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What Should I Expect?

N8_BeeNN8_Bee Posts: 20
edited 06/11/2012 - 8:36 AM in Back Surgery and Neck Surgery
Hello Friends, My name is Nate as you probably already guessed "Duh!". I injured my back back on 6/11/09 and can't straighten up or sleep through the night and I am having severe bladder control issues. I can't take Ibuprofen or Motrin because I'm allergic to NSAIDS. I've had epidurals and they aren't helping. Finally a Neurosurgeon here in Glen Burnie, MD advised me that the damage to my L4-L5 and L5-S1 is such that I am in need of a decompression and fusion. The fact that I am experiencing what he called Cauda Equina Syndrome makes this all the more necessary. My question is, what should I expect from a surgery standpoint, is it inpatient or outpatient and how long does it take to recover if at all and what are the odds of full recovery vs. future pain and suffering? If anyone has any WC hearing info, that'd be great too.


  • welcome and i am sorry you have to go through this surgery. we are all people in pain. the cauda equina is something nobody wants. i had it for a while until surgery cured me.
    we really are not drs so we cant take the place of your dr. he has all your test results plus he has given you a thorough exam. his estimates of time for healing and chances of full recovery should guide you.
    your chances of full recovery depend on whether your nerves have suffered permanent damage. has your dr told you anything in this regard?
    assuming there is no permanent damage you should be mostly recovered within 90 days. also the ces should be fixed. of course there are no guarantees.
    i would think your surgery would necessitate staying in the hospital for 3 to five days. once again your surgeon knows what he has to do with regard to decompressing your nerves so go by his estimate.
    please keep us posted on your progress. there are many videos and articles here for you to study. plus many people here can tell you of their experiences. we wish you luck on the surgery....pete
  • Since you probably have been recommended to move forward ASAP, focus on getting well. Hearings and the what-not can wait. On a two level, give yourself a solid 3 mo. minimum to recover and no twisting, bending or lifting. Pain - its hurts alot, no one hear is going to tell you otherwise, but hopefully your doc will be kind with pain meds for control. Definitely check out the post-op must have list!
  • hi and welcome to the forum! :H we are here to offer you support and answer what questions we can. dear friend, you need to get yourselef medical treatment right away if you are experiencing bladder issues.. :? this is a sign intervention is necessary. you will find all kinds of info on the site as well as lots of personal experiences concerning your surgery. please get more than one opinion if surgery is an option.. check out the "Back and Neck" surgery forum for more input. :D good luck! Jenny :)
  • Sounds familiar!

    I was in the same boat almost.

    I had a 2 level PLIF fusion 7/2008. Plan on a lot longer of a recovery than you think. My job is fairly easy and they almost didn't let me come back after over 5 months. I had to fight to get back to work. And I think I healed really really well.

    Now over a year later I still have some issues, I still baby my back - watch it on the bending, twisting and lifting - and I am doing well, comparably.

    Maybe my expectations are low, I still have backaches and I live a very restricted life now, but... NO MORE cauda equina, NO MORE shooting leg pain. Those were nasty to deal with. Surgery has cured me of those symptoms at least! I can almost forget the humiliation & pain of the pre-op stuff I was going through. Almost.

    I do suggest a Discogram and you can never go wrong with a second opinion - although your case seems very cut and dried.
  • Hi friends,

    I'd like to be able to reply everyday but some days it just isn't possible depending on the degree of my pain. I don't know if I mentioned that I was injured at work and the company that insures employees where I work recently received a huge amount of government stimulus money, so you can probably guess that they don't want to approve my surgery. My doctor recommended the surgery right away back on 9/17... it is now 9/28 and I was advised that a "Utilization Review Committee" has to sit down and review all of the documents that they've received from my Neurosurgeon before they can make a decision as to whether they'll approve my surgery. Of course I'm living as I can't even stand up straight, when I have to go out to the market or some other place, I'm riding the Supermarket Motor-Scooters now ( have to call them that so I feel better about riding them). I'll stop now as this has been over 3 months and I could open a pharmacy with all of the useless pain relievers I have. Maybe depression is creeping in also, I wouldn't be the least surprised. Thanks to everyone for their support.
  • By the way, how do I check to see if my doctor is certified to perform the surgery as I don't want to have to undergo further surgery because they sewed a sponge or surgical tool up in my back?

