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jessica332 08-28-2013 12:47 AM

L3,L4,L5,S1 with nerve compression
Hi all!

Brand new here....need some input/advise....

I ruptured the above discs at work (L3, L4, L5, S1) which are causing the nerve compression, broke off a piece of vertebra and now have a "free floater" as well. Severe nerve pain in both legs, no reflexes in my left knee and ankle, left foot, toe and leg numbness, but I can still bear some weight on that leg. I am 32 and was in overall great health up until my injury, but now I am in excruciating pain all the time, I hobble around like I'm 80 and I am getting really discouraged and depressed. I have been through all the steroid injections, steroids themselves, and I am currently on pain medication, muscle relaxers and nerve pain medication. The Doctors and Surgeons have said No PT as it would be pointless and surgery is my only option and that's just to relieve some of the pain. My Neurosurgeon believes I will have permanent nerve damage and my reflexes may never return and it's a game of wait and see.

I am basically looking at being totally disabled the rest of my life because of this. I am at a loss, I'm 32 and I have been working the same job full time since I was 20, unfortunately it is a VERY physical job and may never be able to return to it.

I am still waiting for them to call me with the date for surgery, since its workers comp, it's just a bunch of hoops to go through. Has anyone ever had my kind of injury/situation? What did you do? How did it turn out?

Thanks so much!!

teteri66 08-28-2013 07:32 PM

Re: L3,L4,L5,S1 with nerve compression
Welcome to the board. I am sorry for the reason you find yourself here.

I would imagine the neurosurgeon is planning on a fusion. Do you know if that is correct? It is always a good idea to get more than one opinion, but perhaps this is not possible with workman's comp. This is a big surgery and will require a lengthy recovery if the results are to have a chance at being successful. Too many people try to rush back to work before the body is ready, and they end up paying the price by increased nerve pain, broken hardware, etc.

I am fused from L3 to S1, obviously for other reasons. I think it is likely you will not return to your job if it is very physical, but I don't see why you would be "totally disabled the rest of my life." This was my third lumbar surgery -- I first had a one level fusion at L4-L5 but even though the fusion was successful, it did not resolve my nerve pain. Then I had a small procedure at L5 to open up the space and make more room for the nerves--and then my surgeon did a revision and added on to the original fusion --and finally got it right. Even though my nerves had been compressed for over five years, I ended up with very good results. I have some neuropathy in my feet -- other than affecting my balance somewhat, it is a small price to pay to be virtually painfree. I have almost no ankle reflex on my right foot and I do not expect it to come back.

If you have a well trained, experienced surgeon, there is a good chance that you will be pretty much back to normal -- but chances are also good that you will not be able to do sustained physical work. I am much older than you...but many of us (younger and older) have a weight retriction --I'm not supposed to lift more than 30 pounds. I know many nurses are not able to return to working on a hospital floor as they can no longer lift a patient, for example. Even if one is "allowed" to go back to a somewhat physical job, one has to think about whether it is a wise choice...and what the spine will be like in twenty more years.... Perhaps while you are recovering you will discover some new career options?

One4btrfly 08-29-2013 12:17 AM

Re: L3,L4,L5,S1 with nerve compression
Hi Erica

What kind of surgery are you having?? Im 40 year old female and also have a physically demanding job that I love. I injured my self at work last March. Never having back issues before things turned for the worse very quickly. I had bad left leg pain with sciatica, loss of sensation in my skin, numbness and tingling in my entire left leg, and flexing my left foot was very difficult. I had horrible pain 24/7. Mine was also a workers comp case so had to go through the hoops as well. Started with physical therapy, chiropractic, accupucture, 3 epidurals, more PT with no relief. I was devistated being so active to being in bed because everything was un bearable! I was on pain meds which gave no relief and nerve blocking meds for the numbness and tingling also with no relief and Ambian i sleep. Of course the depression was worse than the injury, and thought how can i get through this my life is over. I never even took any type medication let alone vicodin, percocet, etc.

