that particular area.

Recovering - same thing. While it not a walk in a park for sure, it takes different time for everyone. But both of my surgeons told me that I may NOT expect to recover before 1 year or even more goes by.
I am, like you, have RA, Lupus and also MS on top of "RA lung and RA heart ".
So it took me full year and more. I dont know anyone who would recover from a big spinal surgery in a month or two. Takes very long time so you will have to have a lot of patience.
'
Please read on Chronic Pain board or even here how to prepare yourself and your house for time when you come home.
Believe me, it a must. I learned it before my surgery from people here and never regretted. It helped me with my every day life since little things we do now, turn out to be big things after surgery.

Wishing you all the best!
Will send good wishes your way !

Moldova

 
Old 07-06-2012, 08:41 AM   #10
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Re: Spinal cord fusion of L4-5 and L5-S1

[QUOTE=Milo83;5013284]I found everyone's responses very interesting... I had a spinal fusion in my neck back in Sept. 2010, and yes, I had my restrictions, and physical therapy, but no pain... I had fallen down two, yes 2 steps and the buldged disk in my neck started to paralyze me slowly...With that surgery they told me it can take up to two years for everything to come back, but I'm doing fairly well from that surgery, and still am walking with a walker.............

Now, just on May 22 of this year, I had a pinched nerve fixed, and also a Lumbar Spinal Fusion... Now this surgery did cause a bit of pain for me, but nothing I couldn't handle, I'm not saying I never took a pain pill, but compared to my neck, yes, I had pain...............

I'm only 6 weeks post-op and going out of my mind with the fact I can't do this or that, even the simple things you are not to do, like bending to put on your socks and shoes.............They stress over, and over to you NO BLT'S which is NO BENDING, NO LIFTING, NO TWISTING, NO STRETCHING...I can now lift up to 8 - 10 lbs which is approx how much a gallon of milk weighs. .
This might sound a bit gross, but you have to be very careful even when you have to wipe your butt...

I have about 3 grabbers in my home, in case I drop something, and have to pick it up.............I must say I have NO pain where I did before the surgery, unless I over do something.......They tell you once you come home, don't just sit or lie down, get up and walk every so often, and everyday try to walk a bit more..........

I am doing 'some' laundry, but if I have to bend too far to get it out of the washer, I use one of my grabbers, same goes for the dryer............I have also started to do some light dusting on top, and then I take a long handle swifter to do sides, etc, so I do not have to bend....

And yes, definetly have stool softners on hand, I left the hospital with RX's for Muscle Relaxers, Pain Pills, Iron Pills (which I only had to take for 4 weeks), and was told to get stool softners or Miralax........

So that's my story for now !![/QUOTE]

 
Old 07-06-2012, 08:56 AM   #11
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Re: Spinal cord fusion of L4-5 and L5-S1

Your surgery was just one day after mine. Did you have the ALIF Spine Surgery? And are you having to wear the Turtle Shell Brace (TSLO)? The past couple of days I cut the dose of my pain meds in half, and have felt much better, along with changing from stool softeners to Miralax. My Dr is the type that is all about....preventing the pain. A couple of days ago, I decided to just hold off on the meds until I REALLY needed them. I am feeling so much better now. I just can't set straight up for long periods. I am suppose to be off work another 5-6 weeks, but am not sure how that is going to work out, since I sit in front of a computer 8 hours a day, doing a very stressful job.

 
Old 07-06-2012, 10:36 AM   #12
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Re: Spinal cord fusion of L4-5 and L5-S1

I will tell everyone that I normally suffer from anxiety/depression/panic disorder, and the surgery has affected me more, not that this will happen to anyone on here......I also have a lot of health issues besides...I must say I trust my spine doctor with my life and couldn't live with the pain I was having..........I tried everything prior to surgery, even the spinal epidurals and they did nothing for me..He was upfront with me, and told me he was hoping to eleviate 30-80% of my pain, but so far, no pain where I had before surgery........

I believe the reason it has affected my anxiety, etc, is the fact, I am still so limited in what I can do.....My husband had taken 3 weeks of vacation, plus my son just graduated from Veterinairy School, and is living with us for now, so he is also a help before and after work if I need something moved, etc.My husband works very long hours and we are lucky to see each other 2-3hrs in a 24hr period : - (

Have a nice day all & since this heat is hitting so much of the country, try and stay
cool !!

 
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Old 07-06-2012, 11:57 AM   #13
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Re: Spinal cord fusion of L4-5 and L5-S1

Sometimes people get caught by surprise due to all the hormonal changes that are caused by general anesthesa. I don't know how it affects men but, for women it can take awhile for things to return to normal.

