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Old 01-15-2007, 11:54 PM   #1
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Pain after lumbar fusion

I had an ALIF L4-L5 fusion with cages, donor bone, and BMP, plus screws on September 12, 2006. I am still experiencing a lot of pain, so my neurosurgeon prescribed three epidural steroid injections. I think they have helped a little, but I still have much pain. My pain management dr. says that my current pain meds can cause pain. Has anyone ever heard that before? I take Avinza 60 mg, 2x/day and MSIR 30mg. 2X/day.

Please help. God bless you.

 
Old 01-16-2007, 02:59 PM   #2
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Re: Pain after lumbar fusion

Quote:
Originally Posted by orchidflower24 View Post
I had an ALIF L4-L5 fusion with cages, donor bone, and BMP, plus screws on September 12, 2006. I am still experiencing a lot of pain, so my neurosurgeon prescribed three epidural steroid injections. I think they have helped a little, but I still have much pain. My pain management dr. says that my current pain meds can cause pain. Has anyone ever heard that before? I take Avinza 60 mg, 2x/day and MSIR 30mg. 2X/day.

Please help. God bless you.
It is possible, but rare. Have you been on higher doses before the dose you are on now? If not, then it may just be that you need to be treated with a different opioid. Even if your current meds are "causing pain," it's not commonly used as a reason to stop opioid therapy. The usual treatment is to change to another opioid, it's called "opioid rotation" and is often used just for this reason.

Best of Luck to You.

 
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Old 01-16-2007, 03:27 PM   #3
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Re: Pain after lumbar fusion

Hi Orchid! (pretty name!)
You only had your fusion in September. This is a very serious operation that you had. I think it is premature of your doctors to be questioning your pain just yet. If I were you I would ask them if they have some sort of time table and if so, where should you be on it now? all cured and down to advil once a day? I'm kidding here, but seriously, everyone heals at their own rate in their own time. Always insist that doctors tell you what where when and why they think you should be at in your recovery. With good communication, you should feel reasurred that you are still healing and its too soon to worry about any kind of syndromes or anything like that.
Who is treating your pain, may I ask? sometimes if its the surgeon, their reaction is 'I have laid my God like hands upon you and healed you. Go forth and sin no more' lol If thats the case you can ask for a referral to PM or ask your primary to take over prescribing for you. I'm sure other people will have good advice for you here too. Take care, Fabby

 
Old 01-16-2007, 03:43 PM   #4
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Re: Pain after lumbar fusion

I can't remember exactly the year I had my spinal fusion but I had the screws, cage and hardware, my neurosurgeon didn't recommend donor bone, he said he liked to take bone and tissue from the patient's hip because it was more likely of a match and more prone to fuse than from a dead person's or another person. Needless to say he created a new source of pain that didn't use to exist. He advised me that I had lived with pain for years prior to the surgery that it was very likely that I would encounter what he called phantom or ghost pain but he said that it should or would go away within 6 months or so. Well it never did go away, I hurt worse after the surgery, had to take ungodly amounts of oral meds and after 3 years of that I developed a tolerance to them so my only option that was afforded or offered to me from my current pain management doctor was the implantable Codman 3000 morphine pump. I have since heard of some type of electric stimulator but my doctor didn't advise me of that at the time. My pump was implanted in Dec 2004, I do remember that date. I have never heard of opiates or medicine to make some one hurt, I know their are side effects with anything but more pain by taking oral meds I am not aware of. After my surgery and a year went by I went back to my surgeon because I was in so much pain, they did an Xray because he had told me sometimes the screws will work loose in the spine with age and time, but the xray didn't reveal anything and telling him I was in more pain a year after the surgery than before the surgery was like telling him he was a failure or the surgery was a failure so I was out of there only to go back to the pain management doctors to go get more pain pills. My doctor told me that oral meds should be limited with a pump, he said that when multiple drugs are administered either orally or intrathecally(spelling sorry) that the different medicines will compete for the receptors that are on your spine that block the pain signals to your brain. Before the pump I had 3 sets of 3 injections, my God what an experience especially the last time in the tail bone. The injections especially the last three hurt me more, I had a tail bone that hurt me every time I sat down for 6 months but that finally went away. Then Blue Cross called me up and wanted me to ask my doctor about botox injections so I mentioned it too my doctor and he said he would give me all of those that blue cross wanted to pay for but thought it was useless in my case so we never went forward. I hope my pain story will help you some with the issues that you are having. God Bless and I hope you get to feeling better soon, I am doing better now than in several years. Have you seen the surgeon that did your fusion? What did he have to say about the surgery, did the fusion fuse? Has he done any test to check the placement of the screws? I hope I have helped you in some small way. Jeff

