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spinal fusion

ursy60uursy60 Posts: 12
edited 06/11/2012 - 8:40 AM in Back Surgery and Neck Surgery
Hi I had spinal fusion done on Nov27, 2009. It was L5 S1. The pain in my back and hip leg is pretty much gone, but 3 weeks post op I started getting horrible right foot pain. It started in my big toe and now it's across the whole top of the foot, and big toe, and under the left side of the foot. It doesn't affect the other toes, but it feels like someone stomped on it and lit it on fire. Putting my sock on is horrible and if the blanket sits onit it makes me want to scream. I never had any foot pain before. I couldn't lie on my back for about 1 1/2 years now that is gone and I had horrible hip/leg pain and numbness before and most of tha's gone. The dr. says it might be nerves. Does anyone else have anything like this?


  • Welcome to Spine Health. You will find this site full of useful information as well as very nice and supportive members who are here to help others and give them comfort as well as find answers to their own problems. The best part about this site is that you are chatting with people who really understand what you are going through.

    Now as for your question, it could have something to do with nerves that may have been impinged before surgery and it may just be a sign that they are "waking up" and starting to heal. I've been told it can take anywhere from 1-2 yrs for the nerves to heal.

    Also I've been told that during surgery your nerves are moved around and that it takes time for them to heal from that.

    I also had fusion at L5/S1 anterior (thru the belly) and I can remember at one time if I tried to walk on my heals I got this shooting pain at the tip of one of my big toes. I can't remember how long postop this was or how long it lasted. I also had and still have at times, random twitching in my legs, toes, arms and fingers. It switches spots all the time and now it's mostly in my legs and not so much in my arms anymore.

    Hopefully this is just a sign that your nerves are healing and nothing serious. If it gets worse or you are still concerned then contact your surgeon.
  • Thanks for the info. Ihope you're right. I see that your fusion failed. How do the screws break. Aren't they suppossed to be fairly strong? I'm curious as to why it took so long to diagnose that it had failed. I'm in Alberta, Canada. I saw my surgeon 3 weeks post op and then I see him again on Feb 22. I've been trying to do everything I'm suppossed to do and not do the things I shouldn't do, but sometimes I forget and the brace could be better than it is. I have 2 screws and 2 little cylinders that they have the bone graft in. How is your back doing now and what do they have planned for you?
  • nerve pain. After a nerve has been compressed for a significant amount of time, it can cause weird pains as it tries to regenerate itself. It can also be a nerve that has been somewhat damaged during surgery. I had surgery over a year ago. I have numbness on the outside of my right foot. I woke up from surgery with it, asking the nurse to help me move so I could get my foot off the bed railing (it felt as though it had been jammed up against the railing and had fallen asleep). Well - no bed railing there! My foot often causes me strange pains as the nerve (still!) tries to regenerate. The latest has been that I am sure there is something in my shoe right under where the arch of the foot meets the heel. It doesn't matter what pair of shoes I wear. I would have though it was plantar fascitis, but it is only on the outside of my foot, no pain at all towards the instep. My toes are numb from the middle toe to the little toe. Ah, the life of a fusion patient!

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • I never realized so much could still happen after the fusion. Of course I was told that it could take up to a year and the nerves won't heal right away, but my foot pain is horrible. I've started walking on the treadmill slowly for 1/2 hour a day.
    Listening to other people makes me realize I'm not that bad off.
  • To answer some of your questions, normally the screws do not brake. In fact, the radiologist and my surgeon both missed that they were indeed broke and he didn't beleive me when I told him that another spine specialist had noticed this right away on the same ctscan that he had missed. He said he's never seen a patients screw brake and didn't beleive me until he sent me for xrays and it was broken. They could've broke from not being fused yet and the extra weight and pressure or from me riding my 4wheeler in the trails at only 2months post op or falling down my steps at 3 months post op. I didn't take it easy after my surgery and recover like I should have. My surgeon insisted that I could go about my normal activities and no harm could be done to my fusion or hardware.

    As for my plans now. I'm in pain mgmt and take lots of meds. I'm going for 2nd ESI 1/11 and go to neurosurgeon on 1/12. I'm not sure what's next for me. The surgeon I went to for second opinion after surgery is trying to spare my fusion w/o doing more surgery. One says I'm fused and another one says I'm not. It's just a waiting game at this point. They want to see if I will start to fuse on my own.

