Discussion
dreamer75 said:
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!!!!
Great to hear that you're all done and home. Do keep us posted with progress.I would be grateful for advice or experiences of spinal fusion, particularly using a posterior fusion clamp rather than the more usual rod method.
I have suffered with back pain and sciatica for many years, with symptoms getting so bad four years ago that I was unable to walk more than a few paces without a completely numb leg and being unable to stand. I was diagnosed with spinal stenosis and underwent a lumbar decompression at L4/5. This was followed by a denervation procedure to try and reduce the remaining pain but although the sciatica was cured the back pain has stayed as bad as ever.
Now the sciatica has returned, but in the opposite leg to last time, and an MRI has shown that another bone spur is impinging on the nerve and needs to be surgically removed. The MRI has also shown that my L4/5 joint has opened up further and is now very unstable so my surgeon has recommended that I consider a spinal fusion.
The surgeon has recommend a clamp on the spinous process across the affected joint which can be fitted at the same time as the spinal decompression without any further incisions. He believes the clamp will stabilise the joint to prevent any further opening, avoid future bone spurs and should reduce the back pain.
Anyone had a spinal fusion and can offer any advice as to whether or not to go with the fusion?
Cool bit of engineering!
I have suffered with back pain and sciatica for many years, with symptoms getting so bad four years ago that I was unable to walk more than a few paces without a completely numb leg and being unable to stand. I was diagnosed with spinal stenosis and underwent a lumbar decompression at L4/5. This was followed by a denervation procedure to try and reduce the remaining pain but although the sciatica was cured the back pain has stayed as bad as ever.
Now the sciatica has returned, but in the opposite leg to last time, and an MRI has shown that another bone spur is impinging on the nerve and needs to be surgically removed. The MRI has also shown that my L4/5 joint has opened up further and is now very unstable so my surgeon has recommended that I consider a spinal fusion.
The surgeon has recommend a clamp on the spinous process across the affected joint which can be fitted at the same time as the spinal decompression without any further incisions. He believes the clamp will stabilise the joint to prevent any further opening, avoid future bone spurs and should reduce the back pain.
Anyone had a spinal fusion and can offer any advice as to whether or not to go with the fusion?
Cool bit of engineering!
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!
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 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.
Im in recovery at the moment from instrumented l4-s1 September last year (rods and pins) mine was due to spondylolisthesis (fracture at the back of vertebrae meaning spine moved forward and caused havoc)
Pre op i was in a lot of pain at the end of everyday and on painkillers , was told op would do nothing for back pain but would help leg pain, well i didnt really have leg pain but its pretty much cured my back pain and im feeling pretty good.
Cycling has been a godsend even though the surgen only officially endorsed a stationary bike the last few months i have been out doing sportives and a few 30+ milers and more a few times a week just being careful not to bin it.
Pre op i was a keen footballer and did martial arts but i have kind of conceeded i probably wont go back to those as although the pain has gone i have lost a range of motion and its hard to explain but theres definately a feeling of needing to be more careful.
Scan on 12th july hopefully to confirm i am fusing well.
Given the choice i would do it again im better for it, wont lie though recovery albeit physically not as difficult as i thought its emotionally tough as theres things you wont be able to do/have to ask for help etc and naturally you want to try to rehabilitate yourself but you really do need to do as little as possible otherwise you will jeopardise recovery.
Edited to ad i have never seen or heard of that device that has been punted to you but it looks incredible
Pre op i was in a lot of pain at the end of everyday and on painkillers , was told op would do nothing for back pain but would help leg pain, well i didnt really have leg pain but its pretty much cured my back pain and im feeling pretty good.
Cycling has been a godsend even though the surgen only officially endorsed a stationary bike the last few months i have been out doing sportives and a few 30+ milers and more a few times a week just being careful not to bin it.
Pre op i was a keen footballer and did martial arts but i have kind of conceeded i probably wont go back to those as although the pain has gone i have lost a range of motion and its hard to explain but theres definately a feeling of needing to be more careful.
Scan on 12th july hopefully to confirm i am fusing well.