    I tried the "Mind over Matter" Mantra Saltzwork, unfortunately, it stopped working after the first 6 weeks, now I'm into the fifth level Mantra, "Just Plain Pissed" (no pun intended as I'm dealing with the ces, sleeping about 2-4 hours a day, and going to the bathroom about 6-9 times an hour, did I mention that I'm only 38?)

    Have a good one friends.
  • it to hurt, expect it to be a long hard recovery and know that each day WILL get better. And don't forget to have a good attitude. If you think you can, you will and if you think you can't you will just lay there and feel worse! Take care of yourself and have help for at least the first couple of weeks. Do what the doctor says and make wise choices. Keep in mind that this is not a quick fix- you will get better and your back will feel better but it will NEVER be as God intended for your back to be. Be realistic about your recovery and results- take one day at a time.
    Good luck to you Nate!

  • I'm not sure on checking out your surgeon, I knew mine's local reputation and he also did my husbands discectomy.

    You made me laugh out loud on the 5th level 'Just Plain Pissed!' Of ocurse, it's only funny as long as you don't think about how real it really is.

    It's so hard when you are in the middle of it all to think that you have to have a good attitue, you probably are for sure dealing with some depression (a perfectly normal response) which, I hate to tell you, does not get better immediately post-op.

    I still fight that overwhelming feeling on some days. Days when I start to feel sorry for myself and wonder what my life would be like if I'd not been in that dang accident. It's defeatist thinking though - it just makes me feel worse - a maddening spiral down and down and down. My nurse had me take Melatonin (OTC herbal supplement) to make sure I was getting good sleep and to help combat the post-op depression. I do suggest checking with your dr. first though.

    Yikes - this is long, forgive me - but I just remembered some of you questions:

    Normal in hopsital is 3-4 days, I had complications and was in for 9.

    Nurses told me that there is only one surgery that is more painful to go through than the fusion, that's open heart.

    Plan on never getting rid of the backache. The surgery is for sciatica (leg pain) and the CES - at least this was true in my case.

    Best of luck and keep us informed - oh, have you had a discogram? What tests have you had done? What kind of work do you do? Is it strenuous?


  • N8 you poor thing. I feel very sorry for you. Have you comsulted with a WC attorney? Do you have major medical insurance through your employer?

    I remember when my wonderful insurance company deniend my PLIF last year. I was already scheduled and had to reschedule after they finally approved it. They sent a partial file to a "NS" for review and approval. The first lie was that they only sent my partial file to the so called NS.... The second lie was that it was not a NS but a general surgeon who hadn't practiced medicine in about 20 years.

    I was on a fishing trip this summer and met an insurance adjuster. I swear they are all instructed to say NO right off the bat. Specially with the spine. IDIOTS!

    I never regretted my PLIF. I took a long time to feel recovered, but it was awesome to feel healthy again.

    Now if I can just get my neck fixed.

  • Hi everyone, I really need advice! My attorney called me today and advised me that AIG (my occupational insurance company) is refusing to pay for my surgery as "they" don't think I am in need of it based upon a review of my examinations by one of "their" doctors. This is also in contrast to an examination done by the IME that they sent me to. THEY don't think I am in need of surgery even though I am in excruciating pain; my wife and I were in the bank today making sure she could access funds in my account when suddenly and might I add totally embarassing, I lost my bladder (CES - Cauda Equina Syndrome).

    I have a hearing scheduled but it's at the end of this month. I have health insurance but at this point, what do I do now as like I said before, I am in so much pain that I can't even sleep.
  • I am so sorry to hear about this. I am new here & unfortunately don't have any advice, but certainly hope there is something you can get done about this, especially in this political climate of health care reform. It's criminal that AIG is second guessing this issue. I was recently diagnosed with severe degenerative spondylolisthesis myself & while I thankfully don't have CES, I experience extreme sciatica and lower back pain. I am still in the process of seeing if pain management will help, but all of the advice I've received so far is that if you can't get the pain managed, and most definitely when you have CES, there really isn't any option other than surgery. Is fusion the only viable surgery? Wishing you the very best...
  • that have CES would be a reason to have an emergency appeal oon your insurance. It is something that is serious and needs to be taken care of. Call your Dr and ask them if they can or your insurance agent can request a emergency appeal based on this condition. Good Luck
  • Hi Nate,

