BLOG – L4-5 Spinal Fusion Surgery

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  • #37213

    Fritz
    Participant

    Hi all,

    I’ve started this thread up as a Blog to record my experiences going through Spinal Fusion Surgery. If you want to know how I got to this point, have a look at my thread called ‘Another Journey’. http://painsupport.co.uk/forums/topic/26659/

    By way of an introduction, I have had a year of problems with my L4-5 disc and, following a three week spell in hospital over Christmas & New Year, I have been advised to undergo Spinal Fusion Surgery.

    I’m going to record my thoughts and experiences on this thread for self-help reasons and to inform anyone following me in what it’s like to go through it.

    The first few posts will be preop and describe why I’m having the op. Then I’ll describe the actual op and recovery as it happens.

    Steve

    #37214

    Fritz
    Participant

    Indications and symptoms.

    For the last four months I have had the following pain, which has steadily got worse and is exasperated by sitting for more than half an hour or standing for more than ten minutes:

    Burning pain in both hips.
    Deep pain in lower back and sacrum.
    Deep pain in both thighs.
    Burning pain in back of left thigh, down to left foot.
    Numbness in left side of left shin.
    Numbness in middle three toes of left foot.

    When I hyperextend my back, I get pins and needles in both feet up into my lower legs.

    #37215

    Fritz
    Participant

    Treatment so far:

    Three nerve block injections in January, March and April 2014. They worked for about a week before symptoms returned.

    Physiotherapy March/April 2014. Mobility restored but pain remained.

    Microdiscectomy in May 2014. This have immediate relief to the pain and numbness in my left leg. The other pains subsided after about four weeks.

    Physiotherapy July/August 2014. Mobility restored.

    Following return of all pain symptoms, another nerve block injection in December 2014. Completely unsuccessful.

    Three weeks inpatient at hospital to bring pain under manageable control.

    #37216

    Fritz
    Participant

    Deciding to go ahead with surgery.

    Having a spinal fusion should be a last resort. It is drastic and irreversible. Success in reducing pain significantly for patients with degenerative discs is 70% and there is a 5% risk that the pain will be worse.

    My condition has stopped me from working. It has ended my career as an ice hockey referee. I can’t stand for more than ten minutes. I can’t play guitar without having first taken strong opiate painkillers. Basically, my life has been severely curtailed by, and now revolves around my ability to manage, my pain.

    Bearing all the above in mind, it now appears that the benefits of surgery outweigh the risks. And I’m going ahead with it.

    #37221

    Fritz
    Participant

    Tuesday 13th January

    I called the waiting list coordinator yesterday. She hasn’t received my ‘card’ yet but thinks the date of surgery will be mid March.

    I had an appointment with my GP this morning. She is pleased I’ve finally got a difinitive treatment plan and an optimistic outlook. She’s not too enamoured with me being back on morphine again but, with surgery imminent she can see it’s only temporary and didn’t give me a hard time over it. I’m on 30mg MST twice a day and have a bottle of oramorph for breakthrough pain.

    GP has also referred me for local physiotherapy. She explained that keeping my back as mobile as possible preoperatively, along with keeping my back muscles toned, will help my recovery post op. So I have something else to look forward to each week while I wait.

    The other helpful thing is that I’m booked in on a fusion surgery seminar at the hospital. It’s a two hour presentation and Q&A session with the nurses, physios and consultants for those waiting for surgery. We’ll be told what to expect post surgery, limitations and tips for getting through it. I’m impressed that they’re providing the seminar as it feels like I’m more involved and going to be better informed.

    One thing that keeps jumping out at me from all the literature is that this is major surgery. Major surgery. I’m guessing/ hoping that refers to the complication level rather than the risk level. The discectomy last May was supposed to be major surgery and that really hurt. I don’t do pain very well so this could be interesting!

    All for now.

    Steve

    #37224

    Navchic
    Participant

    Hi Fritz
    Just wondered have you tried pilates? Might help your post op period, if your core muscles are in good shape. I certainly found it helpful pre op – I didn’t have a fusion but had large incisions (3 of them) for insertion of the SCS. The surgeon said my tummy muscles were so strong they found it difficult to place the stim in my abdomen. However, it definitely helped my recovery, and I was generally more flexible. There are some good physio based programmes, and a good physio should be able to guide you through basic pilates. Very little movement involved, lots of sucking in your tummy – but it does help (not with the pain unfortunately, but with your ability to move as appropriate post op).
    T

    #37225

    Fritz
    Participant

    Hi T

    I have a two-week stay at a rehab centre booked for June. They do modified Pilates like you describe as part of their treatment plan, as well as hydro, spinal mobility class, acupuncture and all sorts of physiotherapy treatments.

