Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

Notice
All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

S1-L5 mild herniation and a "bone spur"

SteveCSSteveC Posts: 63
edited 06/11/2012 - 8:25 AM in Back Surgery and Neck Surgery
Morning All,

Thanks for reading all of this in advance. I'll start out by saying I am in shape, muscularly very strong, do weights, yoga, swim etc., don't smoke and only drink socially.

I am looking for some insight and thoughts on the next best move for me...laminectomy vs. fusion.
Two surgeons have warned me that a lam. will likely require a follow up in 5-10+ years to deal with further disc degeneration. Both have said this is required as a minimum.

One surgeon suggested fusion "now rather than later" since I do have some disc degeneration/thinning and a lam. won't address instability. I have no gross instability, but may have micro-instability (see below). He has said since my problem is S1-L5 that a disc replacement is not the best idea.

My physiatrist warned me that post-operative chronic pain was more likely following a fusion than a lam. (about 50%, versus about 15%). Not a fun prospect.

I think this frames the question: "Since stability points to fusion, is there any way that micro-instability can be assessed?" Since my initial flare up, I have often felt my lumbar/sacrum was "weak" or my hips were "unstable." I've never been sure if this was due to muscular tiredness due to other weakness/compensation or if I am (slightly) mechanically unstable. Which came first? Chicken or the egg?

Here's the executive summary:
23 months ago - searing white hot pain in lumbar/sacrum - no motion or initiating activity. Pain management worked. Chiropractic was "the old fashioned way" and did not work and on 2-3 occaisions made it worse. MRI nothing special to distinguish me from my peer group, some mild disc bulge, some mild stenosis.

4 months ago - sitting down...searing pain, body felt heavy on my back. Could only shuffle 6 inches at a time, with support. Only comfortable position was laying on my side. Had left leg drag a couple of days after, but didn't know how serious it was. Cleared up spontaneously in 3-4 days. MRI was same as before...perhaps a slight increase in herniation? Difficult for even the radiologist to be definitive.

3 rounds of epidurals - helped the pain.

1 month ago - left leg drag. Medrol dose pack, cleared up well in 1 day, 99% in 3 days. Surgical consult ordered - No need for surgery now...but be prepared in the future.

Last week - left leg drag, much worse than before. Bad enough to get an immediate consult with a surgeon and MRI. MRI showed maybe a 1mm increase in my hernaiated disc, putting pressure on the RL nerves, and a facet (?) putting pressure on my LL nerve. My physiatrist warned me that surgery was not being pro-active, it was reacting earlier, rather than later to an emergency situation "You need something done, sooner."

Thank you!
Steve
advertisement
1

Comments

  • Don't know what others would advise, but if you can get 5-10 years without a fusion, that's the route I would take! It just takes so long to recover from the fusion surgery. Who knows, the lammy might do the trick for longer than that! Just my thoughts.
  • :) first, i want to say hi and welcome you to the forum. :H we are here to offer you support and answer what questions we can. i have had a double laminectomy and had a good recovery. it is now over 25 years later and i am having problems but nothing surgery can fix. :''( i would not reccomend a fusion if the laminectomy can do the trick. good luck and ask lots of questions and get all your answers. :? good luck and i hope to see you around the forums. Jenny :>
  • Hi Steve, welcome to SH. You have found a great site of information and support. Have you had flexion and extension xrays to check for instability? Even these aren't absolute as far as the instability goes, but it usually the way to check for instability. I had them with result of marginal instability of my spondylolisthesis L4-5. At time of surgery, surgeon found extreme instability when he got in there. My back crunched with every little movement I made, even just standing and shifting my wieght back and forth on my feet caused grinding crunching noise in my spine. That sensation is totally gone now post fusion.
    As far as which surgery to do, only you and your surgeon can make that decision. I would recommend that you research each option thoroughly. Remember fusion patients often end up with adjacent disc disease later on requiring further fusion due to added stress on the surrounding discs. Often people start with the least invasive option first. Perhaps seek a second opinion from another surgeon to help you decide. Take care, >:D< Cali-Sue
  • I did have flexion and extension X-rays and no gross instability was noted. Although the surgeon says that micro-instabilities could play a role in my symptoms.

    I did speak to another surgeon whose attitude was "wait and see." Much as I don't want to go under the knife...3 hits of "drop foot/foot drag" in 3 months has me more rattled than the "white pain" although, dealing with that is no picnic either.