    I wish you the best of luck on your recovery and be sure to rest when your body is telling you to and do not overdo it like I did. I am now on disability at 32 yrs old. I still have a whole lot of years ahead of myself and don't want to spend them in pain.
  • Hi, I see you have both had fusionsurgery L5 S1
    - I am due to have fusion surgery (through the back, due to spondylolithesis and broken part of vertebrae)Sat 9th and am now feeling extremely aprehensive & nervous. Was misdiagnosed for 18 months which hasn't helped the whole confidence thing. Now have very limited mobility. Just wondered if you could give any advice having been through the procedure yourselves?

    Best regards, Aunty Roo
  • I'm so sorry for you. I can't believe some of these doctors. I was told no lifting over 5 lbs, no bending twisting, or jarring. I've been as careful as possible, but sometimes you forget. I've noticed the last couple of nights that both my legs are twitchy along withthe foot. That must be nerves too.
    I hope everything works out for you. Please keep me informed.
  • Welcome to you both -

    Ursy, I had an l5-s1 done as MI TLIF, did you have an open procedure or an MI? Prior to surgery, I had foot drop along w/ numbness/weakness combined w/ episodes of electric type jolts down the leg into the foot. As others have stated, nerve compressions/manipulation and regeneration can cause some painful & wacky symptoms. Post surgery, I had a period of about 4 months where the pressure of the bedding on my toes (especially the little toe) could send me over the edge, socks could be a problem too. Try strategically placing a rolled up towel(s) so that the bedding will 'tent' some over your foot, it helped me a great deal. As far as socks go, get the loosest/thinnest you can find, it'll help since they don't put as much pressure on the painful area. In the house, I'd walk around barefoot whenever I could. Also, I'd suggest exercising your foot to increase blood flow since this aids healing, the treadmill is a good start, keep the incline at zero so you don't stress your back or the area of fusion. Try ankle pumps, foot circles, calf raises off the edge of the step (hold on to the banister). Try gentle self massage and warm soaks - all of these helped me a great deal. I've found with time, I'm less troubled w/ these symptoms, hopefully, this means the nerves are healing. Try to be patient, my OSS told me it could take 2-3 years for nerve healing & there is never a guarantee the damaged nerves regenerate completely since they are so sensitive to any compromise (compression, surgical manipulation).

    Aunty Roo - please tell us what type of surgery is being planned, there are a number of different types that go through the back, it'll make it easier for others to give you their input. Also, check-out the sticky for pre & post op must haves, very helpful info on what can make the waiting and recovery easier.

    Hope this helps, please keep us posted.

  • I had spondylolithesis too. I went through the whole " it's sciatica and pulled muscles" and jumped through all hoops(xrays, pain meds, antiinflammitories, steroid injections, gabapentin, lyrica, exercise etc) He sent me for a MRI in Oct/08 I got in in Jan/09. The results were "bilateral spondylolysis of L5. Co-existent severe degenerative disc disease is present at L5 S1, along with severe bilateral foraminal narrowing and mass effect on both exitng l5 nerve roots." There is also some other stuff that's not that bad(yet)
    So after that I had him book an appointment with the specialist, but I couldn't get in until the end of April/09. In btween I had steroid injections, which worked great but they only lasted a couple of weeks and I could only get 3 a year.
    When I saw the surgeon he told me that the only thing that was going to help it was spinal fusion.
    I'm really glad I had the spinal fusion, because I can now lie on my back, I couldn't for more than a year an a half because it hurt so bad.
    Before the operation if I stood for more than a minute or 2 my right hip and leg were in horrible horrlble pain. I've spent most of the last year and a half or more on painkillers and antiinflammitories.
    So I'm really glad I had the operation, but it's one of those things where you want instant relief for everything and I guess you can't expect that.
    My right foot really hurts but if it's because of the nerves "waking Up" that will go away.
    I was told not to lift anything over 5lbs after the surgery. No bending forward, backward or twisting. NO smoking, and jarring your back. These are the biggest things that will cause your spine not to fuse.
    My pain surgery pain has not been so bad that I can't handle it. Where they took the graft hurts when I walk to much. I stopped the percocet and Tylenol 4's about 3 weeks post op.
    The pain in my foot started 3 weeks post op. Sometimes it's really bad and other times its not so bad.
    I This letter got kind of long but I know how scared you're feeling. I was too. I still am. My biggest peice of advise is to take it easy and listen to everything they tell you. A few months of your life not be able to do all the the things you are used to is nothing compared to a life filled with back pain.
    I hope it goes well and keep me posted
  • I'm not sure of the name but I had an interbody spinal fusion. They went through my back and I have about an 8" incision site. They also got the bone graft from the same opening. On xray there is 2 screws and two cylinders where the bone grafting material is in.
    I know exactly what you're saying about the bedding and socks. It is a new experience in pain.
    I'm in Alberta, Canada so I don't know if the procedures are the same or the same name. You would think they would be universal, but who knows.
    I started having some really bad spasms in the hospital, so they upped the morphine and mucsle relaxers, so I don't remember my hsopital stay at all. I saw my surgeon on Dec 20, which was just over 3 weeks post op, he said everything looked okay and more or less rushed me out of there. I see him on Feb 22 again so I would like to find out exactly what was done and what they used. Are you able to get a copy of your reports? My MRI also said I had a mild central disc bulge in L3-L4.
    I've started on the treadmill and I'm going to try the exercises you suggested.
    I was starteing to trip over my right foot the last couple months, but I never had any foot pain.
    Thank you for your help
  • I would also advise that you listen to the docs and don't overdo it. Allow yourself the proper time to rest and let your body heal.

