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  • leg height difference after fusion L4 L5 S1,double discectomy,triple laminectomy

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    Old 08-08-2011, 06:01 PM   #1
    Neecywoman
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    Cool leg height difference after fusion L4 L5 S1,double discectomy,triple laminectomy

    Little over 2 years since surgery. My new physical therapist noticed the difference of about a half inch! No wonder why i limp! lol Anyone else have this issue. btw, i'm still in pain every damn day. i'm considering spinal cord stimulator anyone have that either??

     
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    Old 08-09-2011, 10:41 AM   #2
    teteri66
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    Re: leg height difference after fusion L4 L5 S1,double discectomy,triple laminectomy

    Would you mind giving us a quick run-down of your surgery and what has happened since surgery regarding your recovery that has led you to being in constant pain? Was there a time after surgery when you were getting better or had less pain or ??

    Did the PT measure your leg so you know for sure the leg is shorter, or might it be that your pelvis is rotated and you carry one hip higher than the other? Many people are told one leg is shorter and are even given a lift for one shoe...and it turns out the real problem is that one hip is higher and the legs are the same length...that is a matter of structural alignment and can be corrected by fixing the pelvic rotation.

     
    Old 08-09-2011, 05:05 PM   #3
    Neecywoman
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    Re: leg height difference after fusion L4 L5 S1,double discectomy,triple laminectomy

    I had fusion of L4 L5 S1 with double discectomy, triple laminectomy with fixation of 6 screws and 2 rods. I felt healing kind of pain for 4-5 months , syptoms i had prior to fusion seemed to be gone. about 7 months out i started having numbness down one leg into foot, back muscles fatigued/spasmed, deep deep ache in fusion area. Legs feel heavy, walking any legnth of time is a real struggle...when i food shop I cant shop the whole store all at once. Its little over 2 yrs out from surgery and I still have all the syptoms I just discribed. I am seeing a pain management Dr and am scheduled for a 3rd spinal injection. First one didnt get through the fusion, second one got through/or around the scaring somehow. Slightly helped. Pain dr gave me info for spinal stimulator implant. Don't know how i really feel about it.
    I swim everyday, i can get pain free in the pool. I do the exercises and stretches the PT gave me just about everyday.
    Yes the PT did measure my legs and gave me a lift to put in my shoe.
    I haven't been able to work because of the pain and I am on Tramdol, Flexoril and Hydrocodone.

    It's all so frustrating

     
    Old 08-09-2011, 06:15 PM   #4
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    Re: leg height difference after fusion L4 L5 S1,double discectomy,triple laminectomy

    Have you had any other specialists evaluate you to see if they can find a reason for your continued pain? Do you know that your hardware is tight and in the right position? Have they checked for arachnoiditis? Can they see any nerve compression on MRI?

    Didn't I ask you on some earlier post if you had seen anyone at the Roth Institute for a second opinion?

     
    Old 08-10-2011, 04:11 AM   #5
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    Re: leg height difference after fusion L4 L5 S1,double discectomy,triple laminectomy

    It wasn't me you talked to about The Roth Institute.
    Significant scaring is causing some of the continued pain. A neurologist said everything looked ok as far as the fusion goes (he was NOT the dr who did the surgery). The pain Dr is the one who told me a nerve is being compromised because of significant scaring. Deep ache that changes with the weather and muscle fatigue/spasm is a "side effect" of this type of surgery in some. sigh

     
    Old 08-10-2011, 01:56 PM   #6
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    Re: leg height difference after fusion L4 L5 S1,double discectomy,triple laminectomy

    Nerve pain is usually less responsive to external changes than it is to what's going on in your own body. Lots of people have deep aching after spine surgery. But the kind that comes and goes with changes in the weather is often related to arthritic changes in the spine, particularly in the facet joints.

     
    Old 08-10-2011, 03:52 PM   #7
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    Re: leg height difference after fusion L4 L5 S1,double discectomy,triple laminectomy

    I think the deep ache is more from the 6 screws i now have inbeded in the bones. But thanks anyway/

     
    Old 08-10-2011, 09:21 PM   #8
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    Re: leg height difference after fusion L4 L5 S1,double discectomy,triple laminectomy

    Have you consulted with any other surgeons to see if anyone thinks something could be done surgically to improve your pain? Or are they all recommending pain management at this point?