    I am leaning towards the laminectomy at this point. There doesn't appear to be any flags for instability, and prior to the first incidence of "white pain" my back felt very stable.

    But...that being said...my first physio noted some instability in my sacrum (post white pain attack)...I gave up doing laying ham curls as they hurt my lower back...I describe my back as feeling "weak" (and unstable) most often.

    Thanks again,

    Steve
  • I know it is a hard decision to make and probably even harder if you are not in constant pain.
    As has been said only you can make the final decision but you also have to look at the future. Once you have had a fusion there is a high chance that you will need further down the track as it puts more pressure on your discs above and below the fusion. So eg if you had a fusion now L5-S1, you may be looking at another one in 5-10 years.L4-5

    Or if you had the laminectony now you may still be looking at a fusion in 5-10 years but it would be L5-S1.

    Personally, if you are in great pain constantly and had definite instability then I would say go the fusion but if it is for the hernieation and you have tried everything else then why not start with the laminectomy and give it a chance.
    If you are fit and healthy as it seems you are then you have a great chance of this being your only surgery.

    Have you been having intense PT? Often that can revert the disc.

    Sorry for playing devils advocate. }:)

    Blessings Sara O:)
  • Angelback said:
    I know it is a hard decision to make and probably even harder if you are not in constant pain.
    Exactly!

    The surgeons letter described: disc dessication and collapse of the disc space, slight bulge to the right (my leg issues are always to the [strong]left[/strong]). Facet arthrosis and facet cyst directly over the left-sided nerve root (explains my drop left leg and the extreme "white pain" when things really go bad.) No other significant issues. He suggested laminectomy at a minimum

    I would describe my issue as discomfort in my sacrum and a feeling of weakness, but intermittant (pain only when there is a major flare - of which there have only been 2 - but they involve several weeks before they calm down). The ache/weakness can come on for obvious reasons like wrestling my son, or just from waking up in the morning. It is not debilitating, but I do have to be careful what I do, lest I feel weaker. This is the part which makes me think fusion.
    Angelback said:
    if you had a fusion now L5-S1, you may be looking at another one in 5-10 years.L4-5

    Or if you had the laminectony now you may still be looking at a fusion in 5-10 years but it would be L5-S1.
    Agreed. It seems discretion might be the better part of back surgery.
    Angelback said:
    Have you been having intense PT? Often that can revert the disc.
    The PT I had involved Pilates type exercises which are so easy for me, unless of course I am in the middle of a "weak" phase, in thich case the balance skills are way off.

    Likewise, I do yoga as often as a I can. Apart from being inflexible, like most guys, I have no problems...unless of course the back is giving me some issues. If I am, I modify significantly.

    I don't know which came first...does the nerve on the left and bulge on the right give me the feeling of weakness, or is my sacrum wobbly? One PT did notice a "tip" in my hips when doing a laying ham curl.

    Yup, it's a tough choice. I know if it was my prostate, I would be very aggressive, but my back isn't going to kill me, but it will depress me because I can't work out or wrestle my son.

    I suppose if a laminectomy and disc trim, addresses the nerve issues (on both sides), it will act as a diagnostic for instabilities as nerves will be out of the equation.

    Thanks for listening to my out loud thoughts and thank you everyone.
  • A lami takes bone away from the vertebrates. It doesn't address the bulged disc. The disc might continue to bulge even further afterwards and you will be back to square one.
    Sometimes lami's de-stabilize the vertebrates because the procedure involves cutting of ligaments, muscle.

    Fusions are really bad too.

    Real nice choices we have, huh?
    Ugh.

    How is your 4-5 disc?
    -----------------------------
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • you can have a laminectomy and a discectomy at the same time. I know most Drs in Oz do it as a pair because often if you need one you need them both.

    Steve - let us know what you decide.

    Blessings Sara O:)
  • Like Angelback, the doctors here do the Discectomy along with the Laminectomy.

    To the original poster: If a doctor gives you more than one option, in my opinion, then fusion is NOT the way to go. Fusion should only be done as a LAST resort. It doesn't matter if you would eventually need one... It's better to put it off 5 or 10 years, than have one now then another in 5 or 10 years on top of that. Ya know? The longer you can put off a fusion, the better. Any experienced, knowledgeable, caring surgeon who is good at what he or she does will tell you that. If there is another option that is a lot less drastic than the fusion, that should always be the first attempt. It's better to start small. If the Laminectomy doesn't do the trick, it's not a major surgery, so it's not big deal if it fails... Then you know you tried, and you can go into the fusion knowing you did everything you could. HOWEVER, if you go for the fusion and it doesn't fix the problem and you end up with Pseudoarthritis, for example, you may regret it and wish you tried the Laminectomy instead. Fusions cannot be undone. Put it off as long as you can.

