Pending back surgery

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scorpio-girl
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Date Joined Jan 2012
Total Posts : 165
   Posted 5/23/2012 5:40 PM (GMT -6)   
I have a report from the neurosurgeon concerning his proposal for my back surgery. Of course, I don't know what much of it means so I will just quote from the e-mail he sent to me.

"recommendation is to proceed with a decompressive laminectomy to involve L3-L4 and an instrumental fusion at L3-L4 and L4-L5 using pedicle screw instrumentation and local bone as well as allograph. This rec is to treat my lumbar stenosis, spondylolistnesis at L3-L4, neurogenic pseudoclaudication, and radiculopathy The recommendation for the fusion is due to the presence of the spondylolisthesis at L3-L4."

I am to be a couch potato 2 weeks . Week 3 I may drive. I am not to lift anything for 3 weeks up to 5-10 pounds.

Any thoughts on this?

Thanks for listening :)

D'anne McGown

grandmaroses
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Date Joined Jan 2011
Total Posts : 1355
   Posted 5/23/2012 6:16 PM (GMT -6)   
Hi there scorpiogirl

I have to tell you i had a l4-l5 fusion the end of march. I am glad |I had the surgery but wish the doctor had told me everything. You really have to follow all the instructions I was up, and even drove a couple of times but I should not have. You are welcome to check out some of my posts I am currently resting because I overdid things.

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9664
   Posted 5/23/2012 7:18 PM (GMT -6)   
It will be a longer recovery process than what your doctor is saying
so clear your calander for a few months and just take it easy. Also, read up
On older posts about fusions and google lumbar fusions and read
all you can on this and do keep in mind this is major surgery and possibly
seek out a second opinion...from what people tell me once surgery
always surgery and I will send you many prayers...
Hope it goes good for you in what you choose to do..keep
us posted as we do truly care... many well wishes, thinking of yoy.
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

bsjaguar
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Date Joined Jun 2009
Total Posts : 974
   Posted 5/24/2012 3:38 AM (GMT -6)   
Not sure what you do for a living but I have to agree with Chart that the doctor is being unrealistic about the time needed for after a fusion. I had L-4/5 fused and was off work 4 months. I had a very strenuous job though so this was a factor. I was hospitalized 4 days. When returning home you need to rest & no bending or lifting. Get a grabber thing they sell at Walmart. It is important to walk though. I started out with short walks with a companion but eventually was walking all over town. I did use a walker for many weeks because I was so scared of falling.

One thing to consider is that after a fusion the disc above and below the fusion now have to make up for the lost disc movement so they tend to wear out faster. Within 4 yrs of my fusion my L/2-3 disc started giving me problems and 6yrs later is now herniated. So read and get all the information you can before having fusion surgery. Before my surgery my back was so bad I couldn't walk upright anymore so I had no choice. This may be your situation.

You may want to check out the cost of the surgery also. Even with insurance the co-pays & deductibles can get pretty hefty. In 2006 my hospital bill was $64,000 this doesn't include the doctor, anesthesiologist, radiologist and any other ologist that comes into play during your hospital stay. I had some P&G stocks that I had to sell to pay for my bills. I hated having to lose those stocks but I had no choice. So make sure you are ready financially too.

Sorry to be the bearer of bad news but the doctors always act like this will be a breeze and everything will be fixed after the surgery and life will go on. Definately read the past posts here on fusion surgeries. You need to be informed. Of course I'm sure alot of people have the surgery & go on living life to it's fullest but for others it is not the miracle cure the doctors make it out to be.

Keep us updated on your decision. If you decide to have the fusion we can help by giving helpful hints on preparing for the surgery & getting through recovery. Good Luck!
---Jag---


DDD, osteoarthritis, facet syndrome, fusion surgeries C-5/7 & L-4/5 both in 2006, torn meniscus surgeries left knee 2000 & 2002, herniated disc at L-2/3 , fibromyalgia, polymyalgia rheumatica

bsjaguar
Veteran Member


Date Joined Jun 2009
Total Posts : 974
   Posted 5/24/2012 5:39 AM (GMT -6)   
One other thing. Your doctor mentions using local bone. I would question him about this. They normally use bone from the Iliac Crest which is the largest part of the pelvis. My surgeon did not take a chunk out of the iliac crest for the spacer, this was a donor bone but he did take scrapings from the iliac crest. This area bothered me for a long time after the surgery. Check into this because when a large section of bone from the iliac crest is taken, pain for long periods of time can be the result.
---Jag---


DDD, osteoarthritis, facet syndrome, fusion surgeries C-5/7 & L-4/5 both in 2006, torn meniscus surgeries left knee 2000 & 2002, herniated disc at L-2/3 , fibromyalgia, polymyalgia rheumatica

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16408
   Posted 5/24/2012 7:14 AM (GMT -6)   
Scorpio the dr is really playing this off as not much to it type of attitude. It takes people a good year to completely heal from a fusion. Most drs do not want the patients to do a thing except walk the first 6 weeks, no sitting, either stand or lay flat. Sitting causes a lot of pressure on the back. The first 6 weeks of healing is so critical. Whatever you do, please do not get in a car and drive until you have made the 6 week mark, simply because if your got out and was hit things could shift or break and this is just something you do not need.

