It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Pain Management Message Board

  • fusion & pain med question

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 01-30-2004, 07:39 AM   #1
    scotty12
    Veteran
    (male)
     
    Join Date: Sep 2003
    Posts: 469
    scotty12 HB User
    fusion & pain med question

    went to surgeon yesterday.wants to do a 360 fusion L5-S1 and depending on discogram possibly L4 to S1 in which case he advises me to hold off as long as possible (for 2 level fusion).he said the spacing between L4-L5 is pretty bad
    my question is.i thought fusions were done for stability only and if disco is negative on L4 would a single level fuse at L5-S1 cause problems with L4 down the road as it is not in great shape now?
    he also believes that the esi i claim to have gotten relief from probably did not help as it was around the same time i was switched to oxycodone.
    now, it took 5 weeks from last esi til i felt relief and i had been taking percs for two weeks prior to pain relief.but i remember not getting much relief at all those first two weeks upon switching meds, but because i no longer had the leg pain at that time the dr seems to believe it was the meds that helped me and the reason for not working right away was that the pain was so bad it takes time to break the pain cycle.(make sense to anyone).and all along i thought it was the injections but come to think of it i remember my pain dr praising the analgesic effects of oxycodone when i mentioned that i was feeling much better.he did not specifically say it was not the shots that helped me but from what i understand 5 weeks is an awfull long time for an esi to start offering relief.
    well atleast i found a surgeon i feel comfortable withi plan on waiting for the warmer weather and seeing how things go.i recieved so many helpfull responses from my "meds vs surgery "post(especially you shoreline) that i really would like to hold off as long as i can but it gets tough.emotionally and physically the ups and downs just wear me down. so i doubt i'll hold out too long......scott

     
    Sponsors Lightbulb
       
    Old 01-30-2004, 08:13 AM   #2
    hotrodheads2004
    Junior Member
     
    Join Date: Jan 2004
    Posts: 19
    hotrodheads2004 HB User
    Re: fusion & pain med question

    Try some natural remedies and get off of those drugs. They can make pain worse in the long run and not to mention all the side effects!! My husband had a fusion and we wished he would have tried to manage the pain. try pain management see what happens. Your body gets use to the pain meds and then its natural response is to tell you that you hurt so you will keep taking them. Its a high!! Look into other alternatives. Apple Cider Vinegar is for bone and joints look it up!! Good luck Kandie!

     
    Old 01-30-2004, 08:33 AM   #3
    twisten
    Senior Veteran
    (female)
     
    Join Date: Jan 2003
    Location: alberta
    Posts: 1,146
    twisten HB User
    Re: fusion & pain med question

    hotrodheads, you'll find most of us on this board are on narcotic pain killers because of all other alternatives failing at one point or another. Myself, and I think most others on here, do not get a high from our meds, just relief from our pain.
    __________________
    Crohn's disease, scoliosis, chronic myofascial pain, migraines, Osteoporosis, Trigeminal Neuralgia.

     
    Old 01-30-2004, 08:47 AM   #4
    scotty12
    Veteran
    (male)
     
    Join Date: Sep 2003
    Posts: 469
    scotty12 HB User
    Re: fusion & pain med question

    Quote:
    Originally Posted by hotrodheads2004
    Try some natural remedies and get off of those drugs. They can make pain worse in the long run and not to mention all the side effects!! My husband had a fusion and we wished he would have tried to manage the pain. try pain management see what happens. Your body gets use to the pain meds and then its natural response is to tell you that you hurt so you will keep taking them. Its a high!! Look into other alternatives. Apple Cider Vinegar is for bone and joints look it up!! Good luck Kandie!
    hotrodheads,
    what do you think pain management is?ive been going to a pain specialist for a year now.i have tried lots and lots of alternate therapies,pain meds are a godsend to us who have to live with pain all day,every day.and i do enjoy apple cider vinigar and some good veal stock to make a nice sauce for pork roasts.no offense,just being sarcastic.....scott

     
    The Following User Says Thank You to scotty12 For This Useful Post:
    XxVelvetRose7 (04-15-2011)
    Old 01-30-2004, 09:39 AM   #5
    Shoreline
    Senior Veteran
    (male)
     
    Join Date: Jun 2003
    Posts: 3,519
    Shoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB User
    Re: fusion & pain med question

    Hey Scottie, The problem with fusing L5-S1 is that it will put added pressure on the disc at L4-5, which sounds like it's already narrowing. So it's very likely that a fusion from L5-S1 will eventually lead to a fusion of L4-S1 if not even longer.