    I know it's overwhelming to read stories of those who are worse off from the same surgery you are getting ready to have. Just keep in mind that the success rate is usually higher than the failure rate. The only difference is that those who had successful surgeries are not hanging out on sites liek this looking for answers cuz they feel better and are now out living their lives. It's always great to have members come back on after having successful surgery and letting us know how they made out. It's also inspirational to those facing the same surgery.

    If you have any questions or just want to talk over your fears of surgery or whatever the case may be you are always welcomed to send me a PM.

  • could be gout. I have gout and it started showing symptoms right after my first surgery. Stress brings on gout attacks which are uber painful to where the sheet feels like a 100 pound anvil on your foot. Look it up online.

  • Hi back Ursy,

    I'm in the US, but, I think the abbreviations for the procedures are the same no matter where you are. I had an interbody fusion as well, they went in through the foramina. Since they were able to do an MI on me, I have only two 1-1 1/2" scars on either side of my spine & there was enough bone from the lammies where the surgeon didn't need to harvest from my iliac crest. Healing from the long scars in open procedures has to be rough, never mind the pain from the bone harvest site.

    If you're interested, type 'interbody fusion' in the search box at the top of the page & you'll be able to read & see videos on the different types of methods that can be used. I have copies of all my records including CD's of my CT & MRI films, figured it would be good to have my own set of records since fusion is such an extensive & invasive procedure. I know exactly what you mean about back spasms post, mine started in recovery, took about a day before the right RX cocktail was concocted to take care of them. The combo worked well & I was able to DC the meds about 2 weeks out. I have an occasional twinge now & then, nothing major & use tylenol if I need to. I hope your hip pain resolves soon.

    So many of us here seemed to have gone through the years thinking the back pain & sciatica were merely matters of having overdone it til it became so bad we were finally referred to a specialist & learned what the issues are. I had episodes for 20+ years w/ 'pulling out' my back sometimes w/ sciatica where I either doctored myself or if it was bad enough saw my primary. In past, NSAIDS, muscle relaxers, trigger point injections & RX pain meds had helped - this past April, I had an episode that really frightened me since I had pain like never before, along with neurological deficits that were severe. After 10 days of conservative treatment, I was referred to a podiatrist since my primary thought I might have tarsal tunnel (like carpal tunnel). Two weeks later, still no improvement & was referred to an OSS where I learned my back aches, etc. weren't as simple as overdoing it.

    It sounds like you're progressing well, take it slow & easy, try not to BLT (bend, twist, lift) and most importantly rest when you need to - all of these things along w/ keeping a positive attitude help your recovery. My OSS had recommended I take calcium as well as B complex, it supposed to aid fusion & it's thought B vitamins help w/ nerve healing. The calcium I use has D3 & magnesium in it - D3 is critical in calcium absorbtion and it's thought magnesium can be helpful w/ cramping. You may want to ask your doc if it may be helpful to you.