    Steve

    #37318

    Fritz
    Participant

    Monday 19th January

    The pain in my hips over the weekend was intolerable. I was at Uni on Thursday / Friday and sitting in lectures was awful. The staff were very understanding and let me make up a ‘bed’ at the back of the room out of eight chairs, using my rucksack and jacket as a makeshift pillow. I was able to complete the day lying on my side supping tea and morphine.

    By Saturday lunchtime I’d run out of Oramorph on the way home from Uni, such was the pain level. I ended up in A&E in order to get a repeat prescription. Fortunately, they didn’t think I was a seeker and I was given the drugs.

    Sunday was spent in bed trying to cope with the pain on as little morphine as possible. The pain in my hips is incredibly strong. It’s like I have a hot javelin running from one hip to the other.

    Today was a better day. GP appointment first thing and she prescribed two bottles of oramorph so I don’t run out again. I managed to get out in the sunshine and walked the dog at lunchtime. With my iphone, headphones and some good music, it was a rare good time. I got a call from the surgeons secretary when I got back. Surgery has been booked for Thursday 5th March. Only 6 weeks away so I’m very happy. Also found out I’m having a TLIF procedure, which appears to be slightly less invasive than I thought it might.

    Still no word from the physio department but I guess there’s not much they’ll be able to get done between now and March.

    In the meantime, I have to get things straight around the house before surgery as I’ll be immobile for a while after.

    TTFN,

    Steve

    #37346

    JudeB
    Participant

    Hi Steve

    My name’s Judi and I’ve literally just joined the forum after 15 years of severe back problems. I had a spinal fusion operation back in 2001, and so can talk with knowledge about things you might experience. First of all, I only went ahead with the fusion having exhausted all other treatments. I was in a lot of pain EVERY day, and like you couldn’t stand for more than a few minutes, couldn’t walk more than a few yards, and could only sit in a slumped position if I were to get any sort of comfort at all.

    The operation: After the op itself, I spent the next 24 hours in a fog of morphine which was given via a clicker, so that you could dose yourself when the pain got too much. It got to a point where I could no longer bear to press the button as the point of application had become very sore. They relocated the needle. I also had a severe migraine headache after the operation – something which I do suffer from from time to time, so that might just have been me. I then experienced hallucinations from the Tramadol they were giving me. This was only discovered after 24 hours of weird experiences – TV aerial lead became Tom Cruise (NICE), the room had a green and gold aura about it, (seemingly a pleasant experience as apparently I smiled every time I told my husband and daughter, lol) Then the not so nice experience, when the sunflower picture on the wall suddenly became lots of people’s heads looming down at me – a bit like you see on the telly when people are hallucinating. They eventually took me off the Tramadol after my daughter questioned my sanity, lol.

    I had the operation on a Wednesday, and they wanted to get me out of bed on the Friday – they got me to a standing position and I passed out through the pain being so severe. Thereafter followed 8 days of getting me out of bed and walking a little further each day, all while suffering EXTREME pain, together with hydrotherapy which was pleasant. Don’t be surprised if you can’t wipe your own bum (sorry to be so blunt, but you need to know), as the pain in my case was so severe when I tried to twist to do so – a very embarrassing situation to find yourself in. I also messed the bed on two occasions because I had no control over my bowels while my intestines gradually found their way back into their right position.

    I was allowed home after 10 days, and had to sleep downstairs for several weeks. I was only allowed to shower – no baths for 3 months. Four months after the operation, with the follow up hydrotherapy and physio sessions and I was allowed to start back to work, albeit only a couple of hours a day to start with – I am a secretary by trade. During this time I was gradually building up my walking and was feeling enormously better.