    I'm 22 and had to have my L4-L5 fused, and was basically told at some point even though L5-S1 is looking fine for now, I will end up with that one going and having it fused. At 22, I am hoping and praying for at least another 60 years on this earth... My L5-S1 disc is not going to last 60 years between a fused L4-L5, and a tailbone. Lol. But I had no other choice... I was risking permanent nerve damage and permanent weakness in my leg, to the point where I was tripping over it and couldn't even drive without lifting my thigh off the seat to let up a little on the gas. It's rare to need a fusion from DDD at 22, but I had tried the P.T., the Chiro, the injections, the TENS unit, the Ultrasound therapy, the MicroD, the Aquatic P.T.... And it was getting worse... And I reherniated and seriously aggravated my nerve. It was an emergency surgery... 12 hours after seeing my Doctor. That's the only reason they did a fusion for me being so young.... And I am prepared for the future... I know I will end up with more back surgeries, but if I had another option aside from fusion, I would have gone with that first...

    My fusion surgery was a MAJOR success, and I am starting to fuse ALREADY at 8 weeks post op... BUT, like Angelback said and I think someone else... Starting small is most likely your best bet... And if something is inevitable, it's inevitable... But you shouldn't throw in the towel right away just because you dread the future... Do what you can for right now... You never know what the future will actually bring.


  • Thank you all...Right now I am realling leaning towards the laminectomy and disc "trimming"

    The sugeon made the following comments (paraphrased from a letter):
    One consideration...microlaminectomy and decompression of the nerve root - the downside is that it would not address the degenerate changes at the L5-S1 level

    Now regarding fusion:
    More definitive surgery would be a min invasive L5-S1 fusion with interbody fusion and pedicle screw fixation...risks...I would favor the fusion over *disk replacement* because of the anterior approach and risks of retrograde ejaculation. In addition we do see facet arhtrosis at the L5-S1 level in what may be a small facet cyst which could not be address with an anterior approach.

    Thank you all once again.

    Steve

    PS. Final consult with the surgeon mid-December for a January op...will let everyone know how it goes.
  • 1 Surgeon and 1 pain specialist meeting later...
    Surgeon favours "spinal decomporession" comprising laminectomy and arthrosis/cyst removal on the left side only. Slightly bulging disc on right side is not going to be addressed at this time.

    Pain specialist agreed and is going to do an S5-L1 temporary nerve block next week to make sure the only issue is with nerve impingement.

    The op is set ofr 7 Jan...I am actually looking forward to it. :D

    Happy Holidays (of your choice).

    Steve
  • Looking forward to it is a really good sign and the best thing you can take to hopsital with you is a positive attitude and a willingness to work hard.
    All the best for Jan 7th .

    Blessings Sara O:)
  • Steve,

    I had a similar choice, but under different circumstances. In my case, I had back problems on-and-off for 19 years, and constant pain for the last year - even after ESI's. I had a disc bulge displacing a nerve root and the disc had already partially collapsed.

    My surgeon gave me the choice of doing a fusion now or discectomy now and fusion in 5 years (maybe 10). He did warn me that if we did the discectomy, due to the disc already collapsing, it was very likely that the disc would bulge again and hit a nerve. Even if that did not happen, the disc would completely deteriorate and I could end up with a bone-on-bone situation. Actually, he also gave me the option of disc replacement, but due to its currently low success rate and need to repeat down the road, I immediately decided against it.

    Since I had a fusion in my future anyway, I decided to have it done now (well, back in August). The factors in my decision were:

    1. I would rather have back surgery only once, if possible. even if the first one would be "minimally invasive." Why let someone mess around back there more than necessary?

    2. There was a good chance that without a fusion, the same or worse situation and symptoms would return within 1-3 years.

    3. The timing was good for me to deal with recovery from a fusion.

    4. There was no way for me to avoid a fusion, now or in the future.

    5. I happened to find an excellent surgeon with 28 years of experience doing nothing but caring for people's spines.

    6. I spent 19 years having problems and was willing to continue the pain process through surgical recovery. I did not want to be in the position of looking at more back pain and another surgical recovery in the future. I've had enough of that already.