    This site has been invaluable to me, I'm only sorry I found it after my surgery. Nothing beats 'talking' w/ others that have walked a 'spiney' path since they know exactly what you're going through and can offer the support & suggestions that help you through your recovery.

    Please continue to post & let us know how you're doing.

    Hope today is pain-free for you,

    TC & all the best,
  • Hi Everyone,

    After reading Ming's post on success/failure rate, I am here to report a positive experience. I just had a lumbar spinal fusion at L4/L5 and L5/S1 on December 15, 2009.

    At three weeks out, I am doing well. I have been able to decrease pain medication significantly, I have a solid daily walking regimen, and I've even started losing some weight! I still have some post-surgery pain, but it gets less with each day that passes. Before the fusion, I had terrible shooting pain in my legs, and I felt like my spine and hips were on fire. I no longer experience any of the symptoms I had pre-surgery.

    However, I am dealing with some new nerve pain. Four days after surgery, I developed an excruciating pain in my left leg, below the knee. I had never had this pain before, and was terrified I or the surgeons had done something to mess things up. My surgeon said this pain was indeed from an irritated "stretched nerve," and this issue is common after lumbar spinal fusion on L5/S1. He prescribed a round of steroids and told me to cut my walking from 1 mile a day to 1/2 mile a day, at least until the inflammation calmed.

    A week after finishing the steroids, I have worked back up to walking 1.5 miles a day, and the pain in my leg has gotten much better. I have found that breaking up the walking into shorter sessions is quite helpful. (I walk at a pace of 2.3 miles per hour for 15 minutes, three times a day.) Not only do I get a little mental boost from these mini-walking sessions, it helps loosen up muscles throughout my body.

    Ursy60, I hope that you can find some relief from your foot pain. Be patient, and kind to yourself, your body is hard at work with the healing process. I know this is much easier said than done--it seems the virtue of patience is always in short supply.

    May we all find better health in 2010!
  • I had an anterior/posterior spinal fusion L4-5,with hardware removal and additional support put in the L3-4 area. In the hospital,and now as well,my left leg shakes at times (this is the leg that was affected).Also, at times I just "jump" when sitting or lying down. They do moved around the nerves during surgery,and also monitor the nerves for any damage. You should be able to get a copy of the surgeons notes as he did the procedure-my husband asked,and he said anything we wanted we could certainly have-so the dr. should not give you a hard time on that. It is scary,but you can do it!!!!!!Between surgery,anasthesia,and the problems that led us to to having surgery,it is no wonder our bodies and shimmying and shaking---take it slow!
  • Thanks so much for posting your positive fusion surgeries. It's very encouraging to others who are facing similar surgery to hear the positive stories.
  • I am 27years old and have been suffering from low back and left leg pain for almost 2 years. I had a discectomy in march 2009 and it did not relieve my pain. After all conservative treatments have been exhausted and failed I am going to have a L5S1 tlif surgery in a week. I saw my surgeon today and need another MRI before surgery as I may have herniated another disc. I am really nervouse about this surgery. I dontknow what to expect. Surgeon said it won't be as bad as a plif but I don't know if I believe it! How long will I be layed up?how long was hospital stay?' I am currently appealing a denial from SSD as I have been out of work a year and am unsure when if I can work as there are other issues in my back.how long till I'm cleared for work? Any advice wouldbe great!
  • :H I also had nerve pain and Thank Goodness it finally went away. I do understand the pain it causes. I pray you all recover very fast and are now painfree.

    Hey Ming
    Long time no see/hear. How ya doing?
    Evelyn :H
    Had PLIF in 2008 and a Laminectomy. One level fusion, L4-L5.
  • It's hard to give a time frame when you will be back to work and how long layed up. It all depends on how well your body heals. I suggest you do as much research as possible on this surgery so that you are more aware of what to expect. Luckily you've come to the right place for that. Just do a search on this site for tlif l5 s1 surgery and you will find a bunch of information. There may even be a video of how the surgery is performed and what they do.

    It's also the same with how long of hospital stay. Is it going to be minimally invasive surgery? It depends on how well you do after surgery, if you have any issues with anesthetia etc. I was suppposed to stay for 3 nights 4days but had to stay an extra night due to morphine sickness from the pump. I got sick and bp was low, oxygen was low and had low fever as well as nauseous and dizzy. I also had mine ALIF which means in thru belly.

