Discussion
Hi
Is there anybody on here who has had an anterior cage fusion in the lumbar spine?
I am booked in for surgery in mid Jan - surgeon is hoping to do an Artificial Disc Replacement, but certain complications are now making a fusion more likely - we won't know until he opens me up and gets an actual look at the situation.
Thanks!
Is there anybody on here who has had an anterior cage fusion in the lumbar spine?
I am booked in for surgery in mid Jan - surgeon is hoping to do an Artificial Disc Replacement, but certain complications are now making a fusion more likely - we won't know until he opens me up and gets an actual look at the situation.
Thanks!
Well all done and I'm home following Anterior fusion of L4/5.
The first couple of days are extremely hazy - lots of morphine etc., but things started to pick up on Sunday. They carried on with various morphine type drugs + tramadol and paracetomol til they discharged me and now I'm on the tramadol + paracetomol + codeine as and when. The back pain itself is almost completely gone now, but I've got a fair bit of nerve pain in my left leg - it's a familiar pain and I'm not surprised. Hopefully that will die down with time as inflammation goes down, muscles unspasm etc.
I've grown nearly 1.5 cms (the amount they increased the disc space by, from 1-2mm to 1.5cm)and weirdly I do feel taller at home! I'm nto sure you'd notice that much but I'm sure I do !
The incision site is really clean and almost pain free - I can just about laugh (gently) and cough (very gently) now after a week.
Incredible when you think what they've done!!!!
The first couple of days are extremely hazy - lots of morphine etc., but things started to pick up on Sunday. They carried on with various morphine type drugs + tramadol and paracetomol til they discharged me and now I'm on the tramadol + paracetomol + codeine as and when. The back pain itself is almost completely gone now, but I've got a fair bit of nerve pain in my left leg - it's a familiar pain and I'm not surprised. Hopefully that will die down with time as inflammation goes down, muscles unspasm etc.
I've grown nearly 1.5 cms (the amount they increased the disc space by, from 1-2mm to 1.5cm)and weirdly I do feel taller at home! I'm nto sure you'd notice that much but I'm sure I do !
The incision site is really clean and almost pain free - I can just about laugh (gently) and cough (very gently) now after a week.
Incredible when you think what they've done!!!!
Hi - I have a fusion at L4/5 but using a different method; I had a cut in the stomach, and they put a cage between the vertebrae which they filled with artificial bone stuff to encourage my body to fill it with real bone. At that stage I had no disc left and the bones were rubbing on each other making holes, which is why (at the time) I couldn't have an artificial disc. I also have a missing facet on one side (congenital) which would have made the joint too unstable for the artificial disc.
At the time I was gutted about not qualifying for ADR, but subsequently it seems thinking is changing (according to my physios), and fusions are looking good for long term prognosis.
What sort of info are you after? PM me or reply and I'll tell you anything you like !
Mine was 3.5 years ago, after several years of pain. I'd already had a microdiscectomy which provided temporary relief but things deteriorated to the point fusion was needed. Some things are better since the op; my life is transformed. Pre surgery I was nearly housebound and unable to really do much due to not being able to stand for long or walk far. I was managing to race Caterhams up until about a year before the op because I found sitting easy, but standing/walking difficult, but I'd also stopped that.
The op wasn't a walk in the park - a week in hospital, catheterised for a few days, couldn't stand up without fainting for a few days (hence catheter staying in), and had some horrible interactions with morphine which I won't post on a public forum! Morphine pump for a few days, then Tramadol for a while. Also ended up on Gabapentin for a while due to nerve pain in my legs post op which felt like they were being squeezed in a vice. Struggled with withdrawal from the Tramadol, but there are ways to deal with that (mostly just reducing the dosage slowly rather than cold turkeying it like I tried!). 3 months off work - I could probably have gone back sooner, but wanted to be fully ready, and my job involves driving distances.
The op caused some low level nerve issues - one foot is usually cold but sweaty and the other is usually warm but dry. Not a big deal really ! I also have a patch on one leg which felt burnt after the op but is now just a bit numb. Again not an issue.