    Unfortunately, a month after my return to work I had to attend an out patients appointment for an ovarian cyst which had been discover during the op. I’m only telling you this because after 45 minutes of laying down in a very un-lady like position they hadn’t found the cyst, and told me it had obviously dispersed without treatment, and I should get up ….. I couldn’t!! I’m sorry to have to tell you this, but I want you to go into your operation with eyes WIDE open, but since that day I haven’t had a day without SEVERE back pain since. No one knows what it was about the examination/layiing down that day, that triggered it, but I am now very sorry to have to tell you that my back/leg pain is now even worse than it was before the op which at the time I wouldn’t have thought possible. They have re-done all the original tests, hydrotherapy, physic etc, but don’t really know where the problem lays. They believe it is possible that another disc is suspect, but are reluctant to do another op, as this could put me in a wheelchair permanently – I have to use one regularly anyway as I can’t walk more than a few metres, and that’s on a VERY good day. I spend a great part of every day stuck in bed in pain, inspite of taking morphine regularly, and having had my dose doubled in recent weeks.

    I really don’t want to put you off having this op as it may well solve all your problems – I know two other lady’s, who following the same operation went on to live full and active lives, BUT, equally I don’t want you to go in unprepared for what COULD happen either.

    I thought long and hard before deciding to comment on your post, but wish someone had told me that things could end up WORSE after the op, and I’m sure that right now, you’re thinking ‘surely it can’t get any worse’, but trust me, in my case it has.

    Anyway, I seem to have rambled on for ages, so I’ll sign off for now, but if you would like to chat please do feel free to get back to me.

    #37347

    Fritz
    Participant

    Hi Judi,

    So sorry to hear the pain you now suffer as a result of your experiences. It’s stories like yours that temper the claims of some surgeons and rightly cause other patients to fully consider the risks of surgery.

    As I explained in earlier posts, I feel I have done enough research, including the competency of the surgeon who’s doing the surgery! He’s also fully explained the methodology of the MIS TLIF procedure he’s going to do. He happens to be the surgeon that brought the MIS techniques of lumbar surgery over from the states and is regarded as an expert in MIS lumbar surgery. This is so much less risky than the methods used when yours was done 15 years ago.

    Whilst there are always still risks, I am confident that they are sufficiently low to go ahead.

    That said, the point if the blog is to let people know how it goes as it happens, successfully or not!

    Thank you for the heads up,

    Steve

    #37348

    Fritz
    Participant

    Wednesday 21st Jan

    Today I managed to remind myself how much pain I’m in underneath my medication by leaving them at home whilst on a trip out.

    It was supposed to be a short shopping trip but traffic congestion and an indecisive shopping companion turned it into a two hour trip instead of one.

    During this time, the slow release morphine wore off and I didn’t have any oramorph with me. So the breakthrough pain broke through!

    I had to drive home with that lovely burning-javelin-of-fire feeling running through my hips and down my left leg. I quickly relearned my breathing exercises and my son kept me distracted by turning the stereo up loud every time I complained about the pain!

    Fortunately, the drive home was quicker than the outbound journey and oramorph worked surprisingly quickly when we got home.

    In future, I will keep a better eye on when my meds are due to wear off and I’ll keep a dose of oramorph in the glove box. Or shop on amazon!

    More later,

    Steve

    #37359

    JudeB
    Participant

    Hi again Steve

    I’m glad that having read of my experience you still feel happy to go ahead with your op, I really didn’t want to put you off as I know it’s been successful for lots of people, but felt I had a duty to give you the heads up as to what really can happen if things don’t go as expected.

    I was sorry to hear about the pain you experienced while shopping, and having gone through the same thing years ago can confirm that keeping the Oramorph in the car in an EXCELLENT idea, it’s saved me on many occasions.

    Keeping everything crossed that all goes well for you, and will be keeping an eye out for your updates.

