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360 Fusion L 4-5 Anterior and Posterior

MaryAnne59MMaryAnne59 Posts: 57
edited 06/11/2012 - 9:00 AM in Recovering from Surgery
Hi Everyone,
I am new to the group. I am scheduled for a 360 fusion on Monday plus a decompression Laminectomy. The surgeons changed this from an anterior fusion due to the fact that my bones in the back are slipping.
I will have 3 top notch surgeons, a neurosurgeon, an orthopedic, and a vascular surgeon. They are inserting the cage in the front and the screws and rods in the back.
I am just really scared for a few reasons.
I have been in pain management since my previous failed laminectomy and am on Duragesic Patches 50, and Percocet 10 for breakthrough pain.I have been on this dose for well over a year. These meds hardly control my pain now. I hardly go out because of the pain. Will they be able to control my pain in the hospital if I am tolerant to narcotics.

Was your pain post op worse or relieved after a few weeks? Also, I had a foot of colon removed for diverticulitis in 2009 plus 4 previous abdominal surgeries and am loaded with adhesions. After the colon surgery, it was 11 days before my bowels got going again. I need to take 4 peri colace daily. The dr said I have very slow mobility. Did anyone have an ilius or a bowel obstruction after the abdominal approach?

Also, what was your average hospital stay? Did you need to go to rehab? They said 4-5 days and rehab if I need it. Did you go to ICU post op? It is just my husband and myself. Our children are away and we have no other close family, (except our 2 four legged children). How long when you came home did you have someone stay with you?
Thanks so much for any answers you can give me.
Take care and God Bless.
I did read Sticky's advice on what to take to hospital and what to prepare for home. TY.
Mary Anne
Take care and God Bless,
Mary Anne


  • I wish you alot of luck and may God bring you a speedy recovery.
    For the most part you dont have to worry about pain in the hospital as when I had my second fusion of L4-L5-S1 I was already taking very high doses of Ms Contin (180mg 3x day) and my breakthrough was oxycodone 15 mg 4-6 x a day in addition to my reg meds Lyrica 100mg 3x a day plus Xanax for anxiety ...... the hospital did an excellent job in controlling the pain and getting me to sleep in the O.R. so no need to worry about that. It might take you a little time to get the bowels going as per your pre existing issues and all the pain meds you will be geting. My tollerence levels were very high by the time I had my 3rd surgery so that I had no issues with bowels.
    My first surgery was a discectomy, lamenectomy and decompresion of the 3 levels my second surgery was a fusion of l4-l5-s1 and third was a XLIF (extreme lateral interbody fusion) I was up and walking the day after surgery and was actualy sent home after only one night.The hospital did a great job all surgeries with my pain meds in hospital it wasnt till I got home....
    My issues came a week later and now 4 months post op. My pain levels have shot up again.
    I wish you the best!!! remeber the mind is a very powerful drug in getting better. Do not worry about the hospital they will do thier job, you do yours!!!! get better stay healthy!!! Keep your faith in God whatever your religion is keep the faith !!!
    If I can help with anything else let me know !!!
  • like you i take a massive amount of pain killers so i too was worried about pain control post op.when i woke from the operation i screamed the place down as i felt like i was on fire.so they kept me in the medical recovery unit with my own anesthetist/doctor and medical technician.the reason was i need so much care .they tried morphine but even at its highest amount on a PCA is wasn't enough ,so they set up enough this time with diamorphine in ...still not enough !! so the anaesthetist kept given me kattamine every 2 hours .i need all this medication as i take around 500mg of oxycontin a day .i wish you well with you operation ..please have someone with you to help you wash and dress and do all the things you now take for granted as you will be far too tired to do anything yourself .eating may be a problem too .if you are off your food .then ice lollies are a fantastic way of freshening your mouth up .it took me a month befor i could eat bread .as my mouth was dry and it i tried to eat it .it ball up in my mouth and felt like cotton wool! .it will bee a long time befor you are feeling well again but if its done correctly you should be fine .i am now 7 weeks post op and even though no where near where i want to be i do feel better but still needing lots of pain killers .my main problem is sleeping .2 hours i am lucky
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • since I had my 360 ALIF done, but I'm pretty sure a lot hasn't changed. Realistically, your bowels are going to be pissed at you and will take a while to begin working right again. That was one of the more frustrating things about fusion surgery. In my case, it was nearly three months before my bowels were back to normal. It was because of everything being moved around and the amount of medication I was taking.