    My surgeon did not try to convince me to do the fusion now. He merely presented me with the facts of my condition and what could happen from either approach.

    While there is a much greater chance that years after a fusion neighboring disc levels may also require fusion, this does not always happen.

    I asked my surgeon what can be done to prevent that, or to prevent other discs from going due to natural deterioration. He said the best thing to do is try to hold off the aging process. For your back, this can be done by a combination of staying in shape and being careful about your movements.

    Staying in shape includes exercising regularly to maintain your core and back muscles. It also involves becoming and staying as flexible as possible.

    Being careful about your movements means being careful about twisting and how you lift things. Never twist when lifting and pick things up by bending at your knees and using your arms as well - maintain good spinal posture at all times.

    I am in my mid-40's, and while my surgeon could not guarantee not needing another fusion later in life, he said if I take care of myself, there is a good chance I won't need another one. He says this is possible even if start playing golf again - I just need to be careful during my swing, but more importantly, how I bend to pick up my ball.

    To achieve this, I will have to change my lifestyle. I will have to continue doing stretches and exercises for the rest of my life. I cannot allow myself to become overweight - especially adding weight to my mid-section. I will have to be careful about how I bend down and how I lift things.

    I look at these as good changes and have a positive outlook for my future.

    I am not trying to convince you to have fusion surgery now. That is a decision only you can make. I just wanted to give you a different view of the situation and let you know that while the surgical and recovery processes are not pleasant, having spinal fusion surgery is not the end of the world and doesn't have to be as bad as it is made out to be.

    Whatever you decide to do, probably the two most important things to do is be educated about your situation and make sure you get the best surgeon you can find.

    Good luck! :)))
  • Merry Christmas Steve,

    Steve, you have and are going through your decision making in a very well thought out manner, and you are seeking out the thoughts of medical professionals and others here on EH. I commend you for both.

    You have received SUPERB responses from all the above posters. Their experiences, thoughts advice, wisdom, and encouragement.

    Making a spinal decison isn't easy as you well know. It is one you don't make overnight. In the summer of '07 I went through that "process". It took me several months to come to a decision that I felt was right for me.

    I wish you the very best in your upcoming surgery. Please do keep us updated.

    RichT
  • First the medical part...the surgeon suggested a nerve block to confirm the issues were truly nerve related.

    So, as the last patient on New Years Eve I pop in to see Dr C, expecting a similar procedure to the epidurals...not quite. In fact a lot more uncomfortable and it sent lots of unpleasant sensations down my leg. The coolpart was looking at the X-rays as the injection took place (I even got a copy of the X-ray). Ultimately, the symptoms with the nerve block were exactly the same as when I had the leg drag episode and the dull ache I always have now went away. Slam dunk! Now I know deco is the way to go.

    Now the funny part (in retrospect). After Dr C removed the needles etc., I began to feel very dizzy. So I told them I was going into shock. They congratulated for realising it :) and told me it was fairly normal as the muscles don't like having needles stuck in them and neither did the nerves. So I hugged my legs. In comes "my buddy" with a wheel chair and I try to sit up...not going to happen. So I lay back down. Next my buddy comes in with a "recliner" which I manage to get into with a lot of help.

    By the time I get to the pre-surgical area, I am in a bad way, Dr C picks me up and puts me on a guerny (if I was gay and not so ready to faint I would have been fainting anyway, Dr C is a good looking guy!).

    I am about passed out and know they are asking when I last ate (4h a granola bar and 4h before that my usual breakfast) or drank (4h). I felt like I am about to throw up and I notice someone has put a bowl by my head :sick: . They somehow get a BP cuff on me and I am told I am breathing too fast and need to slow it down. Dr C sticks me with a needle and they get a drip going. They asked how I felt...cold, so I got a blanket and close my eyes and concentrate on my breathing. About 15 minutes later I am feeling much better and my BP has risen to 103/65 (when I came in it was 114/70). I asked how low it got...68/53...and it took them a while to get the cuff on. No wonder I felt bad! Luckily my pulse ox was at 100% the whole time.

    I found out afterwards that there are different kinds of shock. Usually, your BP drops and your heart picks up the slack. But this time, BP dropped and my heart slowed down.