However my life is now transformed. I mountain bike, road bike, fly a plane, all of which I've started since the op. I've also had the courage to change jobs which I would never have had the confidence to do before the op. My new company hardly even know I have a back issue - the only time it comes up is when I try to dodge trade shows because standing up all day will have me back at the physio for 2-3 weeks. In all honesty I had a black period after the op because I wasn't magically pain free, and saw a pain management consultant who was incredible. CBT got me back on track and living my life as I should! I still have regular physio because I just have general back issues, and the L4/5 area has always just been a bit iffy. I'm paranoid about surrounding levels which given I'm fairly hypermobile may well cause issues in the future but so far so good.
Given the choice again would I do it? YES! My life is transformed in a good way. It's unrecognisable from where it was 4-5 years ago. I'd suffered for years and my regret is I didn't do it sooner, before most of the damage was done to the vertebrae and nerves. I often wonder if the outcome would have been even better had I done it sooner, and at least I wouldn't have lost my 30's to a bad back
Obviously my fusion was for very different reasons to yours - it used a different technique, and we are different people with different surgeons etc. so I don't know how relevant all this is! For me personally it was the right decision. Any other questions PM me!
At the time I was gutted about not qualifying for ADR, but subsequently it seems thinking is changing (according to my physios), and fusions are looking good for long term prognosis.
What sort of info are you after? PM me or reply and I'll tell you anything you like !
Mine was 3.5 years ago, after several years of pain. I'd already had a microdiscectomy which provided temporary relief but things deteriorated to the point fusion was needed. Some things are better since the op; my life is transformed. Pre surgery I was nearly housebound and unable to really do much due to not being able to stand for long or walk far. I was managing to race Caterhams up until about a year before the op because I found sitting easy, but standing/walking difficult, but I'd also stopped that.
The op wasn't a walk in the park - a week in hospital, catheterised for a few days, couldn't stand up without fainting for a few days (hence catheter staying in), and had some horrible interactions with morphine which I won't post on a public forum! Morphine pump for a few days, then Tramadol for a while. Also ended up on Gabapentin for a while due to nerve pain in my legs post op which felt like they were being squeezed in a vice. Struggled with withdrawal from the Tramadol, but there are ways to deal with that (mostly just reducing the dosage slowly rather than cold turkeying it like I tried!). 3 months off work - I could probably have gone back sooner, but wanted to be fully ready, and my job involves driving distances.
The op caused some low level nerve issues - one foot is usually cold but sweaty and the other is usually warm but dry. Not a big deal really ! I also have a patch on one leg which felt burnt after the op but is now just a bit numb. Again not an issue.
However my life is now transformed. I mountain bike, road bike, fly a plane, all of which I've started since the op. I've also had the courage to change jobs which I would never have had the confidence to do before the op. My new company hardly even know I have a back issue - the only time it comes up is when I try to dodge trade shows because standing up all day will have me back at the physio for 2-3 weeks. In all honesty I had a black period after the op because I wasn't magically pain free, and saw a pain management consultant who was incredible. CBT got me back on track and living my life as I should! I still have regular physio because I just have general back issues, and the L4/5 area has always just been a bit iffy. I'm paranoid about surrounding levels which given I'm fairly hypermobile may well cause issues in the future but so far so good.
Given the choice again would I do it? YES! My life is transformed in a good way. It's unrecognisable from where it was 4-5 years ago. I'd suffered for years and my regret is I didn't do it sooner, before most of the damage was done to the vertebrae and nerves. I often wonder if the outcome would have been even better had I done it sooner, and at least I wouldn't have lost my 30's to a bad back
Obviously my fusion was for very different reasons to yours - it used a different technique, and we are different people with different surgeons etc. so I don't know how relevant all this is! For me personally it was the right decision. Any other questions PM me!
jkh112 said:
Dreamer, thanks for the reply. Exactly what I was hoping to hear. There are so many horror stories online it is great to hear one that has gone well.
I took a long time to recover from my last decompression so am aware how long it can take to see the benefits from surgery.
How is mobility with the fusion? As you seem to be able to,undertake quite active hobbies I presume you do not notice any issues.
I'm aware of it - not from a lack of mobility, but I just feel things in various places if that makes any sense - the occasional twing of a nerve or muscle somewhere in my hip, or my back, or my bum cheeks for example! I'm conscious that I don't want to put too much stress on the surrounding levels, so I've had physio bike fit done to my road bike, and both bikes are slightly more "sit up and beg" than stretched out than would usually be, so it doesn't put too much stress on the back. Similarly I want to get a motorbike license soon and a sports bike probably wouldn't be suitable. I also feel the odd leg involvement, my back muscles get very tight on one side sometimes, blah blah blah, but no I don't really notice lack of mobility. It's one joint only and it's quite low down. Don't roller that level with the foam roller though!! !I took a long time to recover from my last decompression so am aware how long it can take to see the benefits from surgery.