Rose here at the forum will tell you what happened to her because she went home from having a fusion and over did and now she is paying for it.

I am not trying to rain on your parade, I just hate seeing people get told things like what your dr is telling you that you can do and then you get home and find out you can't do as much and get down in the dumps over it. Your dr is just not being realistic with his timeline at all. Have you had a 2nd opinion?

Keep us posted....Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

scorpio-girl
Regular Member


Date Joined Jan 2012
Total Posts : 165
   Posted 5/24/2012 7:30 PM (GMT -6)   
Thanks everyone for your opinions. Yes, I know the doctor is saying 2 weeks and I don't expect that at all. I am a 62 year old female, pretty healthy and am a domestic engineer:) I intend to follow doctor orders to a tea and add some weeks to what he says. I am having this surgery June 20 in Houston. The surgeon is tops in his field of spinal neurosurgery and I have had another doctor look at the results. I wish to do the surgery while my health is what it is now, and I should not have complications unless something not expected. The way my back is now is that it hurts all the time--sometimes worse than others. I have to bend a bit forward when walking to offer some relief. I cannot stand for long and my energy level is cut in half due to the stenosis.

I have had a cervical neck surgery and it took 9 good months--this was a 5 fusion - so basically I got a new neck. That was 2 years ago. I was very careful and I'd say that surgery was 80% success. I am thankful and hope to have the same luck with this lumbar fusion.

Is it true that if some bone is taken from your body that it helps promote quicker healing? Seems like it's a double edged sword-- as getting it from your body is good for the recovery, yet you probably hurt twice as bad in the area from where bone was taken. darned if you do and darned if you don't.

I do appreciate your thoughts and have certainly taken them to heart. I plan to be prepared to mind the doctor and to be realistic about the recovery.
Your notes have scared me enough to really take extra care of my body during this recovery. Thank you.

scorpio-girl
Regular Member


Date Joined Jan 2012
Total Posts : 165
   Posted 5/24/2012 7:34 PM (GMT -6)   
One more other problem I'm having with this stenosis, etc. is that my balance is affected terribly. Anyone else have that problem, and if so, did the surgery help you out?

grandmaroses
Veteran Member


Date Joined Jan 2011
Total Posts : 1355
   Posted 5/24/2012 8:23 PM (GMT -6)   
Scorpiogirl, when I first saw a surgeon 2 years ago he said they would not do surgery until I was in wheelchair. They changed their minds as I was needing a cane mainly for balance and was in so very much pain.

I am still glad I had the surgery even though I am hurting, my mother in law told me when she had her fusion to get out of bed as quickly as possible after the surgery. The nurse told me the same day I had fusion a lady in the room beside mine had the same surgery as I and she was on day 3 and not out of bed because it hurt too much. Be strong, listen to instructions and if you want to talk we are all here.

Oh yes to answer your question I have much better balance now.
Take care
Rose



Insulin Dependant Diabetic, Fibromyalgia, Gerd, IBS, Sleep Apnea, COPD, Spondylolistesis, Diabetic Neuropathy, Fatty Liver, High Cholesterol

scorpio-girl
Regular Member


Date Joined Jan 2012
Total Posts : 165
   Posted 5/24/2012 9:46 PM (GMT -6)   
Roses, do you mind me asking .....when you said you overdid your activity after your fusion, what exactly did you do? Did you do it because you felt like your back was well enough; or were you just not concentratinig on "being careful". I've heard you remark 1-2 times about how overdoing your activity, it cost you because it set you back. Needless to say, I don't want that to happen to me, but I can certainly see how easily that could happen.

Thanks, and I do hope you are much better now and on the road to recovery. Exactly when did you have your lumbar fusion? Did you take pain meds long? How long were you in the hospital?

KezarFan
New Member


Date Joined May 2012
Total Posts : 2
   Posted 5/24/2012 11:03 PM (GMT -6)   
Scorpio, you're going to get lots of varying opinions and stories. Serious back issues like yours aren't straightforward; everyone's different.

