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Lumbar Revision Surgery experience (Long)

BkinsBBkins Posts: 364
edited 06/11/2012 - 8:42 AM in Back Surgery and Neck Surgery
I had lumbar revision surgery done on level l3-l4. I was operated on 1/20/10 at a NYC hospital. I had broken hardware and no fusion at this level. 1 screw was broken and another one was lose. I have had 2 previous surgeries on this level. One in 99 for a laminectomy and the other in 2006 for a fusion.

I will mention a couple of things that were done at my pre-admit testing that I have not read about before. 1st they swabbed my nose, on both sides, and did a culture checking for the staph infection bug. I was clean. They also gave me 2 bags of surgical wipes to be used the night before and the morning of the surgery. After taking a shower the night before I had to used a total of 6 wipes and cleanse my entire body. I had to do this again the morning of the surgery. I also was given a script for an ointment that had to be put into both sides of my nose for 7 days prior to the surgery. This hospital is serious about preventing infections. It was a PIA to do all this but it is nothing compared to a staph infection. I also went into the city to give 2 units of blood.

We stayed in the city the night before the surgery. I had a BLT wrap for dinner which I thought fit pretty well since I wasn’t going to be doing any more BLT. We arrived at the hospital at 5:30 AM and by 7 I had met with all the DR’s that needed to speak with me. I was wheeled into the OR around 7:10. All my other surgery’s I had IV’s started prior to getting in the OR. Not this time. Everything was done in the OR. There were a lot of people doing things to make this all happen. The anesthesiologist put in 2 arterial lines into my left wrist. He numbed the areas first but it still smarted some. Shortly after his said he was putting me to sleep and out I went.

I was in surgery for 8+ hours. They had to open my back up to get the broken hardware out. I was then temp put back together and rolled over so a vascular surgeon could open me up from the front. I had met with the vascular surgeon prior to this surgery and had everything explained to me. He ended up finding some adhesions/lesions that he wasn’t expecting on some other organs and also corrected these problems. The Dr. put in a cage between the l3,l4 level and used a bone matrix along with a long assed screw and washer to keep it in place. I was then sown up and rolled onto my stomach so they could put in new screws and rods into my back. The Dr also relieved a nerve in the l4,l5 area.

I spent the next day in ICU and a step down unit. I was extremely bloated from all the fluids they kept running into me. I was having a bad time with getting enough oxygen into my system and had to have oxygen on during this time. I ended up having to sit up somewhat in the bed to not feel like I was short of breath. PT came and got me out of bed and sat me in a chair for about 5 minutes at the most. I really wasn’t feeling good at this point. I think they may have put pain medicine in via my IV because I didn’t have a pump at this point. I was finally moved to spinal room and out my widow you could see the Empire State Building. I was having issues with pain at this point even though I was on a pump. I had to keep hitting the pump button every 4 minutes. Ever think how many times that is in 24 hours? It is a bunch. I don’t believe they had me on a basal rate with the pain pump as I was still having some issues catching my breath. I had all the usual stuff such as the stockings and the inflate-a-legs. Hate them both. On the 3rd day I was still having breathing problems. It was decided that I was to have an ultrasound and a CT scan to look for problems. Long story short was that I had fluid in my lungs. I was worse then the Pillsbury dough boy as far as being blown up from the liquids. They gave me something to get rid of some of the fluids and also stopped giving me more. 24 hours later I was much better.

All the Dr’s and nurses that came into my room put on fresh gloves and used hand sanitizer. PT came and got me started on walking. At this point I wanted out of the hospital and made a concentrated effort to force myself to walk and get out of bed. The cath came out along with the back drain and I was give stuff to get my system moving again. I was also switched over to pain meds by mouth which I got every 4 hours. I was discharged on the morning of the 6th day. I was given a back brace that is like the one you see people at Home Depot wear only it had hard plates in it to protect the back. I had 1.5 hours in a car to get home, which was no picnic. I had PT come to my house for 4 weeks and then at my 6 week follow up I was given a script for regular PT.

ALL the pain spots that I had prior to surgery seem to be gone. I still have a lot of weakness from the assault my body took. I am working on getting my strength back.



  • Hi Dave, thanks for the great update.
    It's funny but Lynette (I think) just had surgery in NYC and I recall her saying something about wipes to wipe down the body (maybe it was someone else but someone said it).

    Anyhow, sounds like a rough 5 days but now, almost 2 months later, it sounds like you are feeling optimistic that it was worth it.

    Your body is bound to still have weakness after all that work. Heck, I don't think it took them that long to build the bionic man so imagine what your 'super' powers will be like when you get your strength back.

    Keep positive, stay tough, and best wishes for continued success in your recovery!
  • SpineAZSpineAZ WiscPosts: 1,084
    Hi David:

    Thanks for the update, I really do like it when people give long updates as we get to see all the differences between what we have done. The pre-prep with the infection protection was amazing. I've never heard of anything like that!

    I had a hip incision (they laterally put in the implant at L3-L4) so I too had the bloating issues. I had to miss two days of in-hospital PT because they could not get my brace on me due to the bloating and I was weak from not eating.