 
Old 01-28-2007, 07:27 PM   #5
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Re: Pain after lumbar fusion

Quote:
Originally Posted by orchidflower24 View Post
I had an ALIF L4-L5 fusion with cages, donor bone, and BMP, plus screws on September 12, 2006. I am still experiencing a lot of pain, so my neurosurgeon prescribed three epidural steroid injections. I think they have helped a little, but I still have much pain. My pain management dr. says that my current pain meds can cause pain. Has anyone ever heard that before? I take Avinza 60 mg, 2x/day and MSIR 30mg. 2X/day.

Please help. God bless you.

 
Old 01-28-2007, 07:45 PM   #6
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Unhappy Re: Pain after lumbar fusion

hi , i am new to this forum . i had a level3 lumbar fusion in march 2006. the pain in my back and my legs did not get any better. my dr. just kept saying "time and painkillers"..well, in august, i went to another dr., who did mri's, ct's , and nerve conduction. he said that i wasn't fused, so i wore a bone stimulator, nerves still had active damage, which meant something was compressing them. he finally figured out that my sciatica was the nerve being compressed since it was both legs and back and also alot of stenosis left.( i originally went in for spinal stenosis, peripheral neuropathy and herniated discs.) . so , all in all, i had a revision surgery 2 weeks ago..when the dr. got in there, he was happy to see that my bones had fused, but a screw had come loose and was pushing on the sciatic nerve. he ended up taking all my hardware out..thanks god! so, its been a year and 2 weeks, i am still in alot of pain, esp. the backs of both legs and also where the incision is. i realize that surgery was only 2 weeks ago, but i guess i thought that i'd be better than i am! very frustrating. Has anyone else had a fuion that didn't work, and if it did, how long till i know, i guess how long for the swelling to go down , and actually the back of my legs hurt way worse than before the revision! would nerves regenerate that fast or is this something i need to alert my dr. to?

thanks for your help!
nan2687 (me after i get better)

 
Old 01-28-2007, 07:50 PM   #7
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Re: Pain after lumbar fusion

i have never had an epidural work for me and i have had 6..sorry..and i've had 2 fusions this year...i take percocet, vistaril, and zanaflex. from what i've read (and thats alot!!!), unfortunatley opiod drugs are the only thing that'll work, unless you can tolerate either neurontin or lyrica, both designed for nerve pain itself....which usually goes back to fusions..i cannot take either of those, they make me sick, but if you can..it'd be worth a shot!

nan2687

 
Old 01-29-2007, 07:14 PM   #8
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Re: Pain after lumbar fusion

Orchid, I had my fusion surgery the same exact day as you. I was doing well until December. Now I have excruciating pain. My tailbone is killing me. Both sides of the scar hurt. The physical therapist says it is swollen tissue. My hips hurt. Now I have pressure and pain in my legs. I went to the surgeon who sent me for an x-ray. Called him twice and still did not get the results. I also have 3 neck herniations and a tear in the elbow tendon. I can't believe how bad the pain is. All the surgeon and ortho do is change my meds. Percocet is the only thing that takes the edge off. I am wearing my tens machine again which doesn't seem to be doing much. I sit on a heating pad every waking moment. That helps only when on it. As soon as I move it hurts. My primary thinks I am depressed because of the pain. So she gave me Effexor (sp?). I'm on 1800 mg of Neurontin and 2400 mg of Skelaxin. Still in pain. All the doctors keep reminding me I had major spinal surgery and it will hurt. No one can say how long. I looked at the x-ray and see no sign of fusion. Not that I know what I am looking at. Right now I am out of work until April although I don't see that lookin good.