Given the choice i would do it again im better for it, wont lie though recovery albeit physically not as difficult as i thought its emotionally tough as theres things you wont be able to do/have to ask for help etc and naturally you want to try to rehabilitate yourself but you really do need to do as little as possible otherwise you will jeopardise recovery.
Edited to ad i have never seen or heard of that device that has been punted to you but it looks incredible
I had a laminectomy as well which decompresses it, im guessing it is that which has caused the pain relief.
Dont pay too much attention to the professional whingers on tinterweb as i dont think half of them actually want to get better and there will be hundreds more for every one of them that had a positive outcome but you wont hear much from them/us as we are busy getting on with it.
Only you will know if the time is right and everybody will respond differently to the procedure but i have no regrets.
Good luck with it whatever happens 👍
Dont pay too much attention to the professional whingers on tinterweb as i dont think half of them actually want to get better and there will be hundreds more for every one of them that had a positive outcome but you wont hear much from them/us as we are busy getting on with it.
Only you will know if the time is right and everybody will respond differently to the procedure but i have no regrets.
Good luck with it whatever happens 👍
I had a laminectomy as well which decompresses it, im guessing it is that which has caused the pain relief.
Dont pay too much attention to the professional whingers on tinterweb as i dont think half of them actually want to get better and there will be hundreds more for every one of them that had a positive outcome but you wont hear much from them/us as we are busy getting on with it.
Only you will know if the time is right and everybody will respond differently to the procedure but i have no regrets.
Good luck with it whatever happens 👍
Dont pay too much attention to the professional whingers on tinterweb as i dont think half of them actually want to get better and there will be hundreds more for every one of them that had a positive outcome but you wont hear much from them/us as we are busy getting on with it.
Only you will know if the time is right and everybody will respond differently to the procedure but i have no regrets.
Good luck with it whatever happens 👍
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!
I have a similar op scheduled for next week and was wondering if anyone had this done recently? I had my cervical spine done last year and was back on my feet quite quickly (C6/7) and it has been a very successful procedure, but I've been told to expect a much longer recovery from this one (L5/S1)
The pain is quite severe at the minute and having exhausted all other options, including multiple sets of injections, it looks like this may be my last hope of living something of a pain free life. TIA.
The pain is quite severe at the minute and having exhausted all other options, including multiple sets of injections, it looks like this may be my last hope of living something of a pain free life. TIA.
I had S1/L5/L4 fused (ALIF and PLIF) at the very end of November last year. Recovery was set back about 8 weeks by an infection in the psoas muscle which was quite unpleasant, but recovery once that had responded to antibiotics has been fine. I was well enough to ride Liege-Bastogne-Liege in March and am pretty well back to normal fitness now (I'm probably at 90% of FTP and carrying about 2kg more than pre-op). Back symptoms are completely gone, physio is mostly concentrating on tidying up my hip action (I had a spondy, so my hips were tilted) and fixing a number of things that were, candidly, probably just as bad before the op. I'm also an inch taller, which is cool, but was weird to begin with.
Being as fit as you possibly can be before you go in, picking the right surgeon, and listening very carefully to the post-op recovery advice would be my tips. I think I probably exacerbated the infection by pushing too hard in the first couple of weeks post-op (was back at work by week 2, which in retrospect was stupid).
Being as fit as you possibly can be before you go in, picking the right surgeon, and listening very carefully to the post-op recovery advice would be my tips. I think I probably exacerbated the infection by pushing too hard in the first couple of weeks post-op (was back at work by week 2, which in retrospect was stupid).
964Cup said:
Being as fit as you possibly can be before you go in, picking the right surgeon, and listening very carefully to the post-op recovery advice would be my tips. I think I probably exacerbated the infection by pushing too hard in the first couple of weeks post-op (was back at work by week 2, which in retrospect was stupid).
dreamer75 said:
Good luck! It's a slightly strange feeling when you reach for a lightswitch and it's in a different place than it used to be!!!
Thanks, it was a lot more painful than I was expecting. Had the cervical spine done last year and it was no worse than having a tooth pulled, this one is a completly different ball game.
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 !
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