    At the end of all this...I am happy about the forthcoming procedure and even more impressed with Dr C (who I thought was absolutely amazing in the first place). =D>
  • 2 days post-op I am still very sore and popping pergocets and valium as allowed by dosing. In fact I had to ask my wife what day it was and how many days it had been. I am sleeping a lot...close to 18h a day. I'm amazed at how those pergocets put you out. Plus, the nurses did describe me as a light weight, I don't need much to knock me out.

    I do feel the pressure I felt during the last few months has decreased, but it is somewhat difficult to say, I am still a bit loopy.

    The surgeon did tell my wife that my left nerve was well and truly trapped and took a bit of work to loosen it up and get it out. So it is a damned good job I just didn't sit and wait. In fact in hindsight, I have had that pressure type feeling aorund my sacrum for the last 2 years, ever since my first flare up. My nerves have been getting hit for a long time.

    My pain specialist has given me 8 weeks on short term, with periodic evaluations.

    I'll write mroe once I am not on the pergocets as much.
  • Things are pgoressing...I am still very tired a lot of the time. I still have to sit reclined with cushions, sitting normally is not possible. Standing for a while (3-5 mins is OK), but beyond that is sore. I can recline for as long as needed. I am still in anti-thrombosis stockings (not very sexy, you'd think they could at least make them black and shear wouldn't you?) I tried to dress my son this morning and feed the dog and cats and that led to a full Percocet - mustn't overdo it, my body lets me know immediately.

    I'm down to half a 7.5mg pergocet as needed - which typically is first thing in the morning and early evening, sometimes before bed. Doesn't kil all of the pain, but a fair bit. I am very concerned about the additive potential of Percocet, because it does feel very nice. Now on 3 Lyrica a day, morning, night and one other as needed. Also half a 5mg Valium as needed. I try and use 2.5mg Valium/150 mg Lyrica instead of Percocet as it doesn't hinder my thinking so much.

    Any thoughts on the drugs? Should I be so scared of addiction?
  • I had fusion/decompression/cyst removal 11/18. I'm still on some Lortab - approx 25 mgs. a day. Not a doctor but I've been told that my constant reduction in pain medication plus the fact that it's just been 2 months that I've used them does not add up to addiction problems.

    Ask your doc, tho. He's the expert and should be able to answer these questions. Your situation is different as fusion patients like myself can not take and aspirin or ibuprofen for at least 6 months (and tylenol does nothing for me) so I'll probably be on some very low doses of lortab for several months to come.

    Best of luck on your healing!!! Sounds like you are doing well, at this point.
  • I am walking naturally - although only for short time.

    Drugs are no ibuprofen and 2.5mg Valium as needed, plus Lyrica :)

    Still sleep with a pillow under my knees and on my back - I can sleep on my side, but rolling back hurts enough to half wake me up.

    Sitting upright is possible, but I prefer a pillow under me so my butt is lower than my thighs, plus a pillow behind my back to help keep things comfortable.

    Ironically, I feel some discomfot on the right, the same kind of pressure I felt on my left (and I do have a slight bulge on the right which wasn't deal with), whic worries me...but it is early days yet and a lot of stuff is recovering from supporting a very tangled up nerve and hence muscle system.

    :)
  • What is the difference between a discectomy and a laminectomy? I had a laminectomy. This is the first time I've read that you will probably need another laminectomy in 5 to 10 years. The doctor that did my first one said, and I quote, "You'll never have probs. with this disc again." 20 years later, and sure enough, I had to have another.

    csp
  • CSP in an ideal world we all have a problem that is present and static that pops out of nowhere. But just like Schroedingers cat, you never know if it is alive or dead. Same with the the spiney's issues...if your problem was due to an injury, then a single procedure will probably fix everything. If you have a degenerative condition then at some point in the future you will need another procedure.

    As I understand it - and I'm not an MD...discectomy is where they trim away the bulged part of the disc.

    Lamina are defined as: An anatomical portion of a vertebra. For each vertebra, two lamina connect the pedicles to the spinous process as part of the neural arch.
    http://www.spineuniverse.com/displayarticle.php/article1298.html

    You have to chip out part of the lamina to get to the "nerve canal" and the discs.

    So basically I had a bulging disc causing some irritation and a thnning which caused a cyst on a facet which put direct pressure on the nerves. So, they chopped away the lamina with the cyst and then got in to make some space for th enerves and trimmed up the disc.

    Often the whole thing is referred to as a "spinal decompression."