    Sounds like you are well on the way to recovery.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Sounds like you are doing really well. You are well on your way to recovery now, even though you have a long way to go. I hope you keep getting your strength back. It really wipes you out, but each week should be a little better than the one before. Take care, and keep us informed, Robin
  • I did not get the nose swab thing, but my doctor/hospital made me shower the night before and the morning of with this special soap they gave me. I think it is a great idea, provided people actually do what they are told. Infections are so rampant in the hospitals right now!
  • David,

    Yes I too had surgery in NYC. I did have to do the betadine scrub the morning of surgery but did not have the nasal swabs or body towels. I'm guessing they were screening for MRSA with the nasal swabs. Many of us can be carriers and don't even know it so if you had been + they could do extra precautions.

    Your lucky you could have a blt that evening cuz I had done a bowel prep and was on clear liquids watching my family eat NYC pizza that they said "was to die for"It is amazing the differences in practices in spine suegery!!Hoppe you will have a good fusion outcome this time. Lynette
  • Thanks for all the good luck replies. I am finding my progress to be slow even though I was told it would be slow. I am one that hears what I want and filters out the rest of whats said. Thank god for my wife lisening and asking more questions. I have learned over the years to write my questions down but it seems I always miss asking something even though its right in front of me. I guess I tend to space out.

    I am going th PT 2 times a week. I do a lot of walking. We have been going to a Sam's club to walk in the bad/cold weather. I push a cart and have been able to make it close to half the store. This is with doing all the side to side isles. Up until the last week my wife would follow with a scooter that Sam's has by the front door for when I pooped out. I learned the hard way that I wasn't as far along as I thought when I tried "THE" walk with just my cane. This set me back a week and also reminded me that I wasn't as strong as I thought. On the days I don't do PT I do a bunch of stuff at home which are mainly leg stenghtening exercises. I also have been wearing ankle weights most of the day. I am very tired at the end of the day but usually I see a small amount of improvement the next day. I will take any improvemt I can get.

    I didn't mention that on my 6 week visit the Dr. put me on a bone growth stimulator. I wear it 24/7 and will be on it until he sees good bone growth. I don't know why I didn't fuse on the first fusion attempt. In my laymans eyes I blame it on the way the fusion was done. I was told that a cage and bone growth matrix was going to be put in along with the matrix under the rods and screws. This wasn't done as the surgeon said he couldn't get in to put the cage into place because of a blood vessel being in the way. He elected not to put it in. I would of thought he would know there was going to be a vessle in the way. I was pretty unhappy that it wasn't put in. I tend to blame my non fusion on the fact that only half the fusion surface was done. I will never do another fusion with a cage and matrix being put in.

    On another note I wish there was some way to research Dr.'s easily and find out what their success rates are. In almost all states there really isn't a good way to compare. The Dr.s seem to be pretty much protected and the info, if it is collected at all, is not researchable. This has been my biggest frustration. How do you find a great Dr and what are their speciallities and success rates. Over the years I've experienced that a lot of spine Dr.s only are willing to work on virgin territory and get snotty when you come back years latter with more problems. I have had 1 like this and had I know this before he did surgery on me I would of walked away and found someone else. Bottom line is it is a business.

    I tend to get long winded so I will sign off. My hope is that everyone has a pain free day today. We deserve it.

  • Hi David

    Good to hear that you're now doing well and have got through the worst part.

    Keep moving forward slowly, and let us know how you're going as the months go by.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
  • Went in Monday for my 12 week visit. Looking at the x-rays that were taken I can see white where the bones are fusing. I was happy to see that.

    I was told to do PT for another 8 weeks, or until the insurance will no longer pay for it. I am now able to walk without a cane and as a matter of fact we took a bus into NYC and walked the subway and streets to get to the Dr. I was beat by the time we got home and was hurting a bit on Tuesday. I had been using a cane and really couldn't walk, or stand, for to long a time. I have been using the cane for 2 years prior to the surgery so I am doing much, much better. I still have a area on my right upper butt that continues to hurt, but it does come and go and pain meds do help. I have cut back on the pain meds to about 1/3 of what I was taking prior to the surgery. I was reminded by the surgeon that this WAS a revision surgery and that it was the third time that Dr.'s had worked on the same area. I was asking about if it is normal to be at the stage I am at in recovery and he said he would rather me take it slow and steady then try to push the recovery process. I am a bit wanting to move this process along faster. He mentioned to me that I am running out of options so make this one work. Did I mention that I REALLY like this Dr.? I had a couple of other medical issues prior to having this surgery and they are part of the recovery process taking a bit longer.

    I will soldier on and do the PT and more exercises at home on the days in between.

    I have not mentioned in other posts that this Dr. will read and answer e-mails, and do it in a timely fashion. It takes about 1 1/2 days to get a answer back, and either he answers the questions or passes the e-mail on to the person that can answer the question and they call and speak to me directly. To me this is unheard of, but boy it sure is nice.

    Gotta go get on the stationary bike.

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