 
Old 07-10-2012, 04:28 PM   #14
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Smile Re: Spinal cord fusion of L4-5 and L5-S1

[QUOTE=teteri66;5010062]Welcome to the board. There are many older posts on this part of the forum pertaining to lumbar fusions. Also, there is a "stickie note" near the top of the first page of the back board called something like "Post Surgical Must-Haves." It contains much more stuff than any one person would need or want, but it does get you thinking about what life will be like post surgery, and how difficult it is to go for months without bending or twisting at the waist, etc.

I cannot tell you how long the surgery will be. Every surgeon is different. Mine happens to operate very quickly, but he was a trauma surgeon before he decided to take a fellowship in spine surgery. I have had two lumbar fusions. My first surgery was about two hours and my second fusion was just under three hours. I have a friend who had a two level fusion and she was under 7 hours...and there were no complications, supposedly. I can't imagine why it took so long.

If things go without incident and you do not develop complications post surgery, I think the average time of being really laid up is anywhere from eight to twelve weeks. People are usually off work from 2-3 months. I know someone who went back in one month and also have several friends who were out nine months, and two have not been able to return to their jobs at all.

It takes a good year for the new bone growth to become strong and hard, although you may see signs of new bone as early as three weeks post surgery. You will quickly recovery from the surgical incision, but that is the easy part. Recovery is a long, slow process requiring a great deal of patience...and frequently involves taking a couple steps forward followed by one step back. Most people continue to have some pain afterward. If it is caused by a nerve that had been compressed, it can take a long time to calm down or rejuvenate. The surgery itself is often irritating to the nerve and you may even feel more pain for awhile. Recovery can be quite a roller-coaster ride.

The use of a brace is a personal choice of your surgeon. With the advent of "hardware," the brace is not really necessary anymore. Some surgeons continue to use them because it affords the best way to prevent the patient from bending or twisting to the point that it hurts the surgeon's handiwork.

I did not wear a brace with my first fusion. That surgeon used them early in his practice, but no longer sees a point to them. My second fusion was with a different surgeon who almost always uses a brace for all fusions...and he did admit to me that it was just a precautionary thing used to limit the patient's ability to move in the wrong ways. Odd as it may sound, I actually preferred wearing the brace, and I wore it whenever I was out of bed for 11 weeks.

I don't know when you are having surgery, but you might want to take this time prior to surgery to get your home organized -- particularly the kitchen and bathroom. Move things you use frequently to counter height or waist level. Some people make food ahead and freeze it if you don't have someone to cook for you. You will probably want to have someone with you for the first week or two after you get home from hospital. You might be able to get along without any help, but it is very handy to have someone available to help you.

I would have been OK on my own. I could take myself to the bathroom, could dress myself, etc. but some people have difficult with these tasks right after surgery.

Be sure to get some stool softeners, laxatives and stock up on fruit juices, prune juice is good if you can tolerate it...The pain medications and anesthesia are very constipating so you want to try to keep ahead of this issue and don't let it become a big problem.

They will have you up walking the first day. You will most likely have a catheter for the first day or so and will have an IV pain pump that you can control yourself. But as soon as they can, they will switch you to oral medications. They will teach you how to move so you won't hurt your surgical area, how to dress, put on socks, etc. and will have you walking and climbing stairs, and generally taking care of yourself before you leave the hospital.

This is a big surgery and you will find that you are tired for quite awhile afterward. People always seem surprised that it takes so long to get their strength and energy back.

Feel free to ask questions that are of particular interest to you. I try to be realistic in telling people how long the whole recovery process actually is, as I think too many patients have been told they'll be feeling great in six weeks, and then they think something is wrong when this does not happen.
But I don't want to scare you. The process is manageable and most people do just fine. The first week is tough, but the staff will keep you comfortable.

Just remember that what you read on forums online is just a small minority of patients who end up with complications. You do not get a representative cross-sample of the whole population of patients who have lumbar fusion. Those who are no longer in pain are out enjoying life, not posting on a board.

My first fusion was technically "successful" but it did not resolve my issues. After nine months of recovery, PT, etc. I didn't notice any difference from the way I was prior to surgery. I then had two tough years trying to convince people that there was still something wrong that could be fixed. Finally I was operated on again, and the doctor was able to see what was wrong with me...and it was a problem that had not been apparent from any testing or imaging I'd had. I am now 2 years out of that second fusion and I am pleased with the results. I would repeat the experience in a heartbeat.

Hope I've answered a few of your concerns. Let us know when you are scheduled for surgery.[/QUOTE]

 
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Old 07-10-2012, 04:35 PM   #15
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Smile Re: Spinal cord fusion of L4-5 and L5-S1

Thank you so much for the info. I will have someone here for me and i will have the fruit juice added to my grocery list. Thanks for the input.

 
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