    I wish you the best of luck. You should be sure that your surgeon sits down and answers all your questions before the surgery. Also, be sure to follow all post op instructions. Take the time to let your body rest and heal after surgery and don't push yourself too hard and too soon. Also take your pain meds as prescribed for atleast the first week or so even if you have to set an alarm to wake up to take them. It's better to stay on top of the pain than to skip a dose and chase your pain. I also recommend keeping a log of what meds you took and what time as you may be a little loopy. I had problems remembering if I took a dose or not so it was easier to write it down.

    Feel free to PM me with any questions or if you just want to chat. You will find a lot of helpful and supportive people on this site.
  • yes it has been awhile. What happened to our insomniac post lol? I've been having more problems sleeping I've been up late and on here. going to try not to stay on so late tonight.

    Sorry for hijacking the site temporarily.....
  • Went to the doctor twice about the nerve pain. My family doctor told me to try Gabapenten, but I was on that before and will use it as a last resort. I tried Voltaren Emugel and it seemed to help a bit. Went to see another doctor as mine was gone and told him I would like to try a stronger Voltaren and he gave me the strongest Voltaren in a Difussimax that you can get. It also helps some. I heard Amitriptyline is suppossed to help with nerve pain, so I'm gonna give that a shot. If it doesn't work it's back to the Gabapentin.
    On a good note the back feels really good.
    When the foot pain gets bad at night it's back to the t4's and antiinflammitories.
  • I'd be interested to know how you get on with Amitriptyline.
    Hope they manage to sort out the nerve pain.
  • Well I'm happy to say that the horrible pain in my foot is going away. The top of my foot isn't so bad and the toe doesn't bother me all the time anymore.
    What does worry me is, I'm starting to get pain in my left buttock again. This is how the whole thing started. Also does anyone "feel" something in their back. When I move a certain way in bed or lie on my back it seems like I can feel the screws or something.
    I've been so careful about lifting and bending etc. I did have a little slip on some ice, but I caught myself and didn't fall or twist badly.
    Now I'm worried something might have happened. I have no one to ask as my doctor is away and I don't get to see the surgeon until Feb 22.
    You would think the nerves would pinch again so soon after the operation.
    I am doing a mile and half on the treadmill everday.
    Does anyone else "feel" something in their back?
  • How did you get on with the Amitriptyline? Did you have any side effects, and did it work for you?

    Glad that your horrible pain in the foot is going away. It certainly seems to take a long time to get rid of all the follow-on pains from surgery. As long as they all go eventually, I'm sure you will think it was worth it.

    Take care.
  • Hi Ursy60,
    I'm glad the nerve pain is subsiding. As to still feeling something in the back, I thankfully do not feel more than muscle tightness most days. Sometimes I feel achy but that's really it. At six weeks out, I am definitely feeling the difference in how my back is constructed, but nothing like the pain you have described.

    I took a bit of a fall a couple of weeks ago and went straight to the doctor to get an Xray. Everything was fine, but I would have gone barking mad if I hadn't been able to confirm. Does your surgeon have an associate you could see to take a look before Feb. 22?

    Good luck!
  • I don't know that the amitriptyline helped. I've taken it before to help me sleep and had no other side effecs from it
  • Hi Everyone
    I went and saw my family doctor on Feb2 and he told me I had a 2 level fusion. I had him read and give me a copy of the surgery report and it said that on looking at the MRI while doing surgery that they felt there was enough degeneration of L4 and they decided to fuse that also. I didn't know that until Feb2. It seems kind of weird cause my MRI report said that L4 looked okay but L3 had quite a bit of degeneration. I still am having some butt pain, reminds me of sciatica and it hurts down my right calf area. I hope to God it's not pinched nerves again, because that was the most debilitating symptom I had.
    I was doing some squat type things, I've stopped them, maybe that is bad. I'm on the treadmill 45 minutes a day and I go 2 to 2.5 miles per hour. I still feel something in my back. My family doctor said it's to soon to worry about getting another MRI and an Xray wouldn't show anything. I hope he knows best.
  • I went for my 3 month checkup and the surgeon says everything is going fine. He showed me the xray and you can see where the bones starting to fuse. Most days there isn't much pain right now, so that's great. I start physio on Monday, and I also start back to work part time. No lifting over 10 lbs. So far so good. I still expect some bad times ahead, but there is a light ahead of the tunnel.
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