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Upcoming back surgery

Rae-CARRae-CA Posts: 8
edited 06/11/2012 - 8:49 AM in Back Surgery and Neck Surgery
Hi everyone. Getting ready for surgery on 1/20/11 for Spinal Stenosis and Spondylolesthesis. Lumbar laminectomy, bone graft and lumbar fusion on L4/L5. I'm just learning all these new terms. I don't really know much about all of this. I do know I've had enough and want my life back. Going on 7 years now. Went thru all the conservative procedures and have been on vicodin for a year now and my brain doesn't seem to work as well as it should.

I'm getting anxious about the surgery though. Any advice to help get thru this will be appreciated.




  • sounds like you've been through some pain. the procedure(s) you are about to go through are to remove a part of the lamina to free up the trapped nerve,removal of the disc in that area ( possibly) and installation of hardware and bone grafts to make it all grow together. You are in the right place for support, most everyone around here seems great and offer real life experience.

    I myself am currently 1 month post op from a 3 level fusion. Im doing well and noticing relief from some of my symptoms but it is still too early to tell. I read keeping a positive attitude and walking as much as you can post op when you are able to are key to healing up right. If you need anything or have any questions, Im a spine surgery veteran ( total of 5 ) ask away!

    Take care and best of luck to you on your procedure(s)



    Current status: Post op and healing

    5x spine surgery survivor

    Most recent: 3 level PLIF Decmeber 7, 2010

    l3/4,l4/5,l5/s1 fusion / repair of a pars defect at l5/s1

    8 screws, 2 rods. I'm a walking hardware store!

  • Welcome to Spine Health. This is a great place to gather information about spinal conditions and treatments and also there are lots of friendly people who can understand your pain and nervousness.

    I had a laminectomy,disc replaced with cage and fusion at L4/L5 in March this year. I had 4 screws and 2 rods placed to hold it all together while the fusion took place. The bone graft was taken from the back of my spine that was removed, which suited me because it saved me another painful place from the removal of bone from my hip.

    I had severe stenosis on my cord and nerve roots which was caused by the spondylolisthesis which had kinked my cord and pushed my disc back into it leaving the front of the vertebra almost bone on bone. Needless I had severe sciatica and lots of back pain.

    Now I am feeling very much better. The sciatica has gone and my back pain is also much better. I do still have some back pain and neurological symptoms in my feet and legs, but if I had to make the decision again, I would definately go ahead with surgery.

    I definately understand your nervousness about the surgery. It took me a long time to be able to accept that I needed to have it. Initially I couldn't even talk about surgery without crying. I did a lot of research and asking questions here, and I found that knowledge of what to expect helped me to face it. I was ready for a very painful and difficult recovery, but really, despite several set backs and problems, I was surprised how well I coped.

    Have you taken a look at the thread at the top of this page for 'Useful Items for Surgery'. You won't need everything but there are some items that will certainly make your recovery much easier. Have you got someone to stay with you to help you in the early days after surgery once you get home? My husband took 2 weeks off work, and I was really glad to have him there to help me.

    Great to hear from you. Keep talking to us so we can get to know you better and support you through this. :-)
  • SpineAZSpineAZ WiscPosts: 1,084
    Did you discuss with your surgeon the L5-S1 level? Make sure that level looks stable and healthy and consider requesting that he fix anything he may find when he does surgery even if he has to fuse the L5-S1 levels as well. Better to do that then to find out months or years later that the L5-S1 level was in need of repair as well.

    Do your research. Look at pictures of the spine to understand the levels and there are free videos on line that animate how the surgery works, how it's done, etc. That can help you conceptualize what is going on.