I had very similar issues to yours, but two disc levels lower (L4-5, L5-S1). I had a decompressive laminectomy initially by one doc to relieve foot numbness and pain running down the back of my left leg.

That failed, and I ultimately had a bilateral (entry from both front and back, in two separate stages) fusion at the above-noted disc levels. It did the trick; I have been completely free of pain for four years. I know that's not common but it's important to know that some of these really do succeed. My neurosurgeon had told me I'd be better - at my worst I couldn't walk 50 feet without stopping due to the pain - but he couldn't say I'd be pain free.

You asked about the actual process, hospitalization, etc. I'm sure this varies a bit, but in my case I was hospitalized for four nights. First couple days, frankly, aren't pretty. I was flat on my back for 24 hours (precautionary, to ensure that the newly-installed hardware doesn't displace), with a catheter and on an IV pain pump. The first attempts to walk aren't fun. Physical therapists were great, very supportive. It gets better day by day.

At home, as others have noted, it's walking and lying down, walking and lying down. No sitting, which stresses the spine. All I can say is that it does improve day by day and you can't expect it to go faster than your body will allow. Have help around; you will need it. And take the meds -- they really help.

My neurosurgeon did not use an allograft (bone from hip); he uses cadaver bone and material (cement, basically) with added bone-growth hormones. I understand that most surgeons aren't using allografts any more. You might ask your surgeon why he does.

Also, my surgeon was part of a clinical trial that used a bone stimulator post-surgery to enhance bone growth at the fusion site (the idea is that the bone forms a solid mass at the site of the discs that are tilting on top of each other to eliminate slipping, which causes pain). My guy really believed in it, and all I know is that I had a great outcome.

The only odd thing in my case is that I didn't see the surgeon for six weeks. Yes, six weeks. He used sutures that dissolved under the skin, so there were no sutures to remove. And he told me there was no reason to see me sooner; the important thing was to take it easy and allow healing. I expected to see him more frequently and more often. But it worked.

This is not easy; it's major surgery and you'll hear lots of horror stories. Some people do not get better, and others only get modest relief. But others do great. I am a success story, and it took three surgeries and seven doctors for me to finally get there. Be optimistic! And take care.

White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3696
   Posted 5/24/2012 11:45 PM (GMT -6)   
Scorpio I do hope things go well for you with your surgery. You know when I had my fusions in my neck my first one they used the bone off my pelvis and boy that was really painful. My second one they use cadaver donor bone, and my third fusion when they did the posterior fusion of the articular joints, they use the spinous process on right on the vertebrae for the graft material. Anyway I will be interested to see how you come out, I see the neurosurgeon the 19th to see what he is going to do. I have posted about it.
 
When I had my last two fusions I posted on my laptop while I was still in the hospital. It helped keep my mind off the pain. Just a thought wink
 
White Beard
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16408
   Posted 5/25/2012 4:48 AM (GMT -6)   
Scorpio you have been given some good tips, the one about taking your meds is a must, don't try to go without your pain medication when you get home, its easier to stay on top of the pain rather than letting it get out of control, once it gets out of control its so hard getting it t settle down quickly. Stool softners are a must, you don't want to strain and pain meds can plug up the plumbing, eating 4-5 prunes a day works well if you like prunes. The reacher/grabber Jag suggested is awesome for getting stuff off the floor, we have 3 here at the house, at night be sure to have some bottled water & meds at bedside in case you wake up & need to take meds. Try to have easy foods available to pop in the microwave. I noticed many are on walkers when they go mainly to help with balance. Are you going to have help at home when you are released from the hospital?

No one here wants to scare you by any means, we just want you to have the very best outcome. Also, in case Rose does not see your questions, click on her name and you will be able to bring up some of her posts and find the one where she tells about her activities that she should not have done so soon.