 
Old 02-21-2007, 03:49 PM   #9
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Staystrong HB User
Re: Pain after lumbar fusion

Quote:
Originally Posted by nan2687 View Post
hi , i am new to this forum . i had a level3 lumbar fusion in march 2006. the pain in my back and my legs did not get any better. my dr. just kept saying "time and painkillers"..well, in august, i went to another dr., who did mri's, ct's , and nerve conduction. he said that i wasn't fused, so i wore a bone stimulator, nerves still had active damage, which meant something was compressing them. he finally figured out that my sciatica was the nerve being compressed since it was both legs and back and also alot of stenosis left.( i originally went in for spinal stenosis, peripheral neuropathy and herniated discs.) . so , all in all, i had a revision surgery 2 weeks ago..when the dr. got in there, he was happy to see that my bones had fused, but a screw had come loose and was pushing on the sciatic nerve. he ended up taking all my hardware out..thanks god! so, its been a year and 2 weeks, i am still in alot of pain, esp. the backs of both legs and also where the incision is. i realize that surgery was only 2 weeks ago, but i guess i thought that i'd be better than i am! very frustrating. Has anyone else had a fuion that didn't work, and if it did, how long till i know, i guess how long for the swelling to go down , and actually the back of my legs hurt way worse than before the revision! would nerves regenerate that fast or is this something i need to alert my dr. to?

thanks for your help!
nan2687 (me after i get better)
Hi,

I would like to suggest to you that the sciatic pain you are experiencing is not coming from a disc impinging on a nerve at the spinal column but a muscle called the piriformis impinging on the sciatic nerve in the gluteal(buttock) region. This muscle becomes inflamed when other muscles in the regoin are weak. The muscle becomes swollen and presses on the sciatic nerve. This causes the pain from the buttocks down the leg. I would suggest trying to stretch the piriformis muscles on both sides by laying on your back and bringing one knee toward the opposite shoulder and holding it for 20 secs. Do it two or three times with one leg and then the other. While performing the stretch, you should feel a pull in the gluteal region where your pain stems from. If this relieves your pain even alittle, I would suggest going to a massage therapist and having them massage the piriformis muscles as well as your lower back muscles. If this relieves your pain, you know you are on the right track and then you would have to strengthen the muscles of the hips, buttocks and hamstrings to prevent the piriformis muscles from getting inflamed again. I have know several people with sciatica to use this system and they have fully resolved the sciatic symptoms.

Good luck.

 
Old 02-21-2007, 03:58 PM   #10
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Re: Pain after lumbar fusion

thanks very much for the reply, sorry i didn't get back sooner, but i forgot the site's name!!! it just so happens that i have my 6 week ckeck-up tomorrow and feel exactly as i did before surgery (surgery #2)...i truly think it is a nerve pressing on my sciatic nerve, but i never thought about the muscle. hhmm..interesting...the dr. ordered a ct and mri a few weeks ago , which says everthing looks good, but i know better...would something like that not show up on either of those tests?

thanks
nancy

 
Old 02-22-2007, 01:22 PM   #11
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Re: Pain after lumbar fusion

HI
I have wrote a few replies on this site and none of them have been to the thread that causes me the most trouble and it is only today that i realised i should look.

In 1999 i had a L5 S1 fusion with bone graft and a i was fitted in a body plaster cast.
All really fun stuff and i remember being in pain for a good while. I have spina bifida akulta compeded by spondylolisthesis and i had to have the fusion to inhibit any more slipage of the vertabrae to stop paralysis.