    Two items that were so important to me were:
    (1)Toilet seat riser. Costs about $30 and is available at any well known pharmacy chain. You'll find that in the hospital the toilet seat is a bit higher. When you get home you then have to sink back down to the standard residential seat height. So the toilet seat riser adds 5 inches. Easy to use, no installation needed, etc

    (2) 36 inch grabber (available also at large chain pharmacies). One end grasps or picks up items when you use the "trigger" on the handle. So helpful for anything outside your reach (not heavy stuff) and for things you drop

    My personal tips are:
    (1) When discharged from the hospital be as active as you are allowed. After one surgery I laid around and my first day back at work was horrible. Not because of spine pain but I hadn't done anything for over 6 weeks. So after my last surgery with the doctor's permission I'd walk 5 min a day down to the end of my block and back. Gradually built that up to longer walks.
    (2) When at home alone make sure extra toilet paper is in reach. I learned this the hard way once and had to use our other bathroom, which also had a declining roll.
    (3) Have someone pick up your pain meds as soon as you get home. Having been on vicodin consider asking for something a bit stronger. If vicodin is not helping a lot then it will leave you with more pain after surgery.
    (4) I don't have kids, only cats, so I wouldn't need much assistance after I got home except for cooking, etc. I'm the kind that wants to be left alone so I told friends not to visit as I prefer to rest and I'd contact them when I was ready for guests at home (I don't like guests in the hospital at all)
    (5) No need to pack pajamas, reading materials, etc for the hospital. General anesthesia and pain meds will leave you tired and loopy. Hospital gowns are easiest to use. I do take along some extra underwear for when I can wear it and my own hand lotion and toiletries I can't do without.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Just wanted to say good luck! I know folks here will help you understand the terminology and give you an armory of questions to ask the doctor.

    I hope 2011 finds you on the rebound to getting your brain (LOL) and health back!

    Gentle Hugs!
  • Hi and welcome to the Board! We are a friendly, helpful and caring bunch - caring especially because we all know what back pain is like, and a lot of us including me have had spinal surgery. In 1983 I had a C5-6 fusion/diskectomy and in '84 a decompressive lumbar laminectomy, both of which were successful with no residual pain. My advice to you is to try to stay positive, even though, granted, surgery on the spine is scary (the last thing that came to mind before the anesthesiologist put me under for the neck op was the word "faith.") You'll be in our prayers. Hugs, Essmoe

    Scoliosis, herniated L4-5 disk with encroachment on nerve root, grade 1 spondylolisthesis, and mild herniation at L2-3 and L3-4.
  • Sorry for the delay, as I was having a tech problem.

    Thanks so much for all the great info. You all seem so nice and I really appreciate the advice and tips posted. Those of you that have had spine surgery must surely know about the anxiety I'm feeling right now. I can't even imagine 5 spine surgeries (spine78.) Is it true that one back surgery leads to another? I will definitely talk to my surgeon about extending the fusion to L5/S1. If at all possible I would like to only have to do this once.

    My doctor said to plan for 3 months off work but that it will take 9 months to a year to completely heal. How long after surgery should I expect to be on pain meds? I'm looking forward to getting off them. Also, how soon should I expect to be able to go for walks outside? I am really looking forward to being able to to that.

    Another question. Is the pain after surgery really bad? I've been told I have a pretty
    good tolerance but Im not so sure about that. I'm trying to mentally prepare.


  • I'm having the same surgery on 1/24. TLIF on the L5-S1 level.

    I'm expecting to start tapering off my meds by at least 3-4 weeks. After 2 weeks I think the majority of the strong internal pain and the incision pain has passed.

    I think they want you walking outside as soon as you can tolerate it. From what I hear the more you walk the better you heal.

    I was told by some people that doctors don't accurately describe the pain to their patients so as not to discourage them from the surgery! Most report that the first week is a nightmare. On the other hand, most people say that the sciatic pain is resolved right away so that is encouraging.

    I am preparing for the worst and hoping for the best. I plan to take as much meds as they allow me to have (along with Colase!) Also, I keep telling myself that if I don't do the surgery I'm in pain anyway so I may as well do the surgery in the hope that I end up pain free.