How is mobility with the fusion? As you seem to be able to,undertake quite active hobbies I presume you do not notice any issues.
I've also ridden bmx bikes, velodrome bikes. And forgot to say I also started skiing 2 seasons ago - my coach will tell you I'm stiffer and weaker on one side (most people are) and it probably affects how I move on the skis, but I managed a couple of black runs in Val in the 1st season, and managed a few falls without damage
So no, I don't notice the lack of mobility I do have to stretch almost every day, lots more stretching after a bike ride than anybody else, and should be doing exercises every day to keep strength in surrounding muscles.For me it was a game changer. It obviously has its risks though. There's a guy on here davhill who often pops up and he's had a much harder time of things. There are people it doesn't work for so you'll need to make your decision based on your circumstances and specialists etc. of course, but this, at least, is a success story !
I think it's something you'll always have and be aware of, but in my case at least it has transformed life. I've accepted that snowboarding (too much falling on my bum), go karting (too much bumping on the ground and hard impact), and the occasional other sport are not wise, but the CBT taught me to accept that and just find other things to do. Hence the skiing instead of snowboarding, and flying instead of racing the 7. I can still road drive the 7, but the lateral forces on the track were a bit much. Probably be ok now but now flying sucks up the cash instead!
Yes it's special isn't it 
Don't rush to have the catheter removed, don't rush to get off the morphine, and don't rush home!!! I went home a bit too early and had an emergency GP visit 2 nights later. Just recover at your own time but I promise it WILL improve!!! If you're anything like me you feel like you've been beaten up. I couldn't stand up for quite a few days because every time I tried, I fainted. Top tip from a doctor friend of mine; before trying to stand, wiggle your feet around actively and tense/relax the muscles in your legs to get the blood moving around. I had to keep the catheter in until I could walk to the toilet which took several days due to the fainting.
Amazing to be at home in my own home. My mum stayed for about a week, but tbh after the first week or so I improved massively quickly. I used a phone app to track my walking and just walk a little bit further each day - take someone with you at first in case you stumble. Don't walk too far too fast, build it up!
Obviously I'm not a doc and this is just what worked for me - we're all different! I've had to learn different walking techniques and I still do exercises and stretches most days. Don't panic if the pain doesn't go away. Also don't panic if you get other weird pains. I had to go on Gabapentin after I got home due to strange nerve pains which felt like my leg was in a vice. They did stop though. I just put it down to post op trauma, given the amount of wiggle and jiggle that had gone on in my back! That plus being stretched a bit. I had one hot dry foot and one cold sweaty one, and a section of my leg which felt burnt. It all calmed down though so don't panic !
Don't rush to have the catheter removed, don't rush to get off the morphine, and don't rush home!!! I went home a bit too early and had an emergency GP visit 2 nights later. Just recover at your own time but I promise it WILL improve!!! If you're anything like me you feel like you've been beaten up. I couldn't stand up for quite a few days because every time I tried, I fainted. Top tip from a doctor friend of mine; before trying to stand, wiggle your feet around actively and tense/relax the muscles in your legs to get the blood moving around. I had to keep the catheter in until I could walk to the toilet which took several days due to the fainting.
Amazing to be at home in my own home. My mum stayed for about a week, but tbh after the first week or so I improved massively quickly. I used a phone app to track my walking and just walk a little bit further each day - take someone with you at first in case you stumble. Don't walk too far too fast, build it up!
Obviously I'm not a doc and this is just what worked for me - we're all different! I've had to learn different walking techniques and I still do exercises and stretches most days. Don't panic if the pain doesn't go away. Also don't panic if you get other weird pains. I had to go on Gabapentin after I got home due to strange nerve pains which felt like my leg was in a vice. They did stop though. I just put it down to post op trauma, given the amount of wiggle and jiggle that had gone on in my back! That plus being stretched a bit. I had one hot dry foot and one cold sweaty one, and a section of my leg which felt burnt. It all calmed down though so don't panic !
Difficult as it is, try to keep a positive attitude. Hopefully the scan will show something which can be rectified - when's it booked in for?
