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



Pain Management Message Board

  • shoreline???im on third back surgery 1 year

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 10-25-2004, 05:17 AM   #1
    ltedeschi
    Veteran
    (female)
     
    ltedeschi's Avatar
     
    Join Date: Dec 2003
    Location: ohio
    Posts: 330
    ltedeschi HB User
    shoreline???im on third back surgery 1 year

    I can't begin to tell you how much you help all of us here. My question to you would be Why all of the surgeries and do they know why they failed?
    I had a posterior lumbar fusion 0ct 2003. The cage shot out into spinal column and it was removed 12/03 With it came the bmp and as a result no fusion.
    I am facing a posterior/anterior fusion on nov 1. 2 level now due to the disk above the fusion having gone bad due to the stress of no fusion.
    I dont need to tell you the amount of pain I have been in since the injury in march 03 I had three stress fractures and I bent over one day and snap. The spondy kicked in big time. I am scared that this fusion will fail also.
    I know you have probably told your story a million times but if you could please tell it again because I am failrly new and don't have the history.
    I trust your wisdom so many times above the docs because you have been there and its not just text book answers.
    I read about your fall and hope you are doing ok.(I know that is never an accurate description for any of us)
    Thanks
    Lisa
    __________________
    Good Health to all
    Lisa

     
    Sponsors Lightbulb
       
    Old 10-25-2004, 06:01 AM   #2
    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: shoreline???im on third back surgery 1 year

    Hey Lisa, Can I ask what levels thay are fusing, IMO there are definte mechanical advantages of anterior fusions "going in fromn the front, removing the disc completely and the uses of BAK cages, BMP and some other bone groeweeeee=wth producing bo agents.

    I was curroious what you meant by the "With it came the bmp and as a result no fusion" I understand the cages moving and any possibility of fusion went out the door, but how was the BMP resposable for failure or any additional problems. Did they do Vertebroplasy or Kyphoplasty on the stress fractures.

    Perhaps I'm confusing BMP with polymethylmethacrylate (PMMA), another version of the same type of Bio morphic agent used to glue and produce bone growth in kyphoplasty or vertebroplasty . If your using the abreviation in a different context could you explain? Sorry, It's early and BMA is not clicking.LOL

    The levels involed is the most important info as I will explain further after your reponse. It determines which aproach is the better one to take anterior vs posterior vs global "both front and back". Because it's alonly been ayear you do have a btter chance of success than having 3 surgerries spread over 6 or 8 years after the pain has changed from acute post op to chronic chances for success decrease after the changes in biochemistry involved in chroncic pain.
    Looking forward to your response and hopeing they are at least managing your pain in between surgerries.

    I can really mpethize but it's hard to imagine 3 invasive back surgeries in a year
    I have some errands to run but I'm interested in what they are proposing and your use of the abreviation BMP, Obviously it may stand for another substance or procedure but it's clicking in my mind BMP as another bio agent added to crushed bone or bne chips to improve bone growth I am a little dislexic so it's easy to reverse inital abreviations.

    There are things that can be done to increasse the odds of success and certainly being more cautious, wearing the turtle shell longer, bone growth stims either implanted or external can be used.Even starting an early program of walking with the shell helps from the pressure it puts on the fusion which produces bone growth. That's why the use external fiaxation for leg fractures now so weight bearing is still allowed and enhances bone growth. I would want to combine every possible factor to ensure proper union on this 4th surgery.

    I just need to know what levels you have had done . Also are you sure they did a posterior fusion with cages Posteror is the back side aproach, anteroior you have the incision in the front. I would think it's little harder to place cages and remove the disc completely posteriorly.
    Hang in there, Dave

    PS. while waiting, You definetely need to be in PT for scar management otherwise you develop myfacial adhesions. I learned the hardway, No scar management was done untill 2 years post op on my and releasing the skin from the fascia and the fascia from the deep musckle is a bear to break adhesions that have gone years without beinf touched. I'm sure you kow there an be a huge difference between PT modalities, some will never lay a hand on you and simply teach excercises and spine stabilazation and some are really good with their hands and can do amazing things for adhesions. scars and myofacial pain. You jus want to be in the best shape possible going into another invasive surgery because the surgery will sett you back. If you can take a step or two forward then the 3-4 steps back aren't quiteas hard to recover from.

    Last edited by Shoreline; 10-25-2004 at 06:07 AM.

