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    Old 08-17-2010, 07:04 AM   #1
    DracosHuman
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    Question Posterior Lumbar Fusion - Post op questions

    Hi everyone. This is my first time posting to the message board but I have read many posts over the last month. I would like to thank everyone for posting here and helping others.

    I have Grade II Spondylolisthesis with severe stenosis and herniated disc (and all the pain and such that goes with it). I have been unable to sleep in bed for more than 6 months. The only sleep I could get was in a recliner chair which eventually started to have effects on edema in my legs.

    On August 5 I had the posterior lumbar fusion on L4 - S1 and Laminectomy. Prior to surgery I had numbness and pain from the sciatic in the right leg. Post op, I have noticed a marked improvement in the right leg and I can lay down now! (I haven't been in my recliner yet, afraid I won't be able to get out of it at this time.) However, at times, usually after waking up, I have had some sciatic pain in my left leg (which isn't there when I am laying down, start feeling it when I sit up and then it increases and then eventually decreases, takes about 45 minutes to an hour). First time was after laying on my right side with my adjustable bed inclined some. The other times was just within the last 24 hours and after laying on my back. I do adjust the bed to have my feet quite a bit higher to help combat the edema in my legs, which seems to be getting better.

    My question is, is this new sciatic pain possibly due to inflammation from the surgery? Post op pain is not too bad, save for the first 3 to 4 days post op, which I care to forget. Most of my discomfort is from a feeling like someone is gripping hold of my spine and won't let go, and I feel the space their hands are taking up inside. This, is uncomfortable, yet not really painful. Annoying mostly.

    Thank you all for reading.

    Last edited by DracosHuman; 08-17-2010 at 07:16 AM. Reason: Forgot to mention that I had a Laminectomy as well

     
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    Old 08-17-2010, 09:24 AM   #2
    jcrowder
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    Re: Posterior Lumbar Fusion - Post op questions

    I just read your post and it sounds so similar to me I thought I would share this with you. I had S1-L5 fusions done June 30 of this year. I was home for about 3 weeks and had to go to the emergency room because the pain in my right leg was intolerable. They admitted me and kept me for 3 days on IV dilaudid (not sure about the spelling). My doc explained to me that nerves are the slowest healing part of our bodies. I have spondylolisthesis (not sure about that spelling either) and the disc between L4 and L5 was completely gone so my sciatic nerve was being crushed. My surgery created a space to relieve pressure on the nerve and the pain from the nerve "repairing" itself is what sent me back to the hospital. They sent me home on the pill form of dilaudid. I'm doing really well now however everyday, there is a different feeling somewhere in my right leg. Like for a few days my toes feel like they are scalded and then that goes away. Then it will come back again for a few days. One day i may have hip pain, one day i may have knee pain. I just never know what to expect. What i can say, is that these weirdo healing pains i have are still easier to deal with than the sciatica i had prior to the surgery. Hope this helps!

     
    Old 08-17-2010, 11:33 AM   #3
    bigdogdad
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    Re: Posterior Lumbar Fusion - Post op questions

    Dear DracosHuman,

    I have experienced 4 spinal surgeries including one Anterior Multi level Fusion and 3 posterior procedures including laminectomies, fusions, etc. One of my surgeons once said "If you saw the Trauma we put your body through during some of these procedures, you would be very surprised your pain from the surgery isn't worse."

    I have experienced on several occasions new pains which I had not had before the procedures. Specifically, I had right side Sciatic pains post surgery which I had never experienced previously. The swelling of the body in the areas of the surgery were responsible for each of these occurances. A few days post surgery and the "new pains" were gone as were the "old pains".

    I will never forget waking in the recovery room the first time I experienced back surgery and immediately feeling the relief from the horrible sciatic pain I had endured for years prior to the procedure. Just imagine my grief when the next day, the "old pain" returned along with sciatic pain on the other side, which I had never before endured. Fortunately, My surgeon had warned me this was likely and he assured me the "new pain" wouldn't last, and he was correct.

    It's hard to describe the depression you feel having endured a major surgery only to think the problem is not only still present, but now you have new pains which you previously had not experienced. Once the pains subsided, things went much better.

    I personally believe that it is critical that you push yourself to do as much as you can as soon as reasonable. While it is easy to rest and have others do things for us while we are recovering, the reality is that you must be as active as possible post surgery to achieve as thorough a recovery as possible. The less you do post surgery, the worse your problems will become. I have no doubt. This is why many procdures start Physical Therapy even while you were one day post surgery.