As for the walking - I had to build up slowly over a long period. And by slowly I mean starting by walking (slowly and with someone to catch me if I fell) to the end of the road and back. I fact I think I didn't even get that far at first. And under strict instructions not to increase by more than a certain % each time. It took me a long time to get back to walking and even now I don't walk properly (years later).
Have you got a good physio who knows exactly what's been done and why? Mine has been a lifesaver - very much part of the "keep dreamer moving team" - with good knowledge about what's been done, she's been able to help me along the process in conjunction with what surgeons and other consultants have done. Anything from acupuncture to massage, to strengthening exercises, to infrared, to all sorts of stretches, even looking at my car, bike and desk to make sure they aren't contributing to issues.
It's only 2 months since the op - it's early days still. And no, coming off the painkillers wasn't fun at all - went cold turkey off the tramadol initially and that was horrific. Had to go back on and get water soluble Tramadol so I could wean off slowly - GP didn't know water soluble existed btw, the pharmacist told me, so if your'e still struggling with that try the water soluble and a slow withdrawal!
As for the walking - I had to build up slowly over a long period. And by slowly I mean starting by walking (slowly and with someone to catch me if I fell) to the end of the road and back. I fact I think I didn't even get that far at first. And under strict instructions not to increase by more than a certain % each time. It took me a long time to get back to walking and even now I don't walk properly (years later).
Have you got a good physio who knows exactly what's been done and why? Mine has been a lifesaver - very much part of the "keep dreamer moving team" - with good knowledge about what's been done, she's been able to help me along the process in conjunction with what surgeons and other consultants have done. Anything from acupuncture to massage, to strengthening exercises, to infrared, to all sorts of stretches, even looking at my car, bike and desk to make sure they aren't contributing to issues.
It's only 2 months since the op - it's early days still. And no, coming off the painkillers wasn't fun at all - went cold turkey off the tramadol initially and that was horrific. Had to go back on and get water soluble Tramadol so I could wean off slowly - GP didn't know water soluble existed btw, the pharmacist told me, so if your'e still struggling with that try the water soluble and a slow withdrawal!
I can't walk more than a couple of kms now, 3-4 years after the op, just to put that distance into perspective......
I know what you mean about the pain. But re the physio - I guess do what your consultant says, but I worked with mine for a couple of years prior to the surgery and still work with her now - a good physio won't do anything they shouldn't, but mine worked in conjunction with the surgeon and with his guidance, so do what your consultant says presumably ! I wouldn't want to suggest anything different !
I know what you mean about the pain. See what the scan says. My pain wasn't cured at all and I ended up in pain management counselling which was amazing and transformed things. I had nerve issues following the surgery (different to yours) which died down over time. The only time my leg has collapsed is after a skiing fall (see I told you the pain management counselling changed things!) and the physio said it was a pain reflex - he suggested I took pain killers to avoid the body learning the response and then collapsing more often. If that makes sense. But see what the doc says.
I know what you mean about the pain. But re the physio - I guess do what your consultant says, but I worked with mine for a couple of years prior to the surgery and still work with her now - a good physio won't do anything they shouldn't, but mine worked in conjunction with the surgeon and with his guidance, so do what your consultant says presumably ! I wouldn't want to suggest anything different !
I know what you mean about the pain. See what the scan says. My pain wasn't cured at all and I ended up in pain management counselling which was amazing and transformed things. I had nerve issues following the surgery (different to yours) which died down over time. The only time my leg has collapsed is after a skiing fall (see I told you the pain management counselling changed things!) and the physio said it was a pain reflex - he suggested I took pain killers to avoid the body learning the response and then collapsing more often. If that makes sense. But see what the doc says.
It can be very difficult to stay positive. Sometimes it helped me to compare with a week ago. What can I do today that I couldn't do a week ago etc. etc. Pre surgery I was racing Caterhams and ultimately had to leave that behind (along with Snowboarding and Karting), along with trade shows for work, long walks etc. although walking is moving in the right direction now, and instead of racing I fly planes and am taking my bike license later this year, and instead of Snowboarding I ski It is very difficult to stay positive at times but it's so very important. Also don't rush. I had 3 months off work post-fusion (I had holes in the vertebra from the bones rubbing against each other so maybe a slower recovery, plus years of pain and muscle weakness caused by it), struggled with Tramadol withdrawal, Gapabentin etc., and some unpleasant post-surgery nerve issues in my feet and legs which subsided over time.