    Judi

    #37363

    DavidWirral
    Participant

    Hi Steve, Please think long and hard before you decide on your surgery. Have you thought what could happen if it does not work? Sorry to be so blunt but it was not something I did not consider at the time. I had spinal fusion at L5/S1 in June 2012 and I had a three pedicle screws inserted and a metal cage that contained bone farmed from my facet joints. I can not begin to describe the pain I was in post surgery, my discectomy felt like a walk in the park. When I met with the consultant I was told that it would take four hours to complete and there would be no need for a wound drain. The surgery actually took two surgeons 7 hours to complete as they had problems inserting one of the screws. I too was given a morphine button like Judi the first night was unbearable. The next day I had to have x-rays taken these were standing ones and I did not know how I managed to stand for those few moments. I saw the surgeon on the Saturday and he then said the wound drain needed to be removed. I can not tell you the relief I got once the wound drain was removed it felt like a huge amount of pressure had been taken off me and that night was the best nights sleep ever. The following morning I saw the physio who showed me the correct way to get out of bed and exercises to do. Once they checked that I could climb stairs they said I could come home. It was three days after my surgery. I felt great and even returned to work for a few hours per week after 8 weeks using only a walking stick. By early September I had a major pain flare up and I ended up on elbow crutches. I kept telling the surgeon that something was not right. I was not believed eventually through my GP fighting my corner they agreed to do a PET scan this was never reviewed despite me pestering the consultants secretary. When the scan was finally reviewed it showed that there were problems with the screws on the left hand side. I was admitted there and then from outpatients and the next morning I was undergoing surgery yet again. Once again I had a very long operation, the screws had managed to have infection around and had also become loose so the screws were removed I was then patched up with bone cement and I had to wear a huge spinal brace for six months. I was in hospital for over three weeks as I had to be blasted with antibiotics. I am now in the situation where I have been left having to use a wheelchair for distances over 50 metres, I am in constant pain and I take 80mg of zomorph twice a day along with oromorph for when the pain is very bad I take 21 tablets per day. I now have a diagnosis of failed back surgery causing a chronic pain condition that at times there is no relief from. I lost my job as part of a restructure but I suspect that this was due to the amount of time I had been absent. I can not even begin to describe what impact that this has had on my life. Holidays and travel are a thing of the past some days it is hard to even shower and dress. I attended a pain management programme last year and it has helped a little but my pain level is unbearable some days. Even sitting typing this post I am in agony and will need to take some oromorph. If I knew what I know now there is no way I would of gone through with the surgery. Rather than giving me my life back it has done just the opposite and to be honest the pain is worse than my original condition. Please ask your consultant lots of questions around the risks. If you go ahead good luck. I am sorry if the post is negative but I thought it might help your decision making if you heard from someone where it has not worked. Take Care Dave

    #37367

    Fritz
    Participant

    Hi Dave,

    As with Judi, I’m so sorry to hear of your bad experience with fusion surgery. I wish I could be of some comfort for you but, obviously, I’m no surgeon and can’t from a distance.

    I think the point has been made very clear from yours and Judi’s posts that fusion surgery has it’s risks and should not be a decision taken lightly. However, there are other things to bear in mind here:

    1. I have done all my research and weighed up the risks versus the benefits and I shall be having the surgery for reasons already stated above.

    2. People generally come onto this website because they are in pain and are seeking help and/or solutions to their pain. It therefore stands to reason that all those people that have had successful treatment wont be found here as they are getting on with their lives in a better place than they were before. Statistically, in contrast to yours and Judi’s experience, there will be 38 other patients who had a successful fusion.

    3. What I am trying to achieve through this thread is to inform those who follow me, what I go through before, during and after surgery, so that they can see the journey I go through and use it to inform their decision making if their pain gets to this stage.

    Don’t get me wrong, I absolutely feel sorry for anyone in pain, whatever the cause, but staying positive is part of the battle.

    Steve

    #37371

    JudeB
    Participant

    Hi Dave

    I know this sounds AWFUL but I am so relieved to find someone else who has found themselves in a similar position, and with similar pain to my own. Maybe we can offer each other some support?

    I realise that Steve probably thinks we’re looking on the black side because our operations were unsuccessful, but I for one am not, I just wanted to make him FULLY aware of how painful the operation is, and the possibility that things REALLY do go wrong sometimes. Surgeons tend to be very good at glossing over the negatives, mine had a 100% success rate, until me.

    However, I’ve come to terms with my situation now, and try and make the best of each day, even though I spend the vast majority of my days stuck in bed. Over the years I have sought out hobbies that help me to deal with the boredom aspect of being stuck at home, after all, you can only stand so much of day time TV. I’m wondering how you manage to get through your days, I’ve taken up paper crafts – i.e.. card making, scrapbooking etc. which I do on my better days when I can get out of bed for a while. Other days, I spend hours at a time on my lap book, thank heavens for the internet, which barely existed in the average home when I first had back problems. I also do patchwork by hand, cross stitch, and read from time to time, and have recently discovered, since treating myself to a Macbook, that there are apps for downloading jigsaws, which I am REALLY pleased about, as doing the odd puzzle used to be fun, but as the years have gone by I can do less and less sitting at the table, so a puzzle that I can do on the Macbook is great entertainment.

    Feel free to make contact if you feel I can be of any support.

    Judi

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