    The night I had my first Multi Level Anterior Fusion, within 6 hours of being back in my hospital room, the nurses had me up walking in the halls. The next day, I was climbing one set of stairs with careful supervision. When you are in pain, the last thing you want to do is to push yourself and risk the pain worsening. However, within the limits imposed by the doctors, be as active as possible. You will feel better and experience a more thorough recovery.

    Hey, after 10 total operations, I should know........Best Wishes for a complete and successful recovery........

     
    Old 08-17-2010, 04:42 PM   #4
    DracosHuman
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    Re: Posterior Lumbar Fusion - Post op questions

    Dear Jcrowder,

    Sorry to hear you went through a bad time during your recovery but I am glad to hear that things are getting better for you now

    I am relieved by the fact that these new pains I have been getting don't stay for too long and seem to "cycle" in some respect (like yours), making me think that it is most likely due to the inflammation and healing from the surgery.

    Dear Bigdogdad,

    Wow, you have been through a lot. This is my first surgery and although I did a lot of research and sought out the opinion of several doctors before deciding to have the surgery, I still feel like I went into blindly. The first doctor, a neurosurgeon, suggested surgery back in 2002 and I wasn't ready for it at that time. Perhaps I shouldn't have held off as long as I had. I do however feel that I did right by going with the surgeon that I did, a orthopedic spine surgeon.

    I understand what your saying about the depression that comes from having new pains and thinking things are worse than they had been before hand. I am going through some of that now.

    Thank you for responding!!

    Kelly

     
    Old 08-17-2010, 05:35 PM   #5
    bigdogdad
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    Re: Posterior Lumbar Fusion - Post op questions

    Kelly,

    Best wishes for a complete recovery. Did I understand your posting to say that you went from 2002 until now with the back pain before surgery? The reason I ask is because I have experienced the added problem of having the same nerve path communicating pain for such an extended period of time, that my body seemed to accept the pain signal as "normal", even after the structural problem within my spine causing the pain had been physically repaired through surgery.

    Sometimes a nerve block can interupt the pain signal enough to end the pain communication signal. In my case, I ended up having a Spinal Neurostimulator implanted. Never has extended research and thoroughly understanding the available products weaknesses and strengths been more important. I ended up with the Boston Scientific stimulator which has been very effective and helpful in addressing the remnant pain after 4 various spinal operations.

    Once I got my lower back pain problems under control (only took 20 years, $540,000 in medical claims paid and 4 operations) I injured my right shoulder. Now, I have had two shoulder operations in the past 14 months and I just underwent another Neurostimulator trial for my shoulder. I am putting off having that Stimulator implanted because the surgeon is requiring me to wear a neck brace for 8 weeks prohibiting any head turning or vertical movements. That's impossible during motorcycle season and I am not going to miss my planned trip to Montana, Wyoming, Idaho, and the Dakotas, which I take each late summer / early fall.

    One thing which I have noticed to be an absolute truth is that as we age, it takes much longer to recover from each surgery and the pain seems to be much more difficult to manage. Getting older is certainly not for wimps!

    Kelly, I sincerely hope you achieve a full recovery and return to a happy, pain free (or if unable to eliminate the pain, at least manage it very effecively) productive life. As I have always said, there are only one or two people upon whom I would wish the extreme pain and suffering that we have experienced.......

    Stay positive and keep your chin up. The worst is behind you.

     
    Old 08-17-2010, 09:10 PM   #6
    DracosHuman
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    Re: Posterior Lumbar Fusion - Post op questions

    Dear Bigdogdad,

    Thank you for your best wishes. Yes, I went from 2002 till now with the back pain before going for the surgery. At first it wasn't as intense. I was diagnosed with Spondylolisthesis, Grade I in 2002. Surgery was recommended at that time by the Neurosurgeon and I sought out a second opinion and his recommendation was the same. I didn't want to have surgery and held off for a long time. When I couldn't lay down anymore, I knew that it was getting to be the time when something had to be done.

    During that time I had gone for physical therapy and received the shots for the nerve block through pain management.

    Time will tell how effective this surgery was. I do see improvement in the leg that was affected. My ortho told me that I should see marked improvement in the nerve pain early on, but that the back pain would take some time. I know my muscles need to heal and I know that my body is doing what it needs to do to heal. I hope for the best, of course!

    Luckily, since my first posting, the sciatic pain in the left leg has not yet returned. I hope it stays this way and that it was a result of bad positioning while sleeping and/or inflammation. The thought of bringing on an additional problem while fixing another was scary.

    Your trip sounds like lots of fun! I hope you have a great time traveling, it sounds wonderful!!

    My best to you as well.

