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spinal fusion L4-S1

Started by melody5 on 01/17/2019 1:59pm

Hello all,

so i am new here and just wanted to ask a few questions about spinal fusion. im gonna have the spinal fusion surgery on feb 22 and im really scared.

i am 29. back in 2016, i was diagnosed with grade 1 spondylosis. i was told to do physical therapy but i kinda ignored it because it didnt hurt that much back then. xray result: "Impression: There are pars interarticularis defects at L5 with grade I spondylolisthesis at L5/S1. There is moderate narrowing of the L4/5 disc space."

in feb 2018, i fell . i didnt feel any pain at that moment so i didnt go to the doctor. a few days later, my back was killing me. it hurt so much to move. i couldnt really walk. i felt burning sensation, tingling, numbness, sharp pain, throbbing, shooting, basically all kind of pain. then i decided to go to urgent care. they took an xray there and it says i have fractured my spine. so they ordered the CT scan just to be sure. CT scan result: "IMPRESSION: Mild anterior subluxation of L5 on S1 with associated bilateral spondylolysis, No fractures. Disc bulge and facet hypertrophy resulting in mild spinal stenosis at the L4-5 level and marked bilateral foraminal stenosis at the L5-S1 level. "

MRI result: FINDINGS:
There is grade 1 spondylolisthesis at L5-S1 in association with bilateral L5 spondylolysis. There is mild degenerative disc desiccation and moderate disc space narrowing at L4-5.

No acute compression fracture is observed. No pathologic bone marrow signal is observed.

L5 - S1: Annular bulge and superimposed broad-based Left foraminal/extraforaminal disc herniation is observed which impinges upon the exiting left L5 nerve root and contributes to left foraminal narrowing. There is no central canal stenosis. The right neural foramen is patent.

L4 - L5: Broad-based central disc herniation results in mild flattening the ventral thecal sac without central canal stenosis . Associated subtle posterior annular fissure is observed. The neural foramina are patent.

long story short, i tried physical therapy for about 2 months. i was given oral steroids to deal with the pain. I had 2 steroid lumbar injection and 1 SIJ injection. naproxen and gabapentin dont work on me anymore. so i stopped taking all the meds. pain is getting worse. my average is 5/10 and worst is 10/10

i decided to get the surgery because i just want to get over it. the surgery is scheduled and im kinda having a second thought. im really terrified. my numbness was on the bottom of my right foot and now it has gone up to my calf.

for anyone who had done it before, how was it? did it work? how painful is the recovery?

sorry if this is too long

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Hi Melody,
I am 2 weeks post op on L2-S2 fusion. I’m a very active 51 yo gal. This is actually my 2nd fusion. April 2018 I had fused L2-L3 and decompressed from there down. We were hoping the first “smaller” fusion would be enough, but I have among other things Grade2 Retrolisthesis and the lowers didn’t stay in place, but slipped further. It was worth a shot, As I now have 12 screws, bolts and two rods. It took 32 staples to close up my back.

Speaking from my current recovery and my recovery in April I can say for me it was totally worth doing. To me there were two parts I feared about surgery - surgical site pain and spinal pain from changes and healing.

Surgical site pain was a breeze both times. No pain at my staples, mild itches as the skin healed and grew back together. My incision the first time was about 5” and this time it’s 12”. I had a spinal fluid leak that kept my first set of staples in longer, and even required extra stitches at week two but that was only mildly annoying. This time, no leaking, and I left the hospital with no bandage and headed home for a shower.

The healing pain from my spine was not as big as I expected. When they say they get you up and walking right away - not a problem. For the first 48 hours after surgery you have a spinal block they inject at the end of surgery, plus you have all sorts Demerol or a Oxy on board. So it’s sore, achy, but nothing like the pain you’ve lived with getting to this point.

Biggest healing pain is muscle spasms hands down. Take all the muscle relaxers they give you, have ice packs at home, and be ready with a good heating pad after about 10 days. The back muscles will go into “protection-lockdown” mode. This hurts, it really limits mobility, tightens your glute and hamstrings etc. That started to relax for me by week 2, but was a continued challenge to keep my muscles supple as they regained strength over 3 months. Walking is the best therapy! It rebuilds the muscles and helps stretch everything out without over stretching. If your surgery isn’t for a month I’d start walking right now so you are strong going into surgery.

As things healed, or I started moving more I had pain coming and going. Pain from PT or overdoing it - but none of this pain was near the pre-op pain and it progressively got better. After my first surgery I flew to Europe and walked all over the place at 90days post op. Sure I was sore - but muscle sore, not nerve pain, or numbness-tingling.

A couple other pieces of advice from my experience: move anything you need at home to counter height so no need for bending. Get help! Especially the first week. Someone to cook, hang out, help you get dressed, keep your meds organized. Take all the “tools” the PT at the hospital offers. The easy sleeve for putting on socks, the long handled shoe horn, the grabber stick for picking things up off the floor. Get a few granny nightgowns - you are not going to want any waistbands on those sutures/staples for the first week or more.

Before you leave the hospital they’ll want you passing gas but not necessarily having pooped. They will push stool softeners and laxatives - take them all and have plenty at home. Trust me, you don’t want to be pushing from constipation ! That does hurt! As an FYI it can take up to 5-6 days post op to pass your first stool even with all those meds on board to help. So you’ll feel really bloated for about a week. But, by end of week two that clears out.

So, there’s a snapshot of my experience. Surgery is a huge decision and there are as many risks as there are benefits. For me, I was just done with the pain and the limits the condition was putting on my life. Good luck !
Please feel free to PM me if you want to chat more!
Nat

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