Bone Graft Pain (fusion Procedure)

onthemendnow

I've got no theories, just my experience ....

Fusion on 2/25/04, today I'm 15 weeks post-op. Was doing great - actually, still am doing well - but at 12 weeks I felt discomfort around the hip area (site of bone harvest for me too).

At around 14 weeks I admitted "Ok, this just plain hurts!" It's still there, and does feel sort of generalized sometimes like the soreness, charley horse feeling you described, but it's relegated to that one area so I'm figuring it's due to the harvest. I was confused by it at first because it didn't kick in till the 3 month mark. My pain isn't that bad really, but it's always there.

I have a checkup next Friday, will see what dr. says then. At 8 week check, everything was proceeding on schedule and looked good per the x-rays. Hopefully all will still be good next week.

dianaj85

Hi Jo and OntheMend!

I had my surgery April 6th, with bone taken from my hip, and no extra incision for the graft. I haven't had any pain from the donor site at all....I can't tell which hip they took the graft from. I see my doctor on Monday for my 2 month visit, and plan to ask him which one just out of curiosity.

I asked my doctor about potential hip pain prior to my surgery (since I had read so much about it here), and he said that he used to take the bone by scraping, which causes more pain. He said that now he uses more of a drilling technique, and doesn't have as many complaints. I guess it works, since I can't feel it.....although onthemend seems to have pain after several weeks of feeling good. I hope that doesn't happen to me!

Good to hear from you both! You both seem to be doing well!

Melinda

susan_a22

Dear Jo:

Possible theories could be that our pain tolerances are different and medications affect people’s pain differently. My experience from my bone graft (harvested for my right, lower back) was also that it hurt more than the fusion site for the first two and a half weeks. At three weeks, I no longer had the pain and was off of all medication. Truly, hope you feel better. In Christ, Susan_a22

Fiona_Jo

Thanks, I appreciate the responses. I'm really feeling like I'm doing really well except for this pain (I got the go-ahead at my post-op visit on Monday to start taking short walks). So, I am definitely very thankful that I had the procedure. The positives that I'm already noticing (returned leg strength and I can actually move my toes again). Anyway, I love coming to this board and reading the success stories.
Jo

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080807-Cervical-Stim~071707-ACDF-C5-C7 w/instrumentation/bone graft~'07/06 Lumber instrum. removed 05/04-Fusion(DDD/Collapsed Disc L5-S1)08/99-Microdisectomy(Herniated Disc) ~Lupus/EDS,Migraine

Brooke79

Hey There,

I'm 3 weeks post op from my second fusion. In both instances a graft was taken from my hip, first the right and this time the left. Yep, i experience most pain from the graft site.

This is simply because where they have scraped the bone away, there is a little uneveness and the glutes and spinal extensors that all attach and pass over the hip area are now rubbing on an uneven and possibly even a sharp surface. Until they adjust you will experience pain.

I have begun doing glute strengthening exercises whilst im on the floor laying on my side. These hurt at first but now (because i do them daily), i have found my graft site is not as painful anymore. I can only assume that this is because i am working the muscles that pass over the graft site and therefore they are becoming quite accustomed to moving over the new surface.

Hope this helps

Brooke

__________________
October 2003 PLIF for L5S1 Spondy
May 2004 PLIF revision RHBMP2

onthemendnow

Brooke, could you tell us how to do those exercises? I'd love to try them. Thanks!

Brooke79

Hey onthemendnow,

Sure, I do about 30 minutes to one hours worth of exercises a day. Of course, do what is comfortable and if you're concerned about the safety of things like this dont do it until you have cleared it with your specialist. I have given these a lot of thought though to ensure that the spine is not compromised (being on my second lot of surgery and all) so i consider them safe when performed slowly and correctly.

The aim is to ever so gently strengthen the muscles around the spine so as to protect them whilst the bone is attempting to fuse. Working on the abdominals and the gluteals (so long as you are being really careful to maintain very good posture whilst performing the exercises) is the best thing you can do to train your body to use those surrounding muscles as opposed to the spinal structures to move.

The first exercises i do are for the abdominals. Laying on your back a mat on the floor or your bed (the floor is a bit risky in terms of getting back up) have your knees bent with your feet on the floor. Contract your abdominals and pelvic floor muscles and maintain the contraction whilst breathing normally, and slide one foot down and back up. The aim is to use your transverse abdominals (the very deepest abdominals that wrap around the spine) to stabilise your spine and hips so that you should be able to move your leg up and back without there being any weight transfer onto the other leg and there should be no movement whatsoever through the spine. This is tricky to master and it's sometimes hard to tell if you're contracting the transverse because you cant see it and you cant really feel it. You just have to be very tuned into the movement and you know that if you are moving whilst shifting the leg that the transverse abdominals are not too strong. If you find there is a lot of movement then only shift the leg out a little way and back. The aim is to have 10 full leg extensions on each side. The transverse abdominals can never been seen so they dont have the 'look' that the '6 pack' or rectus abdominals do. The truth is the rectus abdominals dont have too much function at all except for where large burst of short lived energy is required such as lifting something heavy or sneezing etc.. It is the deep abdominals or the transverse abdominals that have the ability (once trained) to stay contracted all day and thus reduce the load on the spine thus relieveing back pain. It takes time to train the transverse abdominals so be patient and remember..if you maintain a habit of training the transverse abdominals for 3 months, they will 'learn' to automatically switch on and protect the back. You can also contract the transverse abdominals when you are sitting or standing by pulling them in at the same time contracting your pelvic floor, this acts as a human internal corset to protect the back.

The next lot of exercises I do is for the glutes which also play a very important role in stabilising the spine. Laying on your right side with the right leg bent and the left leg extended, preferably on a hardish surface such as a mat on the floor, contract your abdominals and pelvic floor to brace your spine. Then lift the left leg to a comfortable height..say about 20cms. (If you lift the leg too high you may risk arching your spine to get the height and yo wan to keep your spine as still as possible). Then lower the entire leg toward the ground and back up to the 20cm height. Do this movement slowly and for 10 repetitions. Make sure you are constantly aware of the position of your spine, that your abdominals are braced and that your left arm is supporting the weight by having it out in front of you. Ten reps is enough to start with on each leg. Once you feel that your back is coping with the intensity of the exercise and that youre alignment is good you can progress. There are a few sections to each glute. There is the front aspect or anterior, the rear aspect or posterior and the middle or belly of the glute. To cover all aspects this exercise is performed with the leg at slightly different positions. What i have described above would work the belly or middle of the glute. To work the anterior aspect you then move the extended leg slightly forward from the original position and perfrom 10 reps at that stage. Again you must constantly monitor your abdominal bracing and spinal position. To work the posterior aspect you move the leg slightly behind the original position, and perform 10 reps there. The posterior aspect is perhaps the most concerning because for those with lordosis it can throw the position of your neutral spine. At this stage i do not bother with the posterior aspect because it's simply not worth it.

Hamstring stretches are a must. I'm sure you've been told about that so I wont go into it here but you're more than welcome to other advice. Other exercises to consider are squats and lunges. These can be compromising exercises to do even for someone with a healthy back. The best option here is to ensure you are between two rails for support or if you have a fitball that is sound as well.

Brooke

P.S - sorry for the rant once i start and cant stop...

__________________
October 2003 PLIF for L5S1 Spondy
May 2004 PLIF revision RHBMP2

onthemendnow

The rant's appreciated. <wink> Thank you!!