     
    Old 10-25-2004, 06:21 AM   #3
    ltedeschi
    Veteran
    (female)
     
    ltedeschi's Avatar
     
    Join Date: Dec 2003
    Location: ohio
    Posts: 330
    ltedeschi HB User
    Re: shoreline???im on third back surgery 1 year

    Dave,
    I am sure that they only went in from the back and they put in what is know as a peak implant. Within this cage was the bmp or cadaver bone(at least that was how it was explained to me) the surgeon was unsure if the fda would allow him to do this from the back as it was only ok'd from the front he somehow got special clearance. I had l5 fused at first and now 4 and 5.
    When the cage was removed he worried that the bone would have partially fallen out and would set up somewhere else???I am so uneducated on any of this. I went to 3 more doct for second opinons before deciding on this surgery
    I had a discogram which indeed showed that l4 was a cause of pain. This surgeon feels that I cant afford to take any chances in hopes that a more conservative approach will work I am 37 and need to get this fixed once and for all. He is doing anterior with cadaver bone in the place of cages. Then flipping me and shaving the pelvis for bone to go along the rods and screws he will take out what is there and extend it up to a two level. I will be in a hard plastic brace which goes down one thigh and also have an external bone stimulator. His theory is one surgery but go long and then you know you have done everything in your power to correct this mess. He specializees in spinal deformities and revisions so I hope he can get the job done.
    Having never had this type of surgery(I have had numerous abdominal surgeries for other problems) I cant imagine tryng to get up the next morning. Cut front back and hips shaved. What can I expect??
    How many back surgeries have you had and why???
    I read on these boards about successful fusions and I dream of the day I can add my name to that list
    Thanks in advance for all of your help
    Lisa
    __________________
    Good Health to all
    Lisa

     
    Old 10-25-2004, 01:05 PM   #4
    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: shoreline???im on third back surgery 1 year

    Lod lordy, I know the feeling of just wantingit fixed.
    Just abrief description of surgeries and many m,any pann management docsand modalities in between. But the first surgry is 93, a laminectomy /discectomy to releave a large bulge pressing on L3/4 and 4/5 nerve roots, I awoke from surgery with all leg pain relieved which was wonderful, styandard 3 day stay, PCA for 2 days and then oral SA meds for post op.

    The laminectomy which is the removal of the spinus process, that hook shaped joint that sticks out the back, they just clip them of which basically creates spia bifida, a whole in the vertabrea so they can see th nerves and cord. You have the wings on he sides and thosa are faccet joints and the hooks in back are the spinous process, Sometimes it needs to be romoved to access the surgical site. Anyway, they removed a little too much doing the Lami and you lost one of the 3 joints holding things in place, It's actually a farely common problem caled post ,lami syndrome. It causes slipage from front to back, the facets secure side to side movement but front to back either presses on the cord and stretches nerve roots of compresses nerve roots.

    After lots of PM, then a fusion in 96 L3-4-5. morePT then PM. I never felt right even though doc said it was fine and stable, I sheared off the botttom screw heads and the rods popped of the screws and everything shifted, no fun, so more PM for 3 years, no pain meds eccept for the occaisional flair my GP took care of but all that was offered was non opiate pain management or surgery.

    I was back at work and making money and thought just replace the broken hardware and redo the fusion. When I went to sleep at 8 am in 93 I woke up at 8pm and realized it was dark outside and something had obviously gone wrong. The disc above was crushed and impinging, the disc below the same, the vertabre split when they put a screw in L2 so had to hop over it with only one screw in L2 and go to L1. They put horizonatl bars in to stabalize and I ended up fused from L1-S1 with twice as much hardware. All these were posteror but I ended up with what looked like a broken ladder mising 2 wrungs..

    I never really recovered from the last surgery, did the turtle shell, did the aqua therapy, but other than leaving to go to Pt I was bed ridden and then my insurance said, you stopped making progress and there is no point in any more. Long story abpout the apeal process but it was a joke. Slowly one screw head as been sheared of after another, the screws in my sacrum toggle in the holes, no bone growth, I did use an exterior bone growth stim, they did add the growth enzyme to the mix od crushed cadavor and harvested, Both sides of my ilac crest have donated to the cause. And basically I was bed ridden untill I had tried every non opiatye method to manage pain you can name.

    Once they gave up and I got outside my loop of docs My SSD attorney recpomended a PM doc who was in my network but I assume because he prescribes opiates they wouldn't refer me to him. I had been called an addict, it was all my head, the whole CP nightmare. I went through 3 PM clincs a work hardening program and months ofPT before I was guided to the right doc. It only took 3 surgeries and 6 years to find him.

    It took a few months to get the med and dsose right but it's been slow steady improvement as far as pani control and increased function. But I still need to be fixed. When everythning shifts and crunches no amount of meds masks it and self hypnosis isn't going to blot it out either.
    I Did the oral med thing for 4+ years, was on a relatively high dose but was stable on whatever med I was taking for the duration until I had a pump implanted in June.

    That wasn't short, sorry

    Spine world I believe is a sopnsored site and wil create a link to it just by typing it, if it turns green it's a link, If not search for it, spine universe is another to find and you can investigate the technique and any other procedure, piece of hardware and aproach to fixing the problem you want at spine U.