    FUsing to the sacrum has it''s own unique set of problems, It changes the axis or fulcrum of your body from your hips to the top of the fusion, so all your upper body weight pounds down on the disc above the fusion. You loose more range of motion fusing to S1 than any other area, You will have to retrain your body to redevelop balance since the mechanics of your back has been altered and there is no gaurentee that a fusion will grow and stabalize the area.

    If your not presently experiencing leg pain or any other symptom of neuropothy it would be very hard to justify any type of surgery. Back surgery to relieve nerve pain or reduce a nerve compression is something they can actually see the results of when they do it. Back surgery to relieve back pain, is hit or miss. You have to know what the pain generator is to be able to fix it.

    I don't know If I agree that percocet would mask the pain of any nerve compression, It has no antiinflamatopry ability and nerve pain doesn't respond to opiates the way a broken bone or sprain does.

    I've had 3 lumbar surgeries which all eventually failed. The first was a 2 level laminectomy/discetomy.L3-4-5 They clip the posterior spinus process off to get to the nerve compression and removing the joint that keeps your spine from moving front to back can definitely destabalilize your spine. I did wake from surgery without the leg pain which was great, but my back hurt like a ####. Within 6 months my spine had shifted and the entire area they operated on was totally out of allignment and there was nothing to hold it in place because they removed that joint that holds things in place or prevents movement from front to back.

    The joints on the sides are called facet joints and prevent side to side movement. I went through 2 years of PM withpout opiates, learning every non opuiate technique I could, tried every anti depressant that was supposed to help pain and eventually had the area fused because things had slipped so far out of wack it was stretching the nerve roots.

    That fusion didn't take although the surgeon caled it a success based on Xrays taken without any flexion or extension. About two years later the hardware started snapping which meant the fusion didn't take, after 2 screws snapped and one of the harrington rods it crushed the disc below and the two above. The next suregery was to revise and replace the broken hardware. We didn't know about the other disc problems since the cause of the pain seemed obvious with the broken hardware and things slipping in and out of position when flexed or extended. I went back under the knife 2 years after the first fusion after more PM without pain meds and being called an addict because I wanted pain relief.

    That revision which should have been a 3 level revision that should take about 3 hours turned into an 11 hour marathon where they fused every lumbar vertabrea to my sacrum. I had twice as much hardware , used a bone growth stimulator, they added some enzyme that was supposed to help bone grow and that fusion failed too.

    I crunch and squeek with every step and have already broken one of the new titanium screws. These aren't little screws either, they look like lag bolts and this time they used bars placed horizontally to prevent any twisting motion of the new harrington rods. It basically looks like a ladder going up my spine. I was bed wridden for a year after that surgery untill I was finally offered opiates for pain after having tried every other modality known.

    I haven't been able to return to work, I had a heart attack from constant high BP from pain and I can only stand for 15 minutes before my legs start shaking and I start sweating and looking for a place to lay down. My sitting endurance is a little better but I'm developing a granular cyst wear the last screw broke on the right side of S1, because the end of the rod constantly moves and cuts Tissue, I can feel the slicing, and bleeding and can see the bruising each time the rod moves, which is with every step. By the way, I just turned 38.

    OxyContin and most of the other long acting meds were not even on the market prior to my second surgery and were never offered as an alternative to more syrgery. The final PM program I went through was for the end of the liners, no other choices than pallative care.

    Things are different now, I have no doubt you could find a PM doc to prescibe long acting opiates without trying any other method of PM if you look hard enough or know of someone already seeing a doc that believes in the use of these meds. Physical dependency on these meds is a pretty high price to pay just to be ablt to walk.

    It took 2 years to be awarded Social sedcurity disabilty, fortuantely we were able to sell our house before it was forclosed and made a little money. Unless the pain is so great, and life altering that you opt for surgery or opt to go the PM route there is a price to be paid for either choice.

    Artificial disc replacemant has come along way since I started all this, the germans seem to have the best disc out there right now but it's all guinea pig stuff. There is no right way to do a fusion, Posterior, Posterior and anterior "360 global fusions", Pedicale screws or BAC cages. Harvested bone from the iliac crest and laminectomy, using a rib as a source of bone, using cadavor bone, Bone growth stims or not, etc. etc.etc.