    The whole thing about having another again was the potential for 5-10 years down the road possible continuing disc degeneration could cause more "crashing together" if you will, which would require a fusion to keep things apart as the disc would be replaced by a "mortar" of bone about the thickness of a healthy disc.
  • OK this is a summary of a new thread I started:
    http://www.spine-health.com/forum/back-surgery-and-neck-surgery/post-op-feelings

    I still feel pressure around my sacrum (I had L5-S1 lam/disc) similar to pre-op. I have that "feeling" (a slight numbness from butt to mid thigh - not from the sciatic nerve) that I had in my left leg pre-op...this is also the feeling that I had (but less so) before my drop/drag leg incidents.

    I also feel like I am having to hold my bladder. after trying to get a BM going (which in iteself causes urination), if I move just the way and there's more than a few drops left. Off I go to wipe up and I can take a pretty long whizz. I know this is not classic incontinence, but it isn't normal either...I'm concerned this may be caudus equina syndrome (as defined in Wikipedia among the symptoms are: sphincter weaknesses causing urinary retention and post-void residual incontinence). This has got me worried I may have a mild form?

    Couple of comments - the surgeon said my nerve was well and truly trapped and it would take a while to recover.
  • I wouldn't be too worried yet. The different pains and sensations you will feel after surgery are all over the map. Things you never felt before, things you have, it's totally unpredictable. Unless you can't hold your bladder or BM in and you're having accidents, I highly doubt it's CES.

    If you want some reassurance, I'd say visit your doctor... But usually there isn't much they do that soon after surgery BECAUSE of the fact that the feelings afterwards vary so much from one person to the next.
  • I met with one of the PA's who was absolutely wonderful. She was very reassuring and explained all about what was going on and made some following "recommendations":
    1. Ice...every 4h for 20 mins. I have some nice mushy ice packs they gave me - very comfortable
    2. Take the valium and percocet no matter what. The presence of any discomfort and muscle tightness will hinder my recovery and have me walking in a very stiff way. Taper off after 2-3 weeks and raise Ibuprofen to compensate.
    3. The "discomfort" I feel when I bend forward is due to the stitches stretching (internal) and is very normal.
    4. No lifting above 10 lbs...increase by 5 lbs/week
    5. No driving unless it is an emergency for another week. Passenger is OK for as long as I am comfortable (and I was not today)
    6. No swimming for another week :(

    So there we have it. I'm tired right now, but quite happy :)

    Om Chanti, Chanti, Chanti
  • The incision is feeling good. I've not had a scar in living memory, so it does feel very raised to the touch. But it has lost the swelling which I am told was present at my last consult.

    Yesterday I felt great...went out with the family and was very, very careful. For some reason towards the end of the day I was in enough pain to take a full 7.5 percocet. It wasn't directly in my spine (it never really was apart from the pressure around my sacrum) more out from there but still at about the same level.

    In the morning I managed to take a half a percocet and 4 ibuprofen. 2 hours in an ice pack and I was moving around OK. Then while moving aorund more getting some lunch, hurt again...this time half a valium and 4 more ibuprofen.

    Lesson learned...anything can set things a (few) steps back. If your SO etc., asks you to do something you *have* to say no. I find it hard to do that and suffer. Not that my wife is deliberately trying to harm me, more that she is remembering the muscle bound superman I used to be - and will be back to soon.

    I get to go swimming next week which should help my muscles and my state of mind. I've been a bit grouchy at times, spaced out at others and have been having problems getting the right word from my brain to my mouth. Sometimes I can't even think of the word and end up doing gestures. It's strange. My wife is concerned, so am I, but I am not going to panic until I am off the percocet and valium for a week or so. Even low doses of those over time will cause some degree of physical dependancy.
  • The changes are amazing. Only now after being essentially pain free and having much lower levels of discomfort (mostly in the 0-2 range) can I really appreciate (?) just how much I have been in discomfort of varying degrees since my first hit about 2 years ago and of course since the August 2008 hit. I feel different.

    I have had to take valium and/or percocet twice in the last week. the first time was after 2.5 sitting in the car, then about another 3-4 mostly sitting, followed by 1h in the car. Very, very sore after that. The other time I had some muscle spasms in my back, bad enough to cry out. But valium did the trick in about 5 mins. No more mild inconctinence, some occaisional tingling in my leg. Typically the discomfort is around the tail bone itself. Jeans are not your fried whwn you have a scar forming along that seam!