Im 5 weeks post op from microdisectomy with stem cell replacement on my L4/L5/ S1 nerve root. I am still havin good days and bad days with recovery. One day I feel great and next I ask myself what have I done! But I can walk alot better, im getting movement back on my foot, and numbness and tingling are better.
I do still have sciatic but way better than before. Dr says this is all part if healing.

Back surgery is a very difficult decesion anyone who has had it will tell you that. I hope mine is sucessful. I will say everyone heals different so don't get to down if your's is slower than others! Try and stay away from reading alot of negative posts on surgery . I did that with every little pain I had and I would try and self diagnose myself!!! I learned my lesson not do that.

No one really addresses depression. Mine was bas before and after my surgery. I went to talk to a counselor. This type of injury and surgery was a life changer And I was having diffficulty coping. But that is expected! I wonder how many times i cried my self to sleep... But talking to someone helps and workers comp will take care if that for you!

Please keep us posted! Research your doctor and get more than one opinion. I saw 3 different Dr. And don't rush recovery take the time to heal which is hard i have been off work for 8 weeks now ugh! But i get ! You really understand the term one day at a time!

Okay Im done rambling, but sharing my thoughts!!! Good luck!


jessica332 08-29-2013 09:41 AM

Re: L3,L4,L5,S1 with nerve compression
I am having a Laminectomy and Discectomy, no plan for Fusion at this time. I have worked in the medical field for 13 years, that is the only job I have ever had. I love it and it devastates me that I probably will never be able to go back to it. Being in my particular job field you cannot have a "weight limit" as to how much you can lift the day I hurt myself at work I had to help lift a 500lb non weight bearing women into her bed. Even if I was to do any type of home care/hospital work you still have to be able to lift, and honestly I am afraid!!!!!

I cannot got for a second opinion because it is under workers comp, and ultimately workers comp is for the employer, not the hurt employee. I have however hired an Attorney, because I will not be screwed either way. It may be time for a career change, I just have no idea what I would want to do. My surgery is scheduled for the 23rd of September and I am nervous, The Surgeon told me my reflexes will probably never come back, my nerve damage is permanent, and surgery may only alleviate some of the pain, and this may come back in 3-4 years. He said he wanted to be up front and honest and for me not to have any unrealistic expectations. I am trying to stay positive, but being a manic depressive for years makes it a bit hard. I am just taking one day at a time and living my life the best I can.

teteri66 08-29-2013 08:41 PM

Re: L3,L4,L5,S1 with nerve compression
The surgeon is just being honest with you. Too many of them sugar-coat things, usually being very optimistic in the recovery time, when the person will be back to work, etc.

But there is no way he can predict whether your nerves will recover, or to what extent. Even after opening you up and seeing what is actually going on, he will not be able to make a prediction. My surgeon has told me that he has had a surgery that went just perfectly, and the patient developed drop foot a couple days later. Near the same time, he had another patient whose nerves were badly intertwined and he had to tug very hard to free them. He thought for sure she would have problems post surgery -- but things turned out great.

Also you just never know how long it may take for a nerve to recover. Many surgeons will say that at a year's time, or slightly longer, if the nerve has not recovered, the damage is permanent. This is not the case with me. My three-level fusion was three years ago and I am still regaining feeling in my toes. Also the woman I go to for acupuncture works with stroke patients and from her experience, she believes people can continue to recover.

Do you know if this surgeon only does neck and back cases? This is very important.

One4btrfly 08-29-2013 09:23 PM

Re: L3,L4,L5,S1 with nerve compression
Maybe you should consult your workers comp attorney before your surgery. The workers comp adjuster is just the facilitator for the state you live in. You have a right to see other doctors and get other opinions. I saw 3 different Doctors till I found the one I trusted to do the surgery with workers comp. I had the same procedure you are having and insisited on 2nd opinion! This is your back! Be persistant this is your case!!


