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Could use a little encouragement everyone...

nursedina001nnursedina001 Posts: 235
edited 06/11/2012 - 8:27 AM in Back Surgery and Neck Surgery
Hey all, well I am 6 weeks post op from PLIF L4/L5 and have developed a few new symptoms.

My left foot drop only resolved for about 1-2 days after surgery and now it is back, an dI feel it is worse than before with more numbness,

I am having right sided sciatica pain that was not there before. I am gettting a burning horrible pain on my right buttock that was not there before that is super sensitive to touch. and swelling on incision that goes up and down as day progresses.

Well, I demanded to talk to doc (as some of you know, she did not have great aftercare with me) and she set up and appointment and said that swelling on incision was normal, but wanted an MRI/xray to determine if new symptoms warranted another surgery. I asked her why she only did one level when she was supposed to do 2 levels and she said she erred on the side of caution and did not want to fuse L/5-S1 as well cause she felt I was too young.

Well, went for the MRI and these are the results: my last MRI was only 5 months ago.

Dessication L-3 - S1 (knew that already)

L3-L4 disc bulge (this is new) with bilateral facet hypertrophy and ligamentum flavum infolding (this is all new stuff since last MRI)

L4-L5 mild disc bulge - Ligamentum flavum infolding - all new

L5-S1 - diffuse disc bulge (NEW) which combines with bilateral facet hypertrophy to cause narrowing of the lateral recesses. and signal alteration of the posterior aspect of the disc compatible with an annular tear (NEW) and moderate bialteral neral formainal narrowing.

Also two ovoid fluid collection identified posterior to L3 spinal process measuring 2.1 x .7 x 1.1 cm and one midline through subcutaneous fat at L3-L4 level which is 4.4 x 1.8 x 1.3 cm.

Ok all... I may be a nurse bu tI have no idea what ligamentum flavum infolding means and I have no idea if any of this will require more surgery.

I know I need to wait till my doc calls and we talk it over, but any and all responses and all good wishes are appreciated!!! Also, any adivce you could give me about your own experiences would be greatly appreciated!!

Thanks in advance!!


  • Sorry that you are in pain.
    Infolding probably means thickening of the ligament.It is one of the causes of stenosis.If I were you I'd be more worried about the swelling and fluid collection.
    My humble response and best wishes to you!Feel better!

  • I remember when you were being bumped off your scheduled surgery. It seems like it was a long time ago, but it's only been 6 weeks. You're still very early in your recovery. Doctors use the 12 week window to gauge the recovery rate and they hope by then that you have gotten over the worst part. My surgeon told me it takes 12-18 months for the nerve to totally heal. It's hard to say when the back pain will go away, if it does. My other surgeon told me that back surgery is not for back pain, but for leg pain. I agree it wasn't the most reassuring thing to hear, but we must not give up hope. Did you stop using Fentanyl patches? I read that you were on 75 mcg post op. I had mine increased from 25 to 50 mcg post TLIF. Have you tried putting the patch on your belly to do away with the side effects?
    Well, I know this sounds old but hang in there and don't give up. We're behind you all the way and want to see you get better. Take care
  • We may only be on the internet, but we're there for you. This whole thing sucks, I know. It especially sucks when you're a nurse and now suddenly you have to turn into a PATIENT. Not trying to offend anyone, it's just hard to get into a different mindset.

    Honey, I would get a second opinion. You have ONE spine and that's it. You don't want to ever regret that you didn't just take an extra bit of time to get that second opinion, you want to be able to know for sure you are making the right decisions. Of course, I have to throw in a word about bmp induced bone growth on nerve roots causing worse postop nerve pain, make sure you ask if that's a possibility in your case.

    You can always vent to us. We know how you feel and we know you aren't crazy. Keep on keeping on. I really think you owe it to yourself to get another opinion, just so you can be sure.

  • Yeah, I know it is early to be worried, but she was especially worried about the new symptoms. Mostly because I think she thinks now that she should have done the double fusion in the first place.