Its hard but see what the scan says. Also remember - you own your treatment. It's a weird one, but nobody actually "owns" your problem except you. I found the surgeons, physios, consultants etc. all have their area of expertise but it's easy to fall through the gaps.
It is very difficult to stay positive at times but it's so very important. Also don't rush. I had 3 months off work post-fusion (I had holes in the vertebra from the bones rubbing against each other so maybe a slower recovery, plus years of pain and muscle weakness caused by it), struggled with Tramadol withdrawal, Gapabentin etc., and some unpleasant post-surgery nerve issues in my feet and legs which subsided over time.Its hard but see what the scan says. Also remember - you own your treatment. It's a weird one, but nobody actually "owns" your problem except you. I found the surgeons, physios, consultants etc. all have their area of expertise but it's easy to fall through the gaps.
sorry to hear thatCan you see the neuro chap any earlier? I got transferred to a pain management consultant, who in turn recommended a CBT counsellor (before trying either more surgery or a drug regime) which worked for me - somehow allows me to dial down the volume of the pain. But I have a different pain to you, by the sounds of it.
In my case it was the surgeon who prescribed the pain killers (including adding Gabapentin to the Tramadol post surgery after I got home and had a burning, clamping feeling in my leg like it was being squeezed in a vice) and the GP who managed the ongoing prescriptions etc.
Try not to overdo things, but also don't do too little - tough to figure out!
Ructions said:
Getting the balance right is proving to be quite difficult, but surprisingly doing too little is almost as bad as doing too much.
The neurosurgeon, well his secretary at least has become quite difficult. She refused to give me the results of the scan over the phone and also refused to email them to me, stating data protection issues, though this wasn’t an issue previously. She then blatantly lied to me regarding his whereabouts, telling me he was holding a clinic, then when I asked to speak directly to him she said he was in surgery and when I pointed out her mistake she then said he was at a different hospital and was unable to take calls.
If you google the neurosurgeon the first number of results are about the secretary’s attitude, how rude she is and how it is best to deal with her via email. The only way I could describe her is a militant, man hating, fat lesbian type.
Luckily I am very friendly with the receptionist at my GP, she rang and not only was she given the results over the phone, she also received a copy via email, which she kindly sent me via WhatsApp. So much for data protection.
I’m now trying to arrange a new appointment to see the neurosurgeon, but I cannot get past the gatekeeper. She never answers the phone, too busy stuffing her face with cake and she hasn’t responded to either of the voicemails. I have at all times been courteous and polite in my dealing with the delightful Debbie. (Picture a Bulldog licking p*ss off a nettle crossed with a militant, man hating lesbian and you’ll have some idea as to what I’m dealing with.) This is all at a private hospital, so it isn’t exactly cheap.
That is bizarre! Can you change consultant, or if it's through insurance could you make a complaint through them, or to the hospital he works from? The secretary for one of my consultants won't send through email, but would post to my home address.The neurosurgeon, well his secretary at least has become quite difficult. She refused to give me the results of the scan over the phone and also refused to email them to me, stating data protection issues, though this wasn’t an issue previously. She then blatantly lied to me regarding his whereabouts, telling me he was holding a clinic, then when I asked to speak directly to him she said he was in surgery and when I pointed out her mistake she then said he was at a different hospital and was unable to take calls.
If you google the neurosurgeon the first number of results are about the secretary’s attitude, how rude she is and how it is best to deal with her via email. The only way I could describe her is a militant, man hating, fat lesbian type.
Luckily I am very friendly with the receptionist at my GP, she rang and not only was she given the results over the phone, she also received a copy via email, which she kindly sent me via WhatsApp. So much for data protection.
I’m now trying to arrange a new appointment to see the neurosurgeon, but I cannot get past the gatekeeper. She never answers the phone, too busy stuffing her face with cake and she hasn’t responded to either of the voicemails. I have at all times been courteous and polite in my dealing with the delightful Debbie. (Picture a Bulldog licking p*ss off a nettle crossed with a militant, man hating lesbian and you’ll have some idea as to what I’m dealing with.) This is all at a private hospital, so it isn’t exactly cheap.
And yes too little is worse than too much. But if this is private, I would expect an appt much sooner than you have. After my surgery I was able to speak to the secretary (who in turn arranged for call backs from the surgeon within a short amount of time), and arrange appts quicker than anticipated etc. If it's private I do wonder if it's worth changing consultant if it really is that bad..?
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