    Well, you sure got the short end of the stick, and I am very sorry about that. You are right, it is important to get all the info you can about your surgeon. A good place to start is a medical Library (if you are close to a university) but maybe the regular library van help too. There Are large volumes with the qualifications of all physicians, by state and speciality, here you will find out if he is board certified. But if you call his office, they should tell you also, or you can try the state medical board. As far as if there are any disciplinary actions against him, you can do an internet search, typing in his name, or even "medical disciplinary actions". I don't remember exactly in what order I did it, but it was relatively easy.

    As far as the WCB or insurance issue, try to go to the Main Forum, then under "More Support" got to "Health Insurance Issues". I think you will find that thread useful.

    Good luck!

  • Hi everyone, well what do you know?! On the day I receive the Denial Letter from the insurance company, my attorney calls me while I have letter in hand and tells me that they decided approve my surgery. Don't know what was said but I'm thinking the fact that their own hired gun, IME, also stated that I needed surgery helped my cause and really contradicted what their occupational medicine doctor was stating.

    At any rate, my doctor will be calling me on Monday to get my surgery scheduled. I about as nervous as a 'hooker' (male or female) in church if I can use that expression.

    Thanks to everyone for their wonderful advice and support. I will keep everyone posted on how everything goes as I am able.

    Baltimore, MD resident
    Decompression and L4-S1 fusion with instrumentaion (pending)
  • Nate, it is a crap shoot as far as recovery. I was told to take at least 3 months off of work but was released in 6 weeks with minimal restrictions. Do you homework, take your vitamins, stay in shape and keep asking questions here and it will go easier.

    Good luck
  • I had a three-level and, while it was its own slice of hell, I can honestly say I'm a LOT better now that I'm nearly a year out. The recovery is long and hard, but you will probably feel better afterwards. If you can't straighten up, lie down comfortably, sit comfortably, etc., you most likely need to have those nerves decompressed and get your back stabilized. I certainly don't miss the extreme jolts of pain down my leg when I tried to walk and I can now walk without a cane. I know I'll always have to be careful, but life is back to good and getting better.


    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • My wife is talking about taking off 3 or 4 weeks using her time through FMLA, (essential personnel with State of MD, good thing as she's not subject to layoffs or furloughs). I don't want her to take any unnecessary time off and not have the time she wants or needs for other things and events.

    Did any of you need to have someone with you after you were discharged from the hospital and if so, for how long until you could comfortably and safely take care of necessary things on your own?
  • Asolutely! I can't imagine not having someone with me for the first week at least. I needed help because it is is difficult to get up and down, take care of personal issues, remember meds, prepare food, etc. I was glad I had someone to keep an eye an me as I got my legs back under me - I had stairs to deal with. I know some people do it alone but why wouldn't you if your wife has FMLA? You're the best reason I can think of for her to take leave. Let her do this for you. You will be glad she is there!
  • Hello Friends,
    It's been almost a month since I had my surgery on my spine. The Neurosurgeon did a Laminectomy, Forminotomy, Discectomy and a Fusion of the L4-L5 & L5-S1. I spend 2 nights in the hospital and it's been slow going since I got discharged. I've been having severe pain bouts and the Percocet doesn't offer any form of relief, my night table looks like a Pharmacy with different pain relievers that are useless to me. The doctor prescribed me a steroid call Methyl-Prednisone, what the doctors don't tell you about this medication is that it does work but it also has severe side affects. The side affect associated with this drug is that it can trigger an onset of diabetes (an early onset if you are already in the risk category due to family history, that's me).

    I've been going to the bathroom about 3-4 times and hour, not getting any sleep because of how often I was awake. My wife took me to the hospital and they checked my blood work and told me I had a 579 mg sugar level in my bloodstream. They sent me to the ER and they monitored me for a while and kept giving me these God forsaken finger sticks to ensure that my sugar level was coming back down (on average your sugar level should never exceed 120).