    I know it takes much time to heal but all of a sudden I have a bulge in L3/4 that was not there before, a diffuse bulge in L5/S1 that was not there before, an annular tear in the same place, that was not there before, and this infolding of the ligamentum flavum..hmmmm

    I had to take off the Fentanyl patches due to the vomiting, It was horrible violent cyclic vomiting. It was determined that I am not allergic to Fentanyl since I can get it by IV, bu tI am allergic to the thing they mix it with in the patch. So.,..no more patches for me, Currently I am taking percocet 10/325 alternating with demerol and it seems to be working for the most part.

    Thanks for responding!!
  • I didn't have any BMP. She used only my own bone for the fusion.

    I am worried about the new disc bulges that weren't there 5 months ago (L3/4) and (L5-S1) and the annular tear at L5-S1..and is the infolding of the ligamentum flavum a thing that requires surgery? ugh... I have no idea and the waiting game till I talk to her is driving me crazy!! I make a terrible patient!!!

    Thanks Angie! I appreciate it!!
  • When are you supposed to hear back from the doctor? I'm surprised that you have the results of the MRI before talking to the doctor. I never get any results until I get it from them. Perhaps this is why - it would drive me crazy too.

    I wish I could give you some advice on the readings, but I'm pretty ignorant as to what all that stuff means. Someone typically translates it to me or I "Google" the terms to see what I get. It's amazing what we can find.

    I too am having PLIF (8 weeks) post op issues and had to call the doctor again today. Isn't it crazy how fixing one thing can create such havoc elsewhere within the body.

    Keep us posted on what the doctor says about the MRI. I am so sorry that you have to experience these issues. Take care and let us know what the doctor says.
  • I got the results cause I go to an imaging center to get the tests done, and I just go and ask them for the radiologist report. I know it will drive my doc insane that I got the results probably before she did..lol..

    Thanks for the encouragement, I have no idea when she will call me back..Hopefully by Monday. I am also going ot take the advice of Angie and submit my case to another NS at a great hospital only a couple hours away from me and see if what they have to say about the results and whether or not they think I need the surgery,

    The only bad thing is that if I need surgery, I am not so sure that I want it 2-3 hours away from home, That is a long way away. I have kids y'know?

    I trust my surgeon's skills. I think she is a great and terrifically talented surgeon, I just hate the fact that she is not available as much as I woul dlike her for aftercare, and that really relaly bothers me.

    Well, we'll see what happens..

    Thanks for the support cause I am losing my mind!!

    :) :) :)
  • You're an ER nurse, you lost your mind a long time ago sweetie! :) Doesn't mean you can't think and doesn't mean you don't know in your gut when something isn't right. Our best skill is our "gut feeling."

    Take care of yourself or you cannot take care of your kids. After my botched fusion, I had to make the decision to have surgery 2 1/2 hours away from my babies(now 15, 12, and 4.) What do you tell your patients and their families? If YOU don't take care of YOURSELF you won't be able to take care of your babies. Remember that, I know you've given that advice before, I know you have.

  • Yeah,

    I will get second opinion. But I am not too sure about any surgeon anymore. Just like you said, I have to listen to that "inner" voice.

    I do trust my surgeon, Very much, I am not so sure another surgeon would even tough me at this point, We all know, especially as nurses, how difficult it is to get a surgeon to look at someone after another surgeon has touched them. I am only 6 weeks post op. No surgeon worth his salt would step within 6 feet of me.

    I will however try. I will also wait for my doc to get back to me about results and I will see her opinion on what needs to be done. None of this may require more surgery and I could just have to take some more time to heal and rest.
    Wish me luck and I will keep you updated!!

    BTW...You're right,.,,,I AM CRAZY!!
  • A couple things to consider:

    First, it has been my experience that the reports from different radiologists vary quite a bit, both in detail and in things that are emphasized. Do you know if the same radiologist read this MRI? It is entirely possible that the bulges were there previously, but were not as significant as the other issues you had and therefore, were not specifically mentioned. It is also possible that they were there but were not readily apparent on the MRI.

    It sounds like all the bulges and infolding of the ligamentum flavum may all be contributing to central canal stenosis. Was this a problem for you prior to your fusion?

    I hope the surgeon calls you back soon so you will have the information you need. I know how discouraging it is to have a fusion and come out of it with new/different pain than before the surgery. Been there....
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