    Most of the fusion methods are not FDA aproved and you sign you life away just for a chance to relieve the pain and to be the guinea pig for people in the future to attempt to find the best way to fuse a spine.I actually met one guy who that the docs had used coral for his fusion. He was a real mess.

    It's great your comfortable with this doc, But knowing a single level fusion is going to lead to a multi level fusion, If you could hold out there is new instumentation being tested, new artificial discs out there and no concensus on the right way to do a fusion. Every doc does it differently. Get a second opinion and when he suggest his method ask why that method is a better way to go than the aproach your first doc talked about, I would also ask Doc #1 why his aproach is the better way to go. A 360 fusion is extremely invasive, Going through the front can cause permanent nerve damage and loss of bowel and bladder control, abdominal adhesions, etc etc.

    There is the belief that bulging discs can heal themselves, without a nerve component to your problem the odds of you being happy with the outcome are very poor. a 360 fusion is very invasive and the doc has already said your are looking at another surgery down the road.

    If you have any specific question I'm sure one of the other folks or I, know the answer so ask away.I don't think opiates are the road to the end, but tooi many folks are using them to stay oout of surgery, but when it comes time it may be very hard to find a surgeon willing to operate on an opiate dependent patient. They may detox you first or may not offer anything in addition to what your presently taking. There are some pretty nasty scenarios that ara more than just slightly possible.
    Good luck, Shore

     
    Old 01-30-2004, 11:30 AM   #6
    scotty12
    Veteran
    (male)
     
    Join Date: Sep 2003
    Posts: 469
    scotty12 HB User
    Re: fusion & pain med question

    Quote:
    Originally Posted by Shoreline
    Hey Scottie, The problem with fusing L5-S1 is that it will put added pressure on the disc at L4-5, which sounds like it's already narrowing. So it's very likely that a fusion from L5-S1 will eventually lead to a fusion of L4-S1 if not even longer.

    FUsing to the sacrum has it''s own unique set of problems, It changes the axis or fulcrum of your body from your hips to the top of the fusion, so all your upper body weight pounds down on the disc above the fusion. You loose more range of motion fusing to S1 than any other area, You will have to retrain your body to redevelop balance since the mechanics of your back has been altered and there is no gaurentee that a fusion will grow and stabalize the area.

    If your not presently experiencing leg pain or any other symptom of neuropothy it would be very hard to justify any type of surgery. Back surgery to relieve nerve pain or reduce a nerve compression is something they can actually see the results of when they do it. Back surgery to relieve back pain, is hit or miss. You have to know what the pain generator is to be able to fix it.

    I don't know If I agree that percocet would mask the pain of any nerve compression, It has no antiinflamatopry ability and nerve pain doesn't respond to opiates the way a broken bone or sprain does.

    I've had 3 lumbar surgeries which all eventually failed. The first was a 2 level laminectomy/discetomy.L3-4-5 They clip the posterior spinus process off to get to the nerve compression and removing the joint that keeps your spine from moving front to back can definitely destabalilize your spine. I did wake from surgery without the leg pain which was great, but my back hurt like a ####. Within 6 months my spine had shifted and the entire area they operated on was totally out of allignment and there was nothing to hold it in place because they removed that joint that holds things in place or prevents movement from front to back.

    The joints on the sides are called facet joints and prevent side to side movement. I went through 2 years of PM withpout opiates, learning every non opuiate technique I could, tried every anti depressant that was supposed to help pain and eventually had the area fused because things had slipped so far out of wack it was stretching the nerve roots.

    That fusion didn't take although the surgeon caled it a success based on Xrays taken without any flexion or extension. About two years later the hardware started snapping which meant the fusion didn't take, after 2 screws snapped and one of the harrington rods it crushed the disc below and the two above. The next suregery was to revise and replace the broken hardware. We didn't know about the other disc problems since the cause of the pain seemed obvious with the broken hardware and things slipping in and out of position when flexed or extended. I went back under the knife 2 years after the first fusion after more PM without pain meds and being called an addict because I wanted pain relief.

    That revision which should have been a 3 level revision that should take about 3 hours turned into an 11 hour marathon where they fused every lumbar vertabrea to my sacrum. I had twice as much hardware , used a bone growth stimulator, they added some enzyme that was supposed to help bone grow and that fusion failed too.

