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Old 10-23-2005, 02:11 PM   #1
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physical therapy after laminectomy

I'm 7 weeks post op. Mentally feeling real good, working full time (no choice I own a small consulting firm with 7 employees), driving, light housework. At 6 week post op I started feeling a lot better with upper body strength, although I can still feel pressure in the stich area if I lift more than a gallon of milk. My walking, the original problem that sent me to a neurologist, is ok, better than pre-op but far from great (foot drops), numbness and tremors in my right arm are better than pre-op but definitly still there.

The doctor says I'm doing great -- he says nerves take a long time to regenerate -- its a little frustrating when I read of so many of you that had almost instant abatement of your symptoms. He says give it a year (and he has said this all along, even pre-op).

At about 4 weeks post op I did some exercises that I think I probably shouldn't have -- got horrible shooting pains in my upper right arm. Thankfully that has pretty much gone away.

I started with PT for the gait problem. While the PT office said they had worked with cervical laminectomy patients - they were clueless!! I'm trying a new PT tomorrow at a different practice - they claim to be knowledgeable too. The PT is certified in the MacKenzie method - but from what I'm reading that seems to be more for lower back. Does anyone have ideas on how to find a PT (outside of a major city) who knows neurological function cause and effect?

-Gloria

 
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Old 10-25-2005, 04:37 AM   #2
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Re: physical therapy after laminectomy

I am trying to figure out just exactly what kind of pt they recommended for you.Is this for the upper only or are they doing it for your leg issues as well?Just where was the lamenectomy done in relation to your spine?(do you have other spinal issues as well?)what were your symptoms like pre op?I know,I am nosey,just trying to get a handle here on exactly what you are dealing with.How exactly was it that your legs were affected by your C spine problem,was there compression of the cord that also affected an actual tract within the spinal cord?I know i have big leg problems due to direct spinal cord damage at the C 7-8 and T 1.this also damaged my spinocerebellar and the spinothalamic tracts.my sympathetic nervous system took a big hit too.the C 8 does run to some extent down to the little toe area.Also if you experienced any sort of damage to your corticospinal tract,this would also show up in some cases in the form of some spasticity in your legs to some level.are your leg reflexes hyper?

I know for my c spine surgeries for my herniated disc(C 6,7)i did not require any sort of PT,but for my last surgery from hell,because of the extensive damage to my L leg and my fine motor in my L hand,after a little over two weeks at the university hosp where I had had my actual surgery done,I was immediately(instead of being able to go home)transferred to a wonderful rehab hosp for acute pt and ot.spent a little over two weeks there too.They worked absolute miracles there.In just that short time,but with very very intensive therepy three times a day,i got back at least some function of my L hand and really wonderful results with my L leg.post op,my L leg could not hold any weight at all and every time i would attempt to actully place weight on just my ankle,it would just completely "fold over".what sort of excercises have they had you doing so far and do you feel they are actually doing "anything"?sorry to ramble,i get like that sometimes,Marcia
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 10-25-2005, 06:37 PM   #3
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Re: physical therapy after laminectomy

I had "severe" spinal stenosis C5-C7 with some stenosis and a bone spur C4. My main symptom that got me to the neurologist was a gait problem that was getting worse with some right leg and arm numbness. A also started getting some tremors, primarily on the right side. The neurologist said I had neurological Weakness on that side (reflexes, etc.) No pain!!!! But they said that made the condition all the more dangerous.

The laminectomy was C4-C7. The surgen isn't necessarily big on PT. I want it to make sure I'm doing all I can to recover properly. The first PT I saw was looking at the gait - but she had no knowledge of the neurological effects. This new person I saw yesterday totally understood my surgery (and agrees with my doctor that we can be looking at 6-12 months for "total" (if possible) recovery) but I think he can help me do what I need to do to optimize the recovery (posture, etc.). So I'll see what happens. I work full time and this PT is a 20 minute drive each way where the other was a 2 minute walk -- so it has to be worthwhile to keep with it.

-Gloria

 
Old 10-26-2005, 05:22 AM   #4
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Re: physical therapy after laminectomy

Did anyone,like your NS ever explain to you just why you had/have such extensive leg problems due to an issue stemming from your c spine.I know that in my particular case,my issues are from the dirct spinal cord and tract damage,but it really seems rather odd that with having just the stenosis,it would give you such dramatic leg problems,do you know what I mean?Have you ever had a complete( from top to bottom) MRI scan done to check for other problems?Or could there possibly something else going on in the c spine area.i am only asking as like i said,this is kind of an extreme,and from what i have done as far as research,really rare in nature with such dramatic affectation of your legs,espescially when your c spine problems do not include any affectation of the c 8 nerve.do you actually have your own copies of any and all rad studies that were done on your spine?I don't know,but something just doesn't "click" here for me.i mean I am far from any sort of NS but i have done some rather extensive research on the C spine and spinal tracts just to be able to really understand what I am dealing with with my spinal cord damage and I really don't see that 'connection' of it all as compared to all of your symptoms,you know?it's like something is missing here.maybe it's just me,lol,who knows.just sounds kinda odd thats all.sorry if i am just confusing you even more,it was not my intent.Marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 10-26-2005, 07:57 AM   #5
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Re: physical therapy after laminectomy