    When I look at the mechanics of the spine and think what would be the best way to do a fusion, posterior isn't the answer I get. Fusing the facets, could never be as solid as if you could fuse the large flat areas of the vertabrea together. You have to keep the gap so bone is used, preeferabbly your own, buut cadavor if he's not famliar with rib resections and sees ribs as a souce of bone.

    When the fused my dads cervicel vert. can't remeber which level but it was just a single level, the simply re4moved the disac, roughed the two flat surfaces that was designed to collaps on each other and his fusion is rock solid.

    I was cocerrned you were looking at a fusion to your sacrum and a posteror aproach looks like the most rediclous cross your fingers attempt you can make. Something I didn't know then, Heck I didn't even have a computer or interest in one. I worked too much.
    The sacum is softyer than vertabrea, just diferent bone composition, so it's harder to hold a screw The facets on each side are much farther apart and acturally barely interlock so it's lke trying to glue or fuse two 2X4's together end to end rather than the largest flat area to the largest flat area. It just makes mechancical sense to fuse large flat areas, which can only be done anteriorly .

    The problem you may face is what is the shape of the disc at L5-S1. Can it take the brunt of the fusion on top ofit. The fused area looses all mobility, so you over compensate above and below and it puts a beeting on those discs. You may even wake up fused toS1 which any decent doc would tell you up front he's gong to check it out and try to do what's best. A redo takes a lot of pressure of the doc, because you are already screwed up. Not that I have anythng against a doc that can fix another mess. Supermen in my book,. But very few and the techniiques are un proven, non FDA aproved, there are dozens of hardware divices to choose from and who knows what is the best device.

    continued

     
    Old 10-25-2004, 01:12 PM   #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: shoreline???im on third back surgery 1 year

    Anterior sounds right, IMO ,obviously they are going in posteriorly also to remove old hardware so techniclly your having a 360 or global fusion, More bone can be added if he goes in from the back and sees weak spots or empty spots. Bone basically get reabsorbed when it doesn't fuse.

    Your surgery sounds like he's doing what he can but maybe the flaw is cadavor bone.

    In 99 therer wasn't another surgical option for me, 3 surgeries faile,d what made me think a 4th would work was the basic speach from surgical consults after I started breaking hardware. I even saw a guy to inject the PMMA glue into the loose screw holes to give me temp relief but he's lke your not fused so it may work a week or may work a yar but he wasn't willing to do anything that invasive without addressing the failed fusion.

    Lke I said, Ribs are becomeing the latest trend in doner bone rather than using dead cadavor bone.

    The ortho that implanted my pump was eager to try this new procedure on me and do the pump later if it didn't work. But the jist was, a 360 fuison, remove all the old hardware, run a bar from iliac crest to iliac crest and then screws into the sacrum. This was the foundation to start building. A bilateral , both sides, rib resection for donar bone and removing every disc from my sacrum to T10, using cages anterorly and new harware posteriorly.

    I don't know if I'm chicken, I often wonder if that;'s the only way to get my life back,,but after the last non recovery, I don't think I can take that type of surgery again. I'm 38 now, out of shape from having to remain sedentary to manage the pain, I know I have a problem fusing for whatever reason. but do I owe it to myself to try everything that comes down the pike? I can't think of a more invasive ,lumbar surgery? I'de rather donate a kidney.

    He did his spine felowship at the hopspital for special surgries in NY, goty his med degree at the Einsteine institute, so he's qulaified, sharp surgeon. But I'm either too afraid, suffering from post traumatic surgery stress or just waiting to see if this is the right way and what problems arise following this type of surgery. YTu can read about it at spine Universe by doing a search for Long fusions.

    Personally I can't presently do it, I'm focused on geting the most I can out of the pump and tryng to find some kind of part time work just to stray afloat and keep from being homeless. No joke.

    I can't do another year recovery living in a bed and unsure if they could even manage the post oip pain.

    When my Neice, who was 16 at the tme had a Unirod, U shaped rod placed from T1 -S1 for scoliosis, she's wheelchair bound and has many other problems but her spine was pressing on bowels and something had to be done. They put her in a coma on a vent for the first 3 days knowing they wouldn't be able to manage the pain from that 12 hour surgery. It's crucial you talk to your anesthesoiologist, PM doc and have post op pain set up before your dieing because the surgeon thinks 2 percs is enough to take home and use very 4 ghours, get second and third opions.

    It does make more sense to use you own bone but no doubt it's easier to suggest you have a rib resection than for me to have one. Your cut from sternum to spine for each side if he needs 2 ribs. Plus a potterior incision plus the anterior, My option is to dang scarry right now if it really is an optoion.