    My lower back is in agony (both sides now) and there is pain in my right hip and leg and my right foot has been asleep and/or numb feeling since the surgery back on October 23rd. I have to wear a back brace if I'm not lying down. I can't sit down for more than 1/2 an hour before I'm in pain, unfortunately, lying down causing me all kinds of excruciating pain as well.

    My doctor said I needed the surgery because of the condition my back was in after my injury at work, but wow! It's actually like I traded one problem for another.
  • I'm glad to see you're on the other side of surgery - I was wondering about you. But I'm so sorry that the recovery has been so rough.

    I know it seems like you take two steps forward then one step back, but that's the nature of spine surgery.

    Have you had any follow-ups with your surgeon? What do they say about the pain you're in now?

    I'm having either a PLIF or TLIF on Jan 6 (depends on what they see when they get in there) and it will be my first lumbar surgery. Mine is only one level, but it's scary, as you very well know.

    I hope that your doc says you're progressing normally and that your pain levels decrease as the weeks go by.

    Take care and keep us posted.
  • I actually have my Post-op appointment this coming Thursday. I spoke to my doctor last Sunday, unfortunately, an hour later I was in the ER with dealing with side affects of a medicine he prescribed me. I'm hoping for some positive news so that I can make lemonade out of all of these lemons I've been getting since June.

    I will definitely keep you posted. I hope everyone is doing well.


    Decompression and L4-S1 fusion with instrumentaion
    Surgery on October 23, 2009 Laminectomy, Forminotomy, Discectomy and a Fusion of the L4-L5 & L5-S1
  • Its tough and depressing but keep your head up Nate... there are a lot of good people on here always willing to listen and give advice.
  • I'm sorry that you're having such a hard time post-op. I've not had a fusion myself, but I definitely have ridden that steroid roller-coaster. I myself started a Medrol dose-pack today for the 3rd time this year...I've also received three steroid "boosts" of 150mg prednisone as pre-medication for CT's & epidural steroid injections since March because of my newly discovered contrast allergy. I guess I also should count the steroids injected into my spine twice since October.

    Diabetes is definitely on my radar as my mom is now a type-II diabetic and I'm not in the best shape either. I checked my sugar a couple of weeks ago and it was 109 so I hope I'm safe a while. I think this is something our docs need to be more pro-active about when giving us these meds. Steroids are definitely a double-edged sword...they can benefit us greatly but they have some potentially very nasty side-effects.

    What kind of follow-up did they prescribe re: your elevated sugars? This is something that you need to follow up on with your PCP for sure!

    I hope your surgeon has encouraging news for you and maybe a new plan for pain management???

  • Hello everyone,

    I'm still here on planet, "Give-me-a-stronger-painkiller-cause-this-crap-you-prescribed-me-isn't-working-worth-a. . .". Pain has subsided a little, it's actually not a 10 anymore, it's a consistent 8. I have pain when I walk as when I plant my right foot I have pain from my lower back into my right hip and down into my thigh. The urination frequency has really gone away which is a much needed relief.

    I'm having back spasms though and a really tough time finding a comfortable spot to sleep in at night as if I lay on my back or either side too long. . . pain. If I sit too long, pain and if I stand too long. . . pain. I know this sounds like I'm complaining and things haven't improved but believe me, things aren't anything like they were, they just aren't as they were before I hurt my back.

    I went from a Percocet & Flexoril regimen to a Dalaudid & Clarisoprodol to Demerol & Clarisoprodol. I'm at a point right now where I'm considering leaving all pain meds alone and just bearing the pain because I don't want to develop and addiction.

    Add to that, tomorrow, 12/23/09 makes 2 months that I've been out of surgery and the insurance company that my employer uses, AIG, AIU, Chartis, take your pick, same company, is playing TTD games as they were when I first got injured. yep, you guessed it, today I'm supposed to have a check in the mail and of course, it wasn't there. A call to my Adjustor revealed that they haven't processed a check for me since the beginning of this month, a call to my attorney from what I see so far has been fruitless and. . . I'm sorry, I feel I'm throwing my burdens on all of you and that's not right because we're all on here as we're dealing with one form or level of pain or another; my apologies.

    Seems like if it's not one thing, it's another. I've always worked and I'm not used to this so I guess this is only adding to my pain and frustration.