I have put on tons of weight and am really un fit opposed to just before my surgery.
I was on serious medication to help with pain back then but unfortunelty not ad strong as the stuff im taking now.
If i remember i was in serious pain for a couple of months and then slowly the pain subsided and things got a bit easier and i found that after about 3 months i was fine with not too much pain.

However the problems i have had since then with my spine and th metal work in there has caused serious damage and pain to a degree i had to have further surgery.
I dont want to scare you but i hope you have done the correct thing im not sure if i did but then im not sure if i had a choice.
If you want to know about the problems i am now having i will write a seperate thread and possibly ask for help my self!

Keep on top of your pain killers and anti inflammatary meds and do little but quite often a little walk up the stairs once or twice a day more than normal and things should ease up and become less stiff. I remember now that i was very stiff but it took some time to get things moving again and to loosen things up.

I havnt got much help as i didnt recieve the best after surgery care my self. But the little things do help. good luck and i hope you can get a long a bit easier soon.
LJH

 
Old 02-22-2007, 01:25 PM   #12
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Re: Pain after lumbar fusion

Quote:
Originally Posted by nan2687 View Post
thanks very much for the reply, sorry i didn't get back sooner, but i forgot the site's name!!! it just so happens that i have my 6 week ckeck-up tomorrow and feel exactly as i did before surgery (surgery #2)...i truly think it is a nerve pressing on my sciatic nerve, but i never thought about the muscle. hhmm..interesting...the dr. ordered a ct and mri a few weeks ago , which says everthing looks good, but i know better...would something like that not show up on either of those tests?

thanks
nancy
nancy,

the problem with the way most people are being treated for sciatica is an MRI is taken indicating abnormalities of the spine. The sciatic symptom is then automatically attributed to the spinal abnormality like stenosis or a herniated disc. I can assure that if you had pain anywhere in the leg regardless of where the pain is, the physician would still attribute the pain to whatever spinal abnormality is found on the MRI. Here is something you should know, more and more studies are showing that the majority of people have buldging or herniated discs and have no symptoms. People were randomly chosen to get MRIs and were found to have disc abnormilities, stenosis and arthritis of the spine even though they displayed no symptoms whatsoever. The piriformis muscle sits right next to the sciatic nerve as it begins in the buttocks. If this muscle swells and becomes inflamed, it is sure to impinge on the sciatic nerve. The inflamed piriformis will never show up on any diagnostic test. Please look up on the web, piriformis tendinitis or causes of sciatic symptoms and you should find this information. Nobody wants to believe that a muscle being inflamed can cause a neurologic symptom but it is true and is easily resolvable. By the way, most doctors are not to keen on the idea that the piriformis is the cause of sciatica. If they did, where would all the surgeries performed on the spine go.

 
Old 02-22-2007, 03:06 PM   #13
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Re: Pain after lumbar fusion

thanks, i'm gonna go search right now...it sounds too familiar! went to the dr. today, they are gonna start me on aquaticpt, as they gradually increase me to regular pt. i totally agree about the discs being used as a scapegoat! but these piniformis is gotten me very curious.

thanks a bunch!
nan

 
Old 02-22-2007, 03:45 PM   #14
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Re: Pain after lumbar fusion

Quote:
Originally Posted by nan2687 View Post
thanks, i'm gonna go search right now...it sounds too familiar! went to the dr. today, they are gonna start me on aquaticpt, as they gradually increase me to regular pt. i totally agree about the discs being used as a scapegoat! but these piniformis is gotten me very curious.

thanks a bunch!
nan
Nancy,

Let me know what you think after you research piriformis syndrome.

I think you will see this is for real and is the cause of almost all if not all cases of sciatica. As for physical therapy, make sure they work on strengthening your glutes(butt) muscles, hamstrings(back of the thigh) and hip abductors(sides of the hips). These are the muscles that work with the piriformis and once strong with stop the piriformis from becoming inflamed and swollen impinging on the sciatic nerve.

Good luck.

 
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