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Old 12-23-2012, 12:10 PM   #1
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New Post Lumbar Fusion Problems

In mid November 2012 my orthopedic surgeon released me to do normal activities indicating my PT would let me know how much exercise I could do. I was able to decrease my Lyrica because of post surgery leg pain/ numbness from 300mg to 225mg but still have brain fog and instability when walking or descending stairs.
After multiple bike rides, walks and about 3 PT sessions I developed pain from the groin to above my R knee which now includes the R knee (maybe from the way the leg was weighted). I had eliminated Percocet of up to 80mg per day and only used Lyrica. I am now back on Percocet of about 20-30mg due to the continuous leg pain. I do note a tightness in my back (right side) when reaching behind me. The leg pain started mid quadracep and radiates up and down.
My Doc had given me a back MRI and established there was no bone on nerve (this was prior to the new extreme pain). I was able to get in to see my ortho who ordered a Myelogram that was done 12/21. The report would be given to my Doc by that evening. The Doc is unfortunately out of town until a week into the new year. The Radiologist told me the test may not be definitive.
My Doc had given me Prednisone from 50mg down to 10mg in 5 days. After 3 days the pain was gone and I quit Percocet. It is now back so back comes the Percocet. At least this gives me hope that an Epidural/nerve block might help. My primary care Doc had an MRI done on my R leg from groin to above the knee. The PC Doc sent me to an extremity ortho who found nothing and told me to see my back ortho. Xmas is a nice time of year and the Docs deserve vacations but waiting 2 weeks to get my Myelogram read is frustrating. Who knows. My ortho may have to go back in which greatly concerns me. He did tell me he believes a nerve in my back is very inflamed. So, I wait!

Last edited by fastcarbon; 12-23-2012 at 12:12 PM.

 
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Old 12-23-2012, 06:14 PM   #2
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Re: New Post Lumbar Fusion Problems

When was your fusion? At what level were you fused and where was the entry point (posterior, anterior, etc.)

Is the knee and leg pain on the front or back side of your thigh?

 
Old 12-24-2012, 09:27 AM   #3
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Re: New Post Lumbar Fusion Problems

[QUOTE=teteri66;5108201]When was your fusion? At what level were you fused and where was the entry point (posterior, anterior, etc.)

Is the knee and leg pain on the front or back side of your thigh?[/QUOTE]
teteri66: Fusion S1 -L4 end of July; 360 degree; fusion confirmed10-2012

 
Old 12-24-2012, 09:37 AM   #4
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Re: New Post Lumbar Fusion Problems

[QUOTE=teteri66;5108201]When was your fusion? At what level were you fused and where was the entry point (posterior, anterior, etc.)

Is the knee and leg pain on the front or back side of your thigh?[/QUOTE]
Also; the new current pain is in the front about mid thigh and radiates to include the front of the knee. I do have nerve pain which is not localized but amounts to sensitivity behind the leg and calf (controlled with Lyrica). I was surprised when after a 3rd day of taking prednisone the front thigh pain completely went away until I got to a last day of 10mg. I do have high hopes for a targeted epidural but it will be mid Jan. 2013 before my Doc reads the Myelogram report. My Doc ordered the Myelogram so as to be able to inject steroid in the right place. Apparently the 4 screws and 2 rods can get in the way.

 
Old 12-24-2012, 01:42 PM   #5
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Re: New Post Lumbar Fusion Problems

Did you have BMP?

You could request a copy of the radiology report from the place where you had the myelogram if you are curious before the doctor returns.

It sounds like you did too much activity after having not been active for a period of time...and I imagine the bike riding was particularly irritating to the front of the thigh. The L3 and L4 spinal nerves innervate that front area running from groin down to the knee, with L4 running over the top of the knee cap, down the front of the calf and into the big toe.

It may be that the L4 nerve is still irritated from surgery and the additional increase in activity caused it to flare up.

With a multi-level fusion there is some reorganization that needs to happen with the fascia and soft tissue as it all gets used to the new positioning. Some of that may be causing pain as well.

 
Old 12-24-2012, 02:23 PM   #6
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Re: New Post Lumbar Fusion Problems

What is BMP? I still don't know all the acronyms. I will call the people that did the Myelogram to get it. I have never read one but have read lots of MRI's, CT scans and x-rays (I mean the reports). I hope it is as clear as the MRI's. I was a little concerned about L3 as when I started having problems post-surgery. I was reminded that L3 had stenosis and DDD also from prior MRI's; I did let the Doc do what he recommended and he did not tell me he should do L3 to L4.

 
Old 12-24-2012, 06:35 PM   #7
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Re: New Post Lumbar Fusion Problems

BMP is Bone Morphogenetic Proteins...are proteins that grow naturally in the body and promote bone cell growth. They can now be replicated in the lab and are used in fusions as the graft. BMP can create a fusion without the need for any use of the patientís own bone. It is a fairly new "product" and has only been approved for fusions in specific cases. When not used according to directions, there have been problems of bone overgrowth, in addition to some other issues. There are now some class action law suits and as a result, some surgeons are not using it at the moment.

I had it for my lumbar fusion in 2008, luckily without problems. It almost guarantees that a patient fuses.

 
Old 12-25-2012, 06:34 PM   #8
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Re: New Post Lumbar Fusion Problems

I definitely did get BMP. According to x-rays it was fused in 3 mo.

 
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lumbar fusion, lyrica, myelogram, percocet, prednisone



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