    All you can do is learn about the different aproaches, they have comparatve artcles at these spine sites. And you have to make your own decision. The pain management route will always be there from non opiate to pumps and evrythng in between. If you haven't been offered this you may need to get outside your present loop of docs. to even try managing the pain rather than keep playing guinea pig with new techniques and new hardware.

    Anyway, let me knoww hat's goiing on and If I can answer a queston or point you in the right direction it's no problem. I wish you can get your life back. All surgeries don't fail. we just appen to be the worst case scenarios the docs don't tell patients about. I've heard to many say it will either improve or leave you in the same condition you are now, which is in pain. People often can't imagine being in worse pain, But things can get worse after another failed attempt. It wouldn't be honsest to say it's not taking a risk but I understand why people take that risk.
    Good luck, Gotta lay down, still hurtin from the fall. Take care, Dave

    Sorry aout spelling, I just can't sit long enough to edit before posting, maybe I'll come back andfix my mistakes but i hope you abl;e to understand what I was saying.
    PSS, You probably have a law suite if you pursued it against the guy putting BAK cages in posterorly,I'm not into suing every time something goes wrong, in fact I have never suews anyone but I did look into a medical malpractce case and talkedto several attorneys.

    It really doesn't matter that you signed a consent because your don't have the medical knowledge to understand why not and the possible benefit and all you know is what he has told you so the consent goes out the window when it's based solely won what he told you. I bet =he didn't mention a cage could slip out like it did and when it did it's going smash nerves and need imediate attn.

    Doing something the manufacturer had no intentoion of doing, doing it and telling the hopiatl; your soing a standard fusion with cages which is likely what he did would be like a PM doc giving advice to use Oxy contin rectally because it's stronger and someone ODing. It doesn't matter that rectally is more efficient, it's not designed, tit's warned against and you basing your decidion on his expertise and knowledge, what he told you, Not what the truth is. Your not on equal ground so the consent for no aproved surgery is easily thrown out.
    Take care, Dave

     
    Old 10-25-2004, 04:18 PM   #6
    ltedeschi
    Veteran
    (female)
     
    ltedeschi's Avatar
     
    Join Date: Dec 2003
    Location: ohio
    Posts: 330
    ltedeschi HB User
    Re: shoreline???im on third back surgery 1 year

    You are truly a life saver on th eold brain here. I just have some peace of mind knowing I am not alone. Yeah I know Im taking a chance but at this time I am disabled and it cant get a whole lot worse.(probably should never say that)
    I do have a law suit due to the reason for the shift of the cage was 1. shouldnt have been put in from the back2. the nurse had me roll using the trapeze bar which spine surgery patients should never do and I screamed and told her I busted open my back the supervisor was called and they said I was fine. 3. one week post surgery I went to er in horrible pain They didnt bother with an xray which would have found the cage and it would not have laid on the nerves for 8 weeks.
    The problem as I see it is that all of the expense since surgery 1 like the other surgeries and numerous ct and mri's discograms etc. would be collected from the insurance first in large cases like this I was told due to this being a lifetime problem they would want compensated I would probably owe them lol.
    As of right now I am scheduled on Nov 1st for the 360 fusion and can only hope for the best. Which is what I also hope for you.
    __________________
    Good Health to all
    Lisa

     
    Old 10-27-2004, 06:51 AM   #7
    tanamodessi
    Member
    (female)
     
    tanamodessi's Avatar
     
    Join Date: Sep 2004
    Location: georgia
    Posts: 86
    tanamodessi HB User
    Re: shoreline???im on third back surgery 1 year

    Itedeschi, what were your symptoms I had an anterior fusion w/ bak cages and bmp -l5/s1 on august 19 and i am still in extreme pain especially lying down and getting up.
    I now am experiencing leg butt and foot, pain and burn.

    read post by peadkin and myself she has a lawfirm in chicago checking into her bmp failure she had bmp leakage.

    Best of luck, ~~~DEBBIE~~~

    Last edited by tanamodessi; 10-27-2004 at 06:52 AM.

     
    Old 10-28-2004, 05:06 AM   #8
    ltedeschi
    Veteran
    (female)
     
    ltedeschi's Avatar
     
    Join Date: Dec 2003
    Location: ohio
    Posts: 330
    ltedeschi HB User
    Re: shoreline???im on third back surgery 1 year

    If you are referring to when the cage was out of place I have EXTREME back and leg pain To the point of tears no matter the med.
    __________________
    Good Health to all
    Lisa

    Last edited by ltedeschi; 10-28-2004 at 05:06 AM.

     
    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    My Story...(for Shoreline and anyone else) StMishl Pain Management 9 04-11-2005 01:25 PM




    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 05:09 AM.





    © 2022 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!