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Just for fun - Can you explain surgical report?

Jan MartinJJan Martin Posts: 164
edited 06/11/2012 - 8:34 AM in Back Surgery and Neck Surgery
Hi All,
Can't believe I am 3 weeks post-op today. Feel much better, practically human. I'm walking about a mile 2 or 3 times a day and taking it easy otherwise. Prior to surgery I was told I would have decompression/laminectomiy and TLIF at L4-L5 with instrumentation due to massive herniation and spondylolesthesis. I've stated previously that I was surprised that my incision was so long (8"). I received the surgical report yesterday and am a little taken aback by the amount of work that was done. Who can help me intrepret? I think I get it but I'm too impatient to wait until I see my surgeon in 3 weeks.

The report states:
Decompressive laminectomies at L3, L4, and L5 - I get this.
Dural tear at L3-L5. Oops
Herniated disc removed at L4-L5.
TLIF spacer placed at L4-L5.
Six pedicle screws used.
Transition rod used with dynamic portion at L3-L4 and static portion at L4-L5.
Bilateral posterolateral fusion performed at L4-L5 and L5-S1 using local bone graft and new bone allograft.

I've done a lot of reading/research before and since the surgery but I'm a tad confused about what was actually done as far as what what fused and how. Anybody willing to take a stab at it? I know. None of us are doctors.

I can't wait to see my x-rays!!!!


  • I am no doctor, but it looks to me like you had herniated disc at L4-5 taken out, and a spacer put there so you wouldn't have bone on bone issues there. Because of that spacer, they put some rods on that area (which covers the disc above and the disc below - for stabilization) and that's what they used the little screws for. There is also fusion at L4-5 and L5-S1. For this they used bone graft material.

    Spine-Health states this as the definition of lamina:

    The flattened or arched part of the vertebral arch, forming the roof of the spinal canal; the posterior part of the spinal ring that covers the spinal cord or nerves.

    The Suffix "-otomy" or "-ectomy" means removal. So, whatever precedes -otomy or -ectomy is what was removed....

    All of this could be researched by going to Spine-Health's HOME PAGE. There are videos on a good many procedures - from surgery to ESI's. They are actually pretty neat. If I don't know what something is, I look up definitions and such and piece the information together. I am weird like that.... :B

    Since you've had your surgery, do you have the attitude that I had after mine? That "Why didn't I do this SOONER?" attitude? I waited too long to have mine done (it was just a hemilami at L5-S1) thinking it would get better on its own, yet every specialist I saw before the actual procedure kept asking me when I wanted to have it done. I thought they had ulterior motives (a new car, vacation home, house note to pay for) and, as I said, pooh-poohed them off thinking it'd go away without surgery. Pig-headed me.

    I've learned to leave the speculating to the professionals who have the background information needed to make an informed decision.

    Hope this helps!
  • Thanks for your input. I have checked out all the videos/info on SH for the last 3 months. I sometimes think I am obsessing! I am very weird that way too. I find it all fascinating and feel pretty well informed. I was a little confused about exactly what the report meant. Do I just have instrumentation between L3-L4 and L4-L5 with the spacer at L4-L5 and then just some graft material postlaterally between L5 and S1 with no instrumentation?

    As for your other question - The extreme pain I was in prior to surgery started in January of this year. I kept thinking it would get better. I resisted surgery in that I didn't want to deal with the recouperation. I am a very impatient patient. I'm a teacher though and finally realized that I could not continue working with the level of pain I was in. So, here I am with more involved surgery than I thought and wondering how in the world my students will make it without me for another 2 months. :) The great news is that the leg pain is gone and I am just dealing with post-op stuff. Hopefully all will work out in the long run.
  • The took out your damaged disc, put in a spacer to keep your vertebrae apart, put in your bone graft using some of your local bone and some cadaver bone (allograft), put six screws into your vertebrae, using dynamic (or moveable) rods at the L3/4 level and fixed at the L4/5, and L5/S1 levels. So, you're going to be fused at two levels and semi-fused with a bit of movement at L3/4 - probably done to protect the disc at that level.


    PS -- at least I THINK so!! LOL
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • That's how my brain processed it too. I was just so surprised since it was intially to be a single level fusion. I think they must have put in the dynamic rods at L3-L4 to help dissipate the stress from L4-L5 fusion. Thanks for your suggestions. Can't wait to talk with the surgeon too. You guys are all great sources of information and support.

  • I'm glad you've been busy checking out all the info on this site, and others. As you know from being a teacher, knowledge is power. I think it is very important for spineys to learn all they can about their condition so they can participate in decisions about their care. It is important to work with your surgeon rather than just having to blindly follow a doctor's orders.

    Once your surgeon got in there and started working, he must have realized that the adjoining segments were not strong enough to hold the hardware...so he found a better way to stabilize your spine.

    Aren't you glad you came on here prior to surgery to inquiry about the length of your recovery and whether you could return to school in a few weeks after surgery?

    I know you will work hard at your recovery and will follow your surgeon's directions. It is important to walk a number of times each day. Distance is less important than frequency. Walking helps get fresh blood circulating to the surgical site and, more importantly, stretches the spinal nerves and helps prevent scar tissue. At the beginning I would time my walking to my trips to the bathroom.

    Are you using a walker? How is your family responding? I hope they aren't making fun of you!!

    Just remember that recovery is a long process and requires a great deal of patience. You cannot rush it along. By pushing and trying to hurry the process, you inevitably end up causing a flare and a setback...so, try to relax and go with the flow of nature!!

    Take good care,

  • Nice to hear from you! I never would have imagined I would be this far along at 3 weeks based on how I felt just after surgery. I walk several times every day and feel a little stronger every day. I only used the walker for about a week and a half and never used a cane. Is that unusual?

    I can't imagine going into this without as much knowledge as possible. How scary it would be not to know what questions to ask and to be prepared! I just recommended this site to an older friend who had surgery a few years ago and for whatever reason is in terrible pain now/again. I told her about the great advice and support from everyone here and the wealth of knowledge that can be accessed too. I hope she takes advantage of it.

    My family has been awesome. I think they were a little taken aback when I first got home at the amount of pain I was in and the sight of the incision. I know they felt a little helpless when they couldn't make my pain less those first few days. They have cooked and cleaned and waited on me and I think they really respect my fortitude. They do call me Granny once in a while but if they didn't tease me, I would think something was wrong. I really appreciate their care and concern and especially a good laugh now and then.

    Since school has started here I am getting calls and e-mails from my sub and the teacher who is filling in for me as department chair. It is frustrating and it's all I can do not to call a cab to take me there and let me do it myself! However, I am so glad that I have the leave time and can rest and get strong before I eventually have to go back.

    Take care.
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