    I have managed to get back to the gym 3 times now. First time I did 3 mins elliptical and low weights (with squeeze) on legs, back, bis and tris. I hurt the next day, mostly in my back. I swam last Friday and definitely suffered, I don't think my back likes the flexing of breast stroke. I learned.

    Om Chanti!
  • Hi DrSteve:
    Thanks so much for sharing your post Laminectony/Decompression Surgery information as I have been searching for info on post Lami surgery as I am scheduled for one May 12/09. How many days were you in the hospital? How hard was it to travel in a vehicle after as I have a 4 hour ride home after they release me from the hospital.
    Thanks Again
    Nana Shan
  • It is an in and out the same day. I honestly was a bit miffed about that - by 6pm I was still way woozy by the anaesthetic and really could have stayed overnight.

    Travelling home wasn't the greatest experience. But they gave me a big dose of percocet and a valium and it was all good. I had an extra couple of cushions so my butt wasn't lower than my knees, recline the seat and raised myself up for big bumps. Given you have a 4h ride, doing it right after surgery when you are still half asleep seems a really good idea. Also bear in mind I was L5-S1.
  • It's amazing how being laid up can let your mind do some thinking...and one of the things I got to thinking was how much I absolutely hated my job (OK no surprises there), but it also got me to thinking how unhappy I am with my career path. I'm getting fed up of waiting for "my dues to bring in some returns." So, cutting a long story short, I have decided to pursue options in the health care sector (most likely as an MD - I've already got the PhD). I'm even taking a couple of courses to ge me through the MCATs and the basic med school pre-reqs.

    I spoke to my surgeon and PA about this and they offered to let me shadow them. So I spent a day with them while they did office consults. Very nice to see it as an observer rather than a patient. They also explained to me (within confidentiality guidelines) about each case. Some very interesting stuff, and they were both happy to answer my questions.

    The next part was the cool part...I got to be in the OR with them as well (with patient consent)! I saw a C2-4 fusion and an L5-S1 lami/disc! Brian and Chris (my PA) were a *great* team and talked me through everything and answered all of my questions. I've seen cool, calm and confident people...but Brian is in the top echelons (perhaps Dr C trumps him just slightly). Come to think of it I haven't met anyone in my own field who oozes with such confidence. I am damned glad Brian and Chris did my surgury.

    Some observations...it's amazing just how things are done during the fusions. Let's just say it is a lot less delicate than you might think. OK, so putting screws into the spine doesn't sound like it would be delicate, but putting the bone grafts (?) in place after removal of the disc and with the vertebrae manually seperated, was really not. It takes some force. I was surprised I didn't feel queezy, but there is a certain detachment in the OR as you don't see a face, the only body part on show is the region being operated on.

    I saw the lami/disc on the big screen. Not as exciting, but they are operating through a 22mm tube! Brian pointed out what was going on again. Very clear what was going on. I asked him afterwards about how the nerve gets repositioned and why it doesn't damage it. Apparently nerves can take a lot of moving, it's just knives and constant smashing they can't deal with. So the contcat during surgery is not a big deal.

    I was rather surprised that each of the patients was conscious (although groggy) when they came in and extubated before they left the OR. I do have vague memories of going into the OR, but not coming out. Last thing I remember with clarity was the guerney hitting into some SS shelving going through a door and saying "oops, careful!" On the other side I woke up and said "Have they done it already?"

    The downside...being on my feet (even with breaks) did not do me any favours, even 7 weeks out. In fact I was sore enough that I popped Percocet for the rest of that day and the next (the full dose!)

    Otherwise, things are trundling on, definitely improving, but I feel a lot more irritation now. Perhaps due to ramping down my Lyrica, but also perhaps due to more feeling being restored to the nerve root? I'm not sure, medicine is not an exact science afterall, it is an art, and I saw that in the OR.
  • I'm new on here and wanted to thank you for posting your experience on this message board. My situation is similar to yours except on different spinal levels. I'm 20 days post-op right now and have had my leg pain come back in the last week. Not sure if that is due to the irritated nerves from retraction during surgery which was subsequently hidden by the steroid bath I was given before closure OR something new going on. Everyone says to be patient and that these "tinglings and pain" are normal. It's a little worse than before surgery but manageable. Any advice in regards to that? During your healing process, did you take any anti-infammatories?

    Sounds like you are recovering well and that you are enjoying a new career! Congrats to you!

    ~KB
advertisement
Sign In or Register to comment.