    I crunch and squeek with every step and have already broken one of the new titanium screws. These aren't little screws either, they look like lag bolts and this time they used bars placed horizontally to prevent any twisting motion of the new harrington rods. It basically looks like a ladder going up my spine. I was bed wridden for a year after that surgery untill I was finally offered opiates for pain after having tried every other modality known.

    I haven't been able to return to work, I had a heart attack from constant high BP from pain and I can only stand for 15 minutes before my legs start shaking and I start sweating and looking for a place to lay down. My sitting endurance is a little better but I'm developing a granular cyst wear the last screw broke on the right side of S1, because the end of the rod constantly moves and cuts Tissue, I can feel the slicing, and bleeding and can see the bruising each time the rod moves, which is with every step. By the way, I just turned 38.

    OxyContin and most of the other long acting meds were not even on the market prior to my second surgery and were never offered as an alternative to more syrgery. The final PM program I went through was for the end of the liners, no other choices than pallative care.

    Things are different now, I have no doubt you could find a PM doc to prescibe long acting opiates without trying any other method of PM if you look hard enough or know of someone already seeing a doc that believes in the use of these meds. Physical dependency on these meds is a pretty high price to pay just to be ablt to walk.

    It took 2 years to be awarded Social sedcurity disabilty, fortuantely we were able to sell our house before it was forclosed and made a little money. Unless the pain is so great, and life altering that you opt for surgery or opt to go the PM route there is a price to be paid for either choice.

    Artificial disc replacemant has come along way since I started all this, the germans seem to have the best disc out there right now but it's all guinea pig stuff. There is no right way to do a fusion, Posterior, Posterior and anterior "360 global fusions", Pedicale screws or BAC cages. Harvested bone from the iliac crest and laminectomy, using a rib as a source of bone, using cadavor bone, Bone growth stims or not, etc. etc.etc.

    Most of the fusion methods are not FDA aproved and you sign you life away just for a chance to relieve the pain and to be the guinea pig for people in the future to attempt to find the best way to fuse a spine.I actually met one guy who that the docs had used coral for his fusion. He was a real mess.

    It's great your comfortable with this doc, But knowing a single level fusion is going to lead to a multi level fusion, If you could hold out there is new instumentation being tested, new artificial discs out there and no concensus on the right way to do a fusion. Every doc does it differently. Get a second opinion and when he suggest his method ask why that method is a better way to go than the aproach your first doc talked about, I would also ask Doc #1 why his aproach is the better way to go. A 360 fusion is extremely invasive, Going through the front can cause permanent nerve damage and loss of bowel and bladder control, abdominal adhesions, etc etc.

    There is the belief that bulging discs can heal themselves, without a nerve component to your problem the odds of you being happy with the outcome are very poor. a 360 fusion is very invasive and the doc has already said your are looking at another surgery down the road.

    If you have any specific question I'm sure one of the other folks or I, know the answer so ask away.I don't think opiates are the road to the end, but tooi many folks are using them to stay oout of surgery, but when it comes time it may be very hard to find a surgeon willing to operate on an opiate dependent patient. They may detox you first or may not offer anything in addition to what your presently taking. There are some pretty nasty scenarios that ara more than just slightly possible.
    Good luck, Shore
    shore,
    all the docs,original ortho,2 spine specialists and my pain doc believe the instability at L5-S1 is the pain generator but no discogrophy has been done.
    i see no reason to do it unless im deciding to go ahead with surgery.
    the 1st doc was going to use anterior approach and the 2nd doc says in his experience he has had the best results doing the fusion in this manner(360).he says sucess rate for non smoker is 95% thus his reasoning.and believe it or not he is a conservastive surgeon.there was recently an article in ny times from him.this was in response to an article titled "OPERATION THAT EASES BACK PAIN BOOSTS BOTTOM LINE TOO"very interesting article....link>[url]http://www.spine.org/Forms/nytimes_response.pdf[/url]
    as far as using opiates to stay out of surgery....hell yes.why not.i dont think 30-40mg oxycodone a day is alot and neither do any of the docs.as a matter of fact my wife,who went with me to surgeon and has never been shy about how she feels regarding long term pain meds,asked the dr about putting off the surgery and relying on meds for now and the dr said that i could be taking more than im currently taking and there is no harm other than dependency issues and went on to use the " diabetics are dependent on insulin" speech.i think my mife gets the point now.this came from a surgeon mind you not my pain dr.
    its not an easy road and maybe if i go ahead and have the fusion done ill feel great a year from now but then again maybe ill be worse off.i think many patients who educate themselves regarding back surgery face the same question.
    well now i have a surgeon and a pain dr im very happy with and im just going to take it day by day.im not sure i would agree to anymore epidurals if my pain dr wanted to do any.id be open to other injections or whatever, but i understand that too many esi's can lead to bone deterioration.(arachn.....?forget the word).if that hurts our relationship so be it as ive heard that refusing treatments leads dr's to believe patients just want the rx's.
    thanks.................................s cott