Take care...Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

grandmaroses
Veteran Member


Date Joined Jan 2011
Total Posts : 1355
   Posted 5/25/2012 10:16 AM (GMT -6)   
Scorpiogirl I don't mind you asking anything. When I first got home i had my hubby for day1 nobody else and I slept on and off
Day 2 my younger daughter came helped me shower and made sure everything was clean. Day 3 my older daughter came over to help but I was already up and showered so she made tea, she brought her 3 children and the one little munchkin was not well , she ended up going into seizures and I jumped into action picked up because she was in a kneeling position on my couch, made sure she had nothing in her mouth to choke on and then realized I has her in my ares I put her down in her moms arms. So first bad I lifted more than 40 pounds, I also did not get any rest because I barely got settled from the ambulance leaving and my hubby's dad and his wife came over . They had told me they were coming but I had asked them not to because of my surgery. They were on holidays they live hundreds of miles away.
They stayed fri, sat, sun. I did not get rest time i tried keeping up to the clean ups oh yah I forgot while they were here my hubby had his entire family come over for dinner so everyone got a chance to meet great grandpa.
Then I finally had a few days to rest but since I was not in the habit of resting I walked a lot, the following week we received a call hubby's grandma was in town so once more we had the entire family over and I made the dinner, BBQ ribs, mashed potatoes, a couple salads, and of course that meant I had to go to groc store, so I drove. I noticed I could not stop well I was lucky I did not hit anything.
The company all left and I was still feeling a bit sore but so much better,, so I went outside and started doing some yard work, just light stuff raking dead leaves out of flower beds.
My birthday came and hubby took me to yard sales and I was sore but did not rest I let my family take me out for dim sum but the restaraunt had about 30 step s to get in, I used my cane that day. Due to my own stubbornness I did not rest I relapsed.
I finally had to give up, my back hurt so bad it was like the second day after surgery, I went to my gp he said everything looked ok from the outside, I got some flexeril from him for the spasms. It has been pain, and taking pain pills again. That's my story I might have missed a couple of things.
Please do not ignore the fact you just had surgery, everyone here warned me I did not listen.
I also noticed everyone telling you to keep the pain under control, they try to get it managed before you go home but my hospital gave me a prescription for Tylenol 3 they sain normally they send you home with 12 percocets.
Sorry for the long post but you asked.
Take care
Rose



Insulin Dependant Diabetic, Fibromyalgia, Gerd, IBS, Sleep Apnea, COPD, Spondylolistesis, Diabetic Neuropathy, Fatty Liver, High Cholesterol

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 5/25/2012 10:37 AM (GMT -6)   
Just FYI for the technical terms...

Allograft means from a donor bone/tissue.
Autograft means from your own bone/tissue.

I think someone accidentally reversed the terms. So Scorpio...your Dr. is wanting to use donor bone for this particular surgery.

Did they use your own bone for the cervical one? And wow....I have never heard of someone getting a 5 level cervical fusion....Were you in an accident that caused this and they did emergency surgery? So what levels are you fused?

That is absolutely amazing that you have recovered so well from that one...This new surgery should be a piece of cake! LOL....

There are studies on both allograft vs. autograft and yes, the percentage is a bit higher for using one's own bone for the fusion as any time there is a foreign body that is used in a surgery....everything from a fusion to transplants of heart, liver, etc....There is always a chance of the body rejecting it...

I've had 3 cervical fusion surgeries and the first one was autograft (using my hip bone) but without any instrumentation (no cage/plates/screws) and the last two were allograft with instrumentation. I was very lucky to not have any trouble with my hip and having any lingering pain. The only time it bothers me is if my dog steps on me while jumping on the bed...lol.....

And I had a fairly rare occurrence after my first surgery that after a few years....my body reabsorbed the bone into my body...It just disappeared/disinegrated. So the levels collapsed again.

The second surgery was a terrible mess and was in excruciating pain from the moment I woke up...

The third one was done by both anterior and posterior approach and now all shored up with plenty of titanium. Still have residual chronic pain but the surgery itself is a success in that it releived the pressure off the nerves.

As mentioned and as you know....each person heals differently and you will just have to take it one day at a time. And as I wrote to Rose on another thread....the key is that when you have the good days...to not do too much to make the bad days even worse.

It's all about baby steps....literally! LOL...But I think you are going to do just fine since you have already been through a HUGE surgery on your neck...And as you mention...you are going to follow the Dr.'s orders to a T.

We will be praying for you~
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

scorpio-girl
Regular Member


Date Joined Jan 2012
Total Posts : 165
   Posted 5/29/2012 10:43 AM (GMT -6)   
Snowbunny,

Your note was extremely helpful. For the neck surgery, I am not aware if any bone was taken from my own body - I am thinking NO because I was not aware of pain anywhere except my neck.

No, I was not in a car wreck, and I have no idea how my neck got so fouled up. The first signs were pains shooting down my neck and me having to change my neck position for pains to stop. Our son was getting married close to the time of this incident, and I thought it was just stress related - though I was happy stressed - I had the groom, not bride :) Anyway, the pain continued until I had the MRI was done and the neuro said my neck was a complete mess, so basically I got a new neck! Fusion involved vertebrae 2-6 I believe. The Neuro said that he had done very few 5 and 6 level fusions. And it really is amazing that I did so well considering the magnitude of the operation.

This back surgery is June 20 so I will send out a report when it's all done!

I appreciate everyone's helpful notes for me.
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