     
    Old 01-21-2011, 04:21 AM   #7
    Mandymia
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    Re: Posterior Lumbar Fusion - Post op questions

    Hello I was astounded by your story. Unfortunately we are all going to suffer from either cervical, thoracic or lumbar pain at some stage in our lives. My mother had several operations on her spine. She fell from the ladder 2 meters high and the ladder fell on top of her damaging most of her disks. Her sciatic pain, pins and needles, burning and numbness was so extreme that doctors thought they will try 3 shots of quarterzone injections in her spine. The relief was only for less than 1 day. The pain flared up again. She had done nerve conduction studies and the results of that were that the there was severe compression of the L2-L5 region. The doctors performed a procedure called L2-L5 lumbar laminactomy to release the compression but unfortunately due to scar tissue damage from the operation her symptoms of sciatica continued to annoy her life.

    It was unfortunate that the doctors in Australia did not recorgnise that the there were far more serious complications in my mother's spine. When she fell she also fractured T12-L1 which was called "double crush syndrome". It was crushed to such an extreme which was why a L2-L5 decompression surgery without fusion was going to make much difference.

    I searched for a Spinal surgeon to look into my mother's case and all they could do was give her Lyrica (gabapentin) and increase the dose to 600mg per day which again didn't do anything. It got to the point when I could not sleep for hours in the night listening to her cry and crouch in bed from the sciatic symptoms. The burning and the pins and needles gave a very bad feeling in her legs and the more time we were waiting for answers and help the worst it got. Being a carer and going through all of the spinal trauma's my mother suffered in life since 2004 was quite distressing. I thought I had to do something about it and fast. I "googled" a surgeon in the United States and immediately sent him an email. He offered to take mum as a patient. After changing several flights we finally got there after 24 hours from Australia. There was so much pain during the flight but the flight attendant made mum as comfortable as possible changing peoples seating positions to make mum as comfortable as possible during the long journey.

    In the United States surgeons couldn't believe the extent of complications they come accross from mums spine. Screws, rods, metal plates, the works were inserted. After a 5 hour procedure to fuse T12-L1 mums symptoms of sciatica subsided. They couldn't begin to understand why this type of surgery was delayed but they were glad that mum's surgery in the U.S had a positive outcome. Without this type of surgery mum would have ended up in a wheelchair paralysed from the severe nerve compression. We were filmed with a news crew to tell the story of how mum and I came about to visit the surgeon in the U.S and treat her there.

    Several months later her symptoms of sciatica flared up again causing her grief and heartache once again. Her spinal problems didn't end there. She also had a spinal cord stimulator implanted at the levels L1-SI but it didn't give mum any pain relief regardless of how many times she manipulated the device for minimal comfort. After chasing spinal surgeons to 4 different major cities within Australia, one doctor took on my mothers case and looked into her severe and complicating problems. L2-L5-S1 was severely out of position. Grade 2 Sponylithesis with a curveture spine. She was with a walker and currently is but after this operation her symptoms of sciatica was relieved. However after suffering a fair bit of scar tissue damage and foot drop as the result of the surgery she still feels burning and numbness in her arms and legs although not as severe now as before. The surgeon says the best treatment for this to have hydrotherapy treatment which she is doing now. It is a great relief to be doing physical exercises in 34 degree heated pool.

    Well this is my mother's story and as a daughter and carer it was hard to give up and tolerate her pain but am glad the final operation has released her severe pain. She is still hunching over but in time with a lot of physio and hydrotherapy her back will straighten and the stiffness in her legs and numbness in her arms will slowly subside. Our aim is to get her off the walker and maintain balance assuring her that her walker will no longer be in use, at least not until she is 80+.

    Thank you for reading my mothers story. Please feel free to comment.

     
    Old 02-13-2011, 05:54 AM   #8
    DracosHuman
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    Re: Posterior Lumbar Fusion - Post op questions

    Wow Mandymia, my heart goes out to your mother and you as well! I do hope that her relief from the sciatica continues. I know all too well what that pain is like.

    It's good that she has you to help in her care, my daughters are there to help me and I can never thank them enough. I know it is difficult for them to see me in pain, as I know it is difficult for you to see your mother in so much pain.

    I am now 7 months post op and although my back pain seems to be worse, my sciatica pain is minimal. I know that it takes up to 2 years for a fusion to fully heal so I remain hopeful that the back pain will decrease. I am not sure if the new pains are from scar tissue, swelling or other problems, but I have had some sciatica pain, although minimal, starting in my left leg and I think some weakness in that leg. My foot gets hung up on stairs and while walking. My problems before the surgery were with my right leg.

    Again, my thoughts and prayers go out to you and your mom. I hope her recovery continues in the positive direction.