Yes, I had brain, cervical, lumbar and thoratic MRIs done. All three of the neurosurgen consults, the neurologist and even a chiropractor said that the gait problem is consistant with cord constriction in C6-C7 - they all went on to say that there is no absolute promise that the surgery would fix it.

 
Old 10-26-2005, 08:19 AM   #6
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Re: physical therapy after laminectomy

I'm someone who feels that PT was one of the most important factors in helping my recovery after a second cervical fusion - a couple of things to consider:

-Make sure your therapist is specialised in dealing with spinal issues - you have two components namely neck PT and mobility together with gait and lower body coordination. Don't go to someone that does this infrequently you need an expert with YEARS of experience,

- Although the Mackenzie technique is good for someone who has an acute or chronic neck problem is is an absolute NO-NO following surgery and can do more harm than good.

- It takes a long time. I had PT for 6 months after redo neck surgery and can only say that at the time I didn't seem to be making much progress. That was because my therapist forced me to take it slowly. It was more than worth it, people can't believe I'm fused front and back with my mobility and lack of symptoms. However, it takes time and yes, it may take up to a year to regain more normal strength.

- Don't get discouraged, you'll find progress measured in retrospect on a monthly level and not day by day.

Let us know how you progress!
W

 
Old 10-27-2005, 11:11 AM   #7
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Re: physical therapy after laminectomy

I will double check with the PT - but he did consult with the NS. I did not have fusion, only laminectomy so what they are saying as far as the neck movements in physical therapy make sense. He compared it to a cut knuckle - it keeps opening if you bend one way, but it takes the stress off the cut surface to move the other way.
-Gloria

 
Old 10-27-2005, 11:24 AM   #8
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Re: physical therapy after laminectomy

Quote:
Originally Posted by wimpette
I'm someone who feels that PT was one of the most important factors in helping my recovery after a second cervical fusion -W
I totally agree with W on this. I am one of those people that find it difficult to be diciplined enough to follow the excercise routine day after day...but, it has worked wonders for me, so I stick with it. It is critical to build up the neck muscles to insure that the dominoe effect doesn't occur...it also helps to loosen up the nerves, many times I start my excercises and hear a "pop" or a crunch, in one of the areas that I feel a slight spasm. It clears up right away. If I wait a day or two past my normal routine, it's much harder to loosen up the muscles.

Now, I had ACDF on C5-6 and C6-7. This is much more traumatic than the laminectomy that sunshine221 is asking about. I was not able to start PT until the 6th month of recovery. Initially it was very basic and controlled. While the PT house had auto neck machines, they opted not to use them on me. They were very knowledgeable on neck surgery and how to treat it with the right excercise routine...eventually the workout was extended to full body with some excercises specifically to strengthen lower back which I have a problem with also.

The fact that your doc says it will take a year is not a surprise. I really didn't feel 100% until about one year.

Dennis

 
Old 10-27-2005, 02:59 PM   #9
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hugo eve HB User
Re: physical therapy after laminectomy

Hi Sunshine

Your symptoms are the same to what mine where. I also had what the report called flattened cord at C456 and later C67. Two ops fixed that. The last protusion only affected me when looking up and passed after an hour or two so I caught it before it caused scarring of the cord. The flattening at C456 was far more severe but a MRI showed that 18month after the fusion the scarring had gone! I could hardly walk but now I would say I'm 90% normal. I can stand on either one leg for an extended period of time which I find a useful guage of improvement. I also read that the cord continues improving over 5 years and the percentage of people that get back to normal is in the 90's%. All and all the outcome is very positive. Apparently the nerve system is the slowest healing part of the body.

7 weeks post op I'm doing things I never dreamed I'll be doing again...in fact my muscle are sore from being so active after 2.5 years of relative inactivity..... moderation..... never heard of the word <grin>

Hugz.

 
Old 10-31-2005, 09:41 AM   #10
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Re: physical therapy after laminectomy

Hugo Eve:

Thanks for the reply - I've read some of your other post, didn't realize you had the gait problem too. Thanks for the encouragement. Sat and Sun I did my 1 mile walk which I do when the weather's nice -- it's a slight uphill to the end of the road and obviously slight downhill back - the uphill is harder, but coming home I was walking pretty well yesterday - it was encouraging.

Glad you are feeling better

 
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