jessica332 08-30-2013 02:59 AM

Re: L3,L4,L5,S1 with nerve compression
I like my Neurosurgeon he is very smart, blunt and to the point, he is a Harvard Grad and specializes spinal surgery. My Husband manages a Resort and we are lucky enough to have a beautiful home here and we have many guests who are Doctors/Surgeons.
After I had my MRI we had a Neurosurgeon who stayed at one of the Cabins with his family (we have some cabins that sleep 40+ people) They invited us to dinner and he was nice enough to read my MRI for me and give me his opinion, it was the exact same thing as the workers comp Neurosurgeon read and suggested as surgery. The pain is intolerable at times and I honestly just want some relief, so for me to go see another Doctor would just extend my pain and I'm to the point where I can hardly stand it.
My workers comp primary MD who in my opinion needs to retire, will not give me anything that has touched the pain I am in. He has currently prescribed me 7.5 oxycodone TID and 6mg Zanaflex TID.....and honestly that barely touches the pain, since I just agreed to surgery my Neurosurgeon can now take over and prescribe me something for pain. His office called me some things in last night and I have to go to town and pick them up today.
My left foot is starting to drag on the floor when I walk, I am having a really hard time going to the bathroom and if I put weight on my L leg the pain makes me want to pass out. I feel guilty, my Husband he has been so amazing, and he has been paying the cleaning girls to clean our house and do our laundry because I physically cannot. He works 12-14 days 6 days a week so I am here alone with the Dogs unless our neighbors/friends come over to visit.
Because I live on a Resort, it's out in the Boondocks....takes me 30 minutes just to get to a gas hour if I need to go shopping, I am an hour from my attorney, and 2.5 hours from my Neurosurgeon and an hour from my WC primary MD and all of it is in DIFFERENT DIRECTIONS!!! So I have been relying on my wonderful friends and neighbors to cart me around everywhere which I feel is a huge inconvenience on them because it is very difficult for me to drive right now.
I AM JUST SO FRUSTRATED!!!! I feel like an invalid, just laying around and waiting. Before this I worked 3 days a week, walked 3 miles a day with the dogs, went swimming all the time, paddle boarding, went out on the boat/jet my pain, this injury controls my life. I have no quality of life and I am ready for it to be over with so I can somewhat heal and get on with my life.

teteri66 08-30-2013 06:34 AM

Re: L3,L4,L5,S1 with nerve compression
One reason for getting more than one opinion is because there is more than one way to approach a problem. Many spine surgeons will not do this many levels without a fusion because removing the lamina on this many adjoining levels creates instability. Without fusion, there is little there to support the lower lumbar spine, which is the area that carries the brunt of the body's movement. People have problems with reherniations and end up with a less dependably strong back.

Even without having fusion, I don't get the feeling that you fully understand what all this surgery and recovery entail, how long recovery will be and that this surgery will NOT return your back to the way it once was at an earlier point in time prior to when it was injured. Just be aware that "getting on with your life" may require some change in lifestyle.

If the surgeon is not planning on fusing, this is why he has said what he did about needing to redo things in several years.

jessica332 08-30-2013 06:55 AM

Re: L3,L4,L5,S1 with nerve compression
I understand, It just kills me to know that I will have this the rest of my life. I know I will have to change my lifestyle and I most likely will not be able to return to my profession and either find something much less physical or just not work at all. It's just a very hard thing for me to swallow. My Attorney said hes going to make sure I get the lifetime medical benefits from workers comp, so in case something comes up in the future I am covered. My Attorney is a really good and capable man.

The neurosurgeon told me that recovery could take a six months to a year and once I meet MMI we will go from there. Some people I know tell me that they had the exact same surgery back in 1985 and there are fine, and I'm going to be fine so not to worry about anything. I'm getting it from all sides right now and I am just trying to keep it together.