    Kelly

     
    Old 02-13-2011, 02:52 PM   #9
    Mandymia
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    Re: Posterior Lumbar Fusion - Post op questions

    Yes thank you for your message of courage and support. We are certainly not alone in this world who are suffering spinal pain. Mum has also been in 7 month preop as well and she still has a little numbness in her right and left leg and weekness as well. She feels that everytime she moves the steal rods and plates move as well. Obviously she would have to have bone growth around it not to feel this the doctor said and that will take a lot of time. Given that she is 65 there will be a long road to recovery.

    Glad to hear that your pain has subsided a little. Keep in touch and let me know how your going. I will do the same.

    Take care
    Mandy

     
    Old 02-13-2011, 02:55 PM   #10
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    Re: Posterior Lumbar Fusion - Post op questions

    I really do think that due to the operation one will always get scar tissue damage like my mother. You feel the symptoms of some minor pins and needles as the lumbar fusion involves you lower extremeties. But with a little physical therapy and hydrotherapy treatments your pain will lesson in time and you will become stronger.

    Mandy

     
    Old 04-04-2011, 07:41 PM   #11
    larry cooper
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    Re: Posterior Lumbar Fusion - Post op questions

    [QUOTE=jcrowder;4309168]I just read your post and it sounds so similar to me I thought I would share this with you. I had S1-L5 fusions done June 30 of this year. I was home for about 3 weeks and had to go to the emergency room because the pain in my right leg was intolerable. They admitted me and kept me for 3 days on IV dilaudid (not sure about the spelling). My doc explained to me that nerves are the slowest healing part of our bodies. I have spondylolisthesis (not sure about that spelling either) and the disc between L4 and L5 was completely gone so my sciatic nerve was being crushed. My surgery created a space to relieve pressure on the nerve and the pain from the nerve "repairing" itself is what sent me back to the hospital. They sent me home on the pill form of dilaudid. I'm doing really well now however everyday, there is a different feeling somewhere in my right leg. Like for a few days my toes feel like they are scalded and then that goes away. Then it will come back again for a few days. One day i may have hip pain, one day i may have knee pain. I just never know what to expect. What i can say, is that these weirdo healing pains i have are still easier to deal with than the sciatica i had prior to the surgery. Hope this helps![/QUOTE]

     
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    Old 04-04-2011, 07:50 PM   #12
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    Re: Posterior Lumbar Fusion - Post op questions

    This is my First post and i had a tlif L4 to S1 with a cage I had two collapse discs and found out recently that i had si disfunction after the surgery,my pelvis had shifted and i was wondering if anybody else had that problem

     
    Old 04-04-2011, 08:06 PM   #13
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    Re: Posterior Lumbar Fusion - Post op questions

    It is not unusual to develop some SI joint problems after a lower lumbar fusion. The SI joints are now the first joint that is moveable. The SI joints are designed to have very little motion, so often the ligaments that hold them in position end up getting stretched to some extent. This can allow the pelvis to rotate, or for one hip to seem higher than the other. Among other things, this can cause irritation to the piriformis muscle, which can result in a sciatic-type pain in the hip and leg.

    I don't know how long ago you had your fusion, but it can take quite awhile for the body to get used to the new positioning of the lower lumbar spine. There are exercises you can do to help keep the SI joints in position. Someone knowledgeable in body work can make adjustments if it is causing too much pain.

    If the problem persists, you might want to have your posture checked. Sometimes patients need orthotics for their shoes as pelvic rotation can be caused by problems that begin in the feet, pronation, etc.

     
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    Old 04-04-2011, 08:34 PM   #14
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    Re: Posterior Lumbar Fusion - Post op questions

    thanks for that post but those it cause your hips to pop and make a loud snapping noise and it hurts pretty bad when it happens and i had my sugery may 19 of 2010 and the pain is better some what but it comes and my left leg still is numb all the way to my big toe do thatmean i got nerve damage

     
    Old 04-04-2011, 09:12 PM   #15
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    Re: Posterior Lumbar Fusion - Post op questions

    It can take a good year for the bone to set up and heal. I had my surgery in June and am still recovering. What does your surgeon say about the leg being numb? It should be showing some improvement by now. Was it numb in the same way prior to surgery, or is this current numbness something new since surgery?

    I know it is very discouraging to go through all this and then end up with the very same nerve pain. That happened to me with my first fusion in 2008. The surgery went well and I recovered quickly, but my sciatic pain never changed. It was like I'd never had any surgery at all.

    You may want to consult with a different spine specialist in a few months if you do not feel you are getting sufficient information from your surgeon.

     
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