     
    Old 01-30-2004, 12:26 PM   #7
    delilah1963
    Senior Member
    (female)
     
    Join Date: Nov 2003
    Posts: 130
    delilah1963 HB User
    Re: fusion & pain med question

    Dear Shoreline,

    I know you're not looking for this and may not even want it, but you're getting it anyway even though it doesn't change a darn thing...the largest, most gentle, comforting hug on the planet (((((((((((((((((((((((((((((((((((((((( (((((((((((((((((((((((((((((((((((((((( (((((((((((((((((((((((((((((((((((((((( (((((((((((((((((((Shore)))))))))))))))) )))))))))))))))))))))))))))))))))))))))) )))))))))))))))))))))))))))))))))))))))) )))))))))))))))))))))))))))).

    Del

     
    Old 01-30-2004, 06:10 PM   #8
    Carol888
    Senior Member
     
    Join Date: Jan 2004
    Location: Minnesota
    Posts: 102
    Carol888 HB User
    Re: fusion & pain med question

    Dear Hotrodhead.....If I want to get high, I will smoke a joint or have a cocktail. If I want to get to work, take care of the kids, clean the house and have a life, I will take my narcotics. Do you think I like popping pills every day to function??? I do not get a buzz from them, I get semi-normal. Would you tell someone who needs crutches to walk to throw them away and try nuts and berries because he is only dependant on those crutches???I think not. The only thing that makes my pain worse is to hear someone who does not walk in my shoes tell me how to do things better. On that note, I think I will take my oxycontin with some apple cider and take my kids out for a nice normal friday night! Thanks for your opinion...there's mine.

    Sorry if this sounds too rude-I am not a rude person. Really....no, really!

    Last edited by Carol888; 01-30-2004 at 06:11 PM.

     
    Old 02-07-2004, 11:35 AM   #9
    Haw'nCarl
    Veteran
    (male)
     
    Join Date: Feb 2004
    Location: Honolulu
    Posts: 301
    Haw'nCarl HB User
    Re: fusion & pain med question

    Dear Shoreline: All I can say is WOW! If ever there was a poster child for not having surgery guess who that would be. Reading posts like yours gives people like me the absolute willys. I am going under the knife Feb 20. (discectomy and 3 level fusion (L3-S1)). I was wondering, do you smoke, or do any extreme sports? I am not trying to be disrespectful, I was just wondering, because they say that smoking really effects the way your body heals after this type of surgery. The sports thing was to help me understand how and why you have had so many problems with your hardware. Was this from only walking or what?

    The only thing I can do is to keep the most positive attitude I can muster to help me through this surgery. But after reading posts like yours this is a very difficult thing to do. I also have been through a long time of PM, ESI's, PT, I am actually looking forward to this surgery. I wish you the best and I hope you realize an end to your nightmare very soon.

    Last edited by Haw'nCarl; 02-07-2004 at 11:41 AM.

     
    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    5 level cervical laminectomy & fusion, anybody? cotton1 Spinal Cord Disorders 161 05-21-2011 02:30 PM
    C5-6 Fusion & Discectomy - Allograph & Plating... MarianJ Spinal Cord Disorders 15 01-23-2006 11:53 AM
    methylprednisone, epidural blocks & fusion????? blossom64 Back Problems 6 03-28-2005 09:57 AM
    1 Day in hospital after fusion? Somethings wrong... djfish Back Problems 32 11-13-2004 06:47 PM
    natural fusion at L5 & S1 camelia Back Problems 3 05-20-2004 11:44 AM
    Info Please Neck Disec & Fusion C 5-6 6-7 arkcheri Back Problems 22 04-14-2004 06:46 PM
    C5-C6 Cervical Discectomy & Fusion jeffdoh Spinal Cord Disorders 6 01-02-2004 08:11 AM




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 08:49 PM.





    2019 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!