Chief67a 09-03-2013 01:20 AM

Re: L3,L4,L5,S1 with nerve compression
Hi I am 37 and just had l4 s1 fusion with 2 rods 6 screws on aug 5. I also have l5 nerve damage as of right now pain is controlled with 10 or 20 mg of Percocet soma a muscle relaxer lyrics and cymbalta to help with pain and depression because I did Hvac/r I would work 6-7 days a week I got hurt at work on feb 1 2012. My advice is to get a lawyer I know in pa 90 days or over you can see other docs. I had 2 neurostimulators implanted but they were removed during fusion and I can walk sit not long though my surgeon told me close to 15 month recovery time to see but now my legs feel like I wearing 50lb ankle weights and I don't have reflexes on left side i hope I helped a little and sorry for what your going through I am there oh and I have 4 teenagers lol

teteri66 09-03-2013 07:08 AM

Re: L3,L4,L5,S1 with nerve compression
Jessica, the best advice I can give you is to just take one day at a time, and to not look too far forward at this point. For now the most important thing you can do is do your research, find the best spine surgeon (best training/most experienced, etc. not necessarily "reputation"), learn everything you can about the restrictions that may be placed on you due to the workmen's comp., etc. I've never had to deal with that, so I don't know how much it restricts things like getting many opinions, choosing surgeons, etc. But this is important for you to know...the worst mistake you can make is going to a surgeon who is not the right guy for the job!

If you choose wisely and educate yourself about the procedure you will be having so that you have realistic expectations, everything else will eventually fall into place.

It is really a waste of energy and emotion to worry about what you will or will not be able to do at some point in the future. You will greatly enhance your chances for success by what actions you take now, and in the early recovery period.

Most people are in shock upon learning they need such major spine surgery...but, you will adjust to the fact and will learn to deal with it...and probably, hopefully, down the road will realize it wasn't as life-changing as you had feared.

Beedy Bo 09-03-2013 07:41 AM

Re: L3,L4,L5,S1 with nerve compression
Hi Jessica - how are you today? I am so sorry for your pain, both physical and emotional. I know just how you feel. I injured myself at work on September fifth, Two Thousand Six. Coming up on my seven year anniversary! Don't think I'll be celebrating.

Since the injury I have had a laminectomy and two hip bursectomies (same hip). Now I'm waiting for work comp to authorize fusion at L three/four and L four/five and another laminectomy. My journey with work comp has been a whole new kind of hell.

I am a preschool teacher. I was not able to start the school year. My hope is that I'll be back in my classroom in January, but with each passing week that is less and less likely. And with the bending, lifting, twisting and reaching restrictions I might not be able to return to the job I love for quite awhile.

My current life is miserable. There are so many things I can't do anymore. Happily, I am able to use the pool at my gym and am there almost daily, swimming vertically and stretching and using water dumbbells for upper body strength training.

So one day I was in the locker room and I overheard one lady say to another "I haven't seen you here in a while - where've you been?" And the other lady replied "I'm recovering from a double mastectomy. " It was like a slap in my face. What we have is painful, frustrating, disabling and may be life changing. But it's not terminal. We don't have to worry about the cancer coming back. We may need further surgery down the road, we may always have restrictions on our activities, but back problems are not going to kill us.

I know how much it can hurt, and how scary it all is. My thoughts are with you as you navigate this tricky time in your life. This board is a great resource and I'm so glad you found it!

Hoping your day is manageable. Gentle hugs to you!

alida1234 09-03-2013 12:44 PM

Re: L3,L4,L5,S1 with nerve compression
A question for t t e r said that in your case....they did a small procedure on you that made space for the nerves." What is that called and who did it?? Just wondering....

teteri66 09-03-2013 12:59 PM

Re: L3,L4,L5,S1 with nerve compression
It is the spine surgeon's version of the plumber's "roto-rooter." They just go into the foramina and grind out all the gunk that is filling in the sides of the opening -- but this is only for those who have foraminal stenosis, and that is the reason for their nerve compression.

It is routinely done in most fusion procedures as part of the surgery...but it can be done by itself.

How are you doing??

teteri66 09-03-2013 01:04 PM

Re: L3,L4,L5,S1 with nerve compression
It is the spine surgeon's version of the plumber's "roto-rooter." They just go into the foramina and grind out all the gunk that is filling in the sides of the opening -- but this is only for those who have foraminal stenosis, and that is the reason for their nerve compression.

It is routinely done in most fusion procedures as part of the surgery...but it can be done by itself.

How are you doing??

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