    I hope everyone is well and I'll stop here.

    Be Well,


    Decompression and L4-S1 fusion with instrumentaion
    Surgery on October 23, 2009 Laminectomy, Forminotomy, Discectomy and a Fusion of the L4-L5 & L5-S1
  • Nate - so sorry you are still on planet pain.

    Question for you: Did you have an accident? Is that why you are waiting for a check? Or is it for short term disability or something? I ask because I have a little bit of experience in the accident/attorney business (not the disability so much though).

    I don't know that at 2 months you need to be worried about addiction yet. Just don't abuse or overuse the medications. You need pain relief to heal.

    Are you walking? Motion is the Lotion - at least that was what I was told when I was hurting a lot post-op. You need to get oxygen to the surgical site so it can heal - walking does that.

    As far as ever getting back to what you were before your injury - well, I'm still waiting for that and I think I've just given up on that pipe dream. It's been over 4 years since my accident and I don't see an end to the pain yet. Just more and more surgeries - and NO money either. Yep, I've been paying my deductibles and my expenses when I've had to take FMLA (unpaid) leave. I keep thinking eventually... eventually things might come around...
  • I really feel for you. Your pain since surgery I can see has been horrendous and getting no check from Insurance sucks. I went 2 months with no pay from my std company and I am single. that was hell in its self. Credit cards, car pmt companies were all so mean to me. Only my phone company was nice.

    I went thru similar one level surgery, and have had a good recovery. I am not trying to rub it in your face but they do exist. Don't lose faith and whatever mantra helps, use it. AND PLEASE NEVER EVER APOLOGIZE for venting. That is why we are all here. A source of info or a shoulder to cry on.

    Best to you and your family. Hopefully you can find something to make you smile over the holiday season.

    Traci :)
  • SpineAZSpineAZ WiscPosts: 1,084
    so sorry for the WC trouble you seem to be having to endure in addition to the pain!!!!
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Hi Saltzworks,

    I actually injured my back at work way back on 6/11/09. I teach an IT class for Comcast and was instructed by my supervisor to conduct an equipment inventory of (cable boxes, modems, routers and the like). There were warehouse personnel there but I was instructed to do the task because the PC needed to be repaired and I was the only one with the expertise. While conducting the inventory, I had to lift and carry some equipment that couldn't be scanned where it's stored, that's when I heard and felt a "Pop" in my back. I'm out on Temporary Total Disability but the Workplace Insurance company keeps playing musical paychecks with me, and it only adds to my already mounting frustration.

    If you have any suggestions for me, I'll try most anything as I hate totally relying on my wife (who's been truly great by the way) financially.

    I'll continue in another post

    Decompression and L4-S1 fusion with instrumentaion
    Surgery on October 23, 2009 Laminectomy, Forminotomy, Discectomy and a Fusion of the L4-L5 & L5-S1
  • Hi Saltzworks,

    I actually injured my back at work way back on 6/11/09. I teach an IT class for Comcast and was instructed by my supervisor to conduct an equipment inventory of (cable boxes, modems, routers and the like). There were warehouse personnel there but I was instructed to do the task because the PC needed to be repaired and I was the only one with the expertise. While conducting the inventory, I had to lift and carry some equipment that couldn't be scanned where it's stored, that's when I heard and felt a "Pop" in my back. I'm out on Temporary Total Disability but the Workplace Insurance company keeps playing musical paychecks with me, and it only adds to my already mounting frustration.

    If you have any suggestions for me, I'll try most anything as I hate totally relying on my wife (who's been truly great by the way) financially.

    I'll continue in another post

    Decompression and L4-S1 fusion with instrumentaion
    Surgery on October 23, 2009 Laminectomy, Forminotomy, Discectomy and a Fusion of the L4-L5 & L5-S1
  • Nate,
    You seem like a really strong man and you have made me laugh several times just reading your posts (which I need at 3 weeks post op from a 2 level fusion) don't ever lose your sense of humor. Please remember that everyone's recovery is different, two months seems like a long time but it really isn't. Keep looking for the light at the end of the tunnel because it is there. Your back may never be what it was prior to your accident but keep on fighting and never give up. Keep on venting as much as you need to because it helps.
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