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Old 01-14-2013, 02:48 AM   #1
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Unhappy Advice needed on Dynesys problem with a screw in S1

Hi there I need some advice had dynesys done S1 to L3 a year ago. Every time I attended clinic I kept getting filtered out to a registrar even though your supposed to see the consultant first post op. anyway 8 months on still had not seen him. I had been experiencing problems in my lower back, back spasms, pains down my legs slight paralysis had occurred several times. I did loose control of my bowls once. I eventually got an appointment in November my consultant suggested having a caudal epidural injection done to get through Christmas but n the meantime had me sent for a bone scan. Had this done the bone scan done and epidural done. The epidural has already worn off lasted around a month. I had a follow up and it has come to light that he screw in S1 is moving around! I have been told to bare and grin it for another year I am so angry as I had been telling the registrars for months that there was something wrong and hey chose to ignore me! Is there any other options? I cannot deal with more injections as I suffer terribly with the hot flushes and makes me feel generally unwell need some advice on this please, I have taken steps to get a second opinion

 
Old 01-14-2013, 05:55 PM   #2
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Re: Advice needed on Dynesys problem with a screw in S1

Welcome to the board. I'm sorry you are having problems stemming from your surgery. It is my understanding that the only solution would be to stabilize that screw that is loose.

I imagine it is allowing that segment to move and even very slight movement can result in the type of pain you are experiencing. I would be very concerned due to its location, and the fact that you had some bowel involvement already, that you might develop "cauda equina syndrome" as a result of this instability and the fact that a nerve is still being compressed.

I don't know how this would be handled in the UK, but here they would take you in and do a revision surgery...and it would be done sooner rather than later.

Do you have any way to convince them to act sooner??

I would suggest you read up on "cauda equina syndrome" and learn all about the symptoms...and see if you can make your case with these people.

 
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Old 01-14-2013, 06:00 PM   #3
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Re: Advice needed on Dynesys problem with a screw in S1

Hi lolly, Welcome to the board! Im so sorry to hear about the difficulties that you are having both with seeing the dr & the post op complications. I cannot imagine having such a surgery & not seeing the actual operating surgeon immediately after! You poor thing! I hope that the symptoms have resolved for you now. I remember when i had laminectomies & had a spinal fluid leak postoperatively, that the dr tried everything to buy time in between surgeries & i heard something about one year being optimal. However, this never occured I had one repair @ 4 weeks, the next LL i leaked also & that repair was done @ 8 weeks. In my opinion i wwould be concerned about the possibility of cauda equina syndrome, a post op complication that is often an emergency characterized by loss of bodily functions, paralysis etc. But, you HAD these symptoms as in the past correct? I would get a second opinion as well as try my best to see my actual surgeon face to face to report my post op condition & hear his recommendations. I really hope this gets sorted out for you. How are the drs treating your pain besides the epidural steroids?

Last edited by gmak; 01-14-2013 at 06:09 PM. Reason: wording

 
Old 01-15-2013, 12:26 PM   #4
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Re: Advice needed on Dynesys problem with a screw in S1

Many thanks for your feedback. This cauda equina syndrome was orginally flagged up when I spoke to my physio she stated I had the symptoms of this. This was why I ended up making a complaint. My consultant has stated looking at an MRI that I had done as I raised the issue with the last registrar has said that my spinal canal is wider than what it was before surgery and does not believe that I have cauda equina syndrome at this stage even though I have had times sudden urgency to go to the toilet and had loose bowl movements but not got an upset stomach. I am so upset with the whole thing am awaiting an appointment for getting a second opinion at Oxford where I believe they have the best spinal surgeons in the country. I have previously read up about cauda equina syndrome i do believe I am suffering with this. I keep getting a pinching sensation down my legs too on top of everything else. Would say even though it has been ayear since surgery they could actually rectify this problem?

 
Old 01-15-2013, 12:30 PM   #5
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Re: Advice needed on Dynesys problem with a screw in S1

The consultant thinks its acceptable to keep bringing me in for epidurals, which long term is no good. The epidural has only lasted a month I have a wedding to plan as I'm supposed to be getting married but its falling on deaf ears

 
Old 01-15-2013, 01:40 PM   #6
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Re: Advice needed on Dynesys problem with a screw in S1

Both symptoms you mention would result from nerve compression...which could be coming from the central canal, stenosis in the foramen or the spinal nerve itself being irritated or pinched. It could be that the loose screw is going right through a nerve. I have a good friend that had this happen and as you can imagine, it causes a GREAT deal of pain.

 
Old 01-15-2013, 01:45 PM   #7
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Re: Advice needed on Dynesys problem with a screw in S1

ESIs are not going to resolve your issues. I'm surprised you get any relief at all because issues of instability cannot be resolved with a steroid! It may reduce inflammation enough that something temporarily isn't rubbing or touching a nerve, but with a screw loose, it is not holding things together.

Can you explain to those of us that live in the US what the difference is between a registrar and a consultant? What is each title's educational background to qualify for the position? I gather the consultant is like what we call a doctor or a physician....??

 
Old 01-15-2013, 02:13 PM   #8
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Re: Advice needed on Dynesys problem with a screw in S1

Difference between a registrar and a consultant is a consultant is already trained in that specialised field whereas a registrar is in training to specialised field basically a trainee consultant

 
Old 01-15-2013, 02:16 PM   #9
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Re: Advice needed on Dynesys problem with a screw in S1

I also know that the posture of my back is not sitting properly as to my horror I went to take some flat boots to be re heeled recently to find that the right foot was much more worn than the left. I am hoping that the new hospital are going to help me with this hut we shall see!

 
Old 02-01-2013, 05:47 AM   #10
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Re: Advice needed on Dynesys problem with a screw in S1

Hello, I have succeeded with the new hospital they completely are in agreement with me. The new consultant showed me my scans and clearly shows the screw is defo touching the nerve root. Even though the other hospital failed to mentioned this to me! New consultant has stated that this procedure has been banned in the U.S. does anyone know if this is true? Uk hospitals are now trailing this procedure so I really feel I have been used as a guinea pig in my eyes!

The new hospital will do a new CT scan to make sure that the screw is still touching the nerve root. They are recommending I have the whole thing removed sooner rather than later which I am pleased about. I have been left for nearly a year after surgery with this problem!

Last edited by Administrator; 02-01-2013 at 06:24 PM.

 
Old 02-01-2013, 06:10 AM   #11
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Re: Advice needed on Dynesys problem with a screw in S1

[QUOTE=Coollolly12;5117748]The consultant thinks its acceptable to keep bringing me in for epidurals, which long term is no good. The epidural has only lasted a month I have a wedding to plan as I'm supposed to be getting married but its falling on deaf ears [/QUOTE]

Hi lolly, If i am understanding right it has been a year since your surgery & i thought that the dr was giving the epidural steroids to get pain relief until ome year after surgery & then revision surgery would be done to remove the screw that is loose in hardware & that that is the pain generator. How long has it been since you saw the actual surgeon & an MRI was done? Im sorry that you are hurting & that you have to go through the tedious process of arranging & getting esi done for only one month of pain relief because in my opinion that is so much trouble & putting off a try at a more permanent solution.

 
Old 02-02-2013, 04:44 PM   #12
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Re: Advice needed on Dynesys problem with a screw in S1

It has been over a year already. I didn't actually get to see the consultant until 11 months after surgery. Had bone scan done which has flagged up the issue with the screw in S1. He wanted me to wait another year before having it removed. To be honest he did not mention that the screw was acti touching the nerve root at all. It was not until I went to another hospital that they showed me the scan. I will be having a new CT scan done to verify that this is still the case

 
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