    What does your surgeon believe is the cause of your renewed pain after seven months of at least a bit of progress?

     
    Old 08-11-2011, 04:28 AM   #9
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    Re: leg height difference after fusion L4 L5 S1,double discectomy,triple laminectomy

    The orthopedic surgeon said we could "try" taking out the hardware. Could help, could also make things worse. Neurosurgeon i saw one and a half years post op said everything look fine as far as the fusion goes, tried me on Neurontin for 4 month with no relief and another round of Physical thearpy. The neurosurgeon then refered me to pain management Dr. He believes a good amount of the pain in steming from significant scaring.

     
    Old 08-11-2011, 08:12 AM   #10
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    Re: leg height difference after fusion L4 L5 S1,double discectomy,triple laminectomy

    I apologize if you feel like I'm prying, but I hate to see people end up with pain management for life if there is a possibility that whatever is the pain generator could be dealt with. I've found that surgeons, for whatever reason, tend to tell patients that nothing more can be done, or "this may be as good as it gets," or it would be too dangerous to go in another time, etc.

    Unfortunately, some surgeons also tell patients everything looks great and then they later find out that they aren't fused at all, or are only partially fused, or a screw is poking through a nerve, or something similar.

    In my case, my one level fusion at L4-5 was successful, but at six months I pretty well knew that I could wait forever for the nerves to recover and I was still going to be in the same amount of pain, with the same inability to walk more than a block, or stand more than a couple minutes. At first I was told those usual statements and was referred to pain management and everyone wanted me to try a spinal cord stimulator. I was convinced my pain was coming from something other than permanent nerve damage, so I kept looking for answers. I won't bore you with all the details...but eventually it was decided there was still some instability that was causing some nerve compression, and my surgeon planned another fusion. It was only after he was doing the surgery that he discovered a major structural issue at L3-4--the facets were worn down to little nubs, providing no structural support whatsoever. This is something that should have shown up on MRI but did not, and it was a complete surprise to him when he got in there and could actually see what was what.

    He ended up having to remove the pedicle screws at L4-5 because they were not compatible with the new hardware, he had to do some reconstruction at L3-4, and then he added screws and new longer rods, so I am now fused from L3 to S1 and without any leg pain for the first time in over six years.

    A friend who had fusion with one of the top surgeons in her state, who trains all the fellowship students who are future spine surgeons, was told repeatedly that her fusion looked perfect, everything was in place, that there was no reason why she should still be in pain. This went on for several years until she was beginning to think she was losing her mind because the doctors told her there was no reason for the pain and perhaps it was all in her head, etc.
    Finally she went to a doctor who is known for being willing to take on the complex spinal cases. He immediately ordered a bone scan and it was discovered that she had only partially fused, that part of her hardware was just hanging loose and one screw had penetrated the L5 nerve and the nerve was growing around the screw. The doctor said it was a miracle that she was even able to walk. She had a revision surgery and is still recovering. She will never be pain-free, but she is better than she was and can now resume most of her old activities.

    If both of us had listened to our surgeons' original advice, I think we both would be in wheel chairs now as it was just too painful to be weight-bearing...and we were both deteriorating as we still had nerve compression.

    You live in a part of the country that is rich with excellent spine specialists. If you have any interest in pursuing another opinion, you won't have any trouble finding someone who deals in complex cases and revision surgeries. I felt the need to keep looking for answers until I was convinced that nothing more could be done for me. (within reason, of course -- I wasn't about to go to someone who promised any easy solutions -- only fellowship-trained spine surgeons with top credentials, etc.) If that had turned out to be the case, then I was willing to try the SCS...but I was so convinced that there was a solution for my particular problems.

    I know people who are pleased with their SCS and it has turned out to be a device that has allowed them to resume their lives.

    It is an individual decision and I respect that. But it is important for everyone to understand that different doctors do have different opinions and just because one doctor says that there are no options other than pain management, that may or possibly, may not be the correct answer. There just might be another option out there. So it is difficult to know when you've explored all options and when it is time to accept that nothing more can be done and it is time to move on to another approach...like SCS or an implanted pain pump or....

     
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