    I'll be rooting for you!
  • One question - Do you know why your doctor is doing a bone graft and not using BMP?
  • I don't have an answer for that. I had to look up BMP. I see my surgeon on the 18th, 2 days prior to my surgery and I will ask.
  • SpineAZSpineAZ WiscPosts: 1,084
    My series of surgeries is mostly due to my unique problem of lax ligaments and tendons. Joints don't hold together well including the spine.

    Even so I always ask them to do whatever is needed once they get in there, if it looks "iffy" I want them to do it. My prior orthopedic spine surgeon said My C4 looked "iffy" but "no need to do it now". 5 yr later I may need to have that done in the near future. I wish he had done it at the time.

    Not to scare you but back surgery is painful. It's the muscles they go through, the swelling after that affects nerves, and the hardware placed in the spine which cause pain. In most cases you awake with what is called PCA. Patient Controlled Analgesia which is an IV attached to a pain med dispensing unit. You push the button when in pain and the machine controls how much you get. So you can't overdose even if you hit the button 60 times an hour. Mine I could hit the button every 8 minutes and get a dose. If I hit it at minute 7 it wouldn't do anything. There are advantages in that you are controlling it. The disadvantage is if you sleep a long time and have had no dose. But even with oral meds if you are sleeping you don't get the meds until you wake up and ring for the nurse. At least with PCA you wake up and hit the button.

    Getting back to work varies by person, type of surgery, and type of job. The minimum is usually 3 months and frequently 6 months the more physical the job is. But even a job that requires you sit for 8 hr a day may be too much at 3 mo as that's taxing to the area you had surgery on. If your employer offers Short Term Disability ask HR/Benefits now how to apply and get that all ready. You can apply a week or so ahead of time though no decision on your claim will be made until they can verify your surgery occurred, what type, etc. They need an operative report or doctor to complete a form to fully evaluate a claim.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 

  • Rae, to answer your questions;

    I work as a Teaching Assistant in a Primary school, so need to be able to do a lot of bending and stooping. I was off work for 6 months and am now more or less back to normal. I still avoid bending repeatedly for too long though. I tend to get down on one knee which enables me to keep my back more or less straight.

    I have recently had an x-ray done and finally (at 9 months) I have been told that fusion is underway. That was great news! :D

    I wasn't on strong medication for very long at all (only had the IV pain pump of morphine for 6 hours!). After about 4 weeks I only took paracetamol at night to help me to sleep. I do still wake a lot at night and have to change my position because I am aching. I think it might just be me rather than my surgery though. 8}

    As for walking outside, I started doing that as soon as I got home (after 5 days) with my husband with me, and gradually increased the distance. Walking really is very helpful in your recovery. My physiotherapist said that if I do nothing else, walk, walk, walk. It increases the blood flow and oxygen to the area to promote healing and fusion. It also gently stretches the muscles, ligaments and nerves and gets them used to working again. I also found it great to be outside in the fresh air and sunshine (if you are lucky) and was helpful for my morale and to feel that I was getting back to 'normal'.

    I personally found that the pain was not as bad as I was expecting. Everyone is different so your experience could be very different. I think it is advisable to be ready for pretty bad pain, and hopefully, like me, you will be pleasantly surprised how well you cope. I definately found that the anxiety beforehand was worse than the actual surgery. Even though I had several complications both in the hospital and after I got home, I am very glad that I went ahead and had it.

    I wish you well, and look forward to hearing that you are doing great once you get home again. :-)

  • Hi Rae.
    Don't wait till right before surgery (2 days) to ask about anything. Just place a nice phone call into the surgeon and ask. No need really to wait.

    re: nervousness

    It's gonna sound wacky, but maybe ask if you can go take a tour of the operating room sometime this week or next.
    Fear of the unknown contributes to the whole experience. If you become somewhat familiar of where you will be before, during, and after, maybe it will help allay some worry.

    Worth a shot. (it worked great for me)
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
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