    Pain management should be adequate while in the hospital. Keep in mind they will want to wean you off strong stuff as soon as they can. Don't wait until the pain is intolerable before telling your nurse. Anytime pain medicine has to play catch up, it's going to be a rough ride.

    Try to go into this process with an open mind. There is going to be bumps in the road but don't get depressed. It's easy to do that. Just keep posting, a lot of people on this site have gone through what your doing and can give good feedback.

    Good luck!

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Thanks so much for your help, Mitch, Tony and Keith. I will check out your post Tony.
    My pain management Dr (not associated with the surgeons) gave me a script for 60 dilaudid 4mg for when I come home. He said I can take these instead of the percocet if the pain is bad, but to continue wearing the duragesic patch q 48 hours. He did not seem to think I would be cutting down on my pain meds till at least this summer. I also take Ativan,PRN Soma (1 PRN) and Topamax.

    I will be also wearing a brace. Did you have one? How long did you have to wear it? I am also getting a bone growth stimulator. I had to apply one to my neck for 4 hrs a day for 6 months.
    Maybe, I can take my shower at night when my husband comes home from work.
    Tony and Mitch - I hope your pain calms down again. Have your doctors said why the increase in pain at this time?? I will be praying for you both.
    Keith, How are you 5 years later and when did you first start to feel like the surgery was 'worth it"?

    Take care and God Bless,
    Mary Anne >:D<
    Take care and God Bless,
    Mary Anne
  • Hi,

    I have had 3 fusions, the first one was a 360 fusion of L4/L5. I had a previous laminectomy at that level.

    My hospital stay was 5 days. I was sitting up the next day and standing. The next day I was walking with a walker. None of this was easy at first.

    I found lying on my back the most comfortable, with a wedge under my knees.

    I live alone and set my house up before surgery. Everything at counter level so no bending. I had a safety bar installed in my tub/shower and put a plastic stool in so I could sit.

    I bought a long handled shoe horn. I mostly wear clogs but when I was able to go for walks it helped with getting on shoes with laces. I replaced my laces with elastic ones so that made it even easier.

    A long handled grabber is very important.

    I wore elastic waist band pants or sweats and didn't worry about socks.

    My bed is high so that made it easy to get in and out of. Practice log rolling in and out. It is just as it sounds. They will have you practice this at the hospital.

    I went to PT after 3 or 4 weeks. I had a strong core before surgery so that helped. I still had strengthening exercises to do. My insurance allowed 15 visits and I used them all.

    I did have illius and a long time getting things back in order.

    Be sure to follow the no bending no lifting no twisting orders of your doctor.

    I was allowed to swim after my stitches came out. I swim regularly and it is helpful to my back.

    Walking is one of the things you will be allowed to do. Start slowly. Walk short distances several times a day and then slowly increase the distances, still going out several times a day.

    Good luck and let me know if you have any more questions.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • Hun if you are on lots of pain meds, be prepared to wake up in a lot of pain right after surgery. I'm not saying you will be in a lot of pain, just prepare yourself to face that as a posibility. Ask for phenergan and muscle relaxers, the narcotics only do part of the job, that phenergan amplifies the pain meds, and the muscle relaxers help in a different avenue of pain control.

    I have been using strong pain meds for only 9 months now and I never can convey the amount of pain I was in for the first 30 minutes after waking up, but the staff got it under control. I was home on Wednesday about noon this week, surgery was monday about noon. I am also a nurse so what I know and what I feel are two different people inside me. I'm frustrated with not being able to move, and yet the nurse in me is trying to analyze the science of it.

    They gave me more meds than they would give 3 men to get my pain under control those first few moments, but after that, the pain has been manageable. I don't want to scare you, but be prepared, cuz I picked my surgeon based on his patients that I cared for after they woke up from surgery. I know he was the best in the hospital, but the anesthesiologist is the one you need to have the talk with about the pain once you wake up.

    Every human response to pain and to medication is unique. If you have a team you trust, then know they will do the best they can and keep you alive and safe and as pain free as possible.

    I woke up cussing and screaming and took the plastic vomit basin and crumpled it in my grip to the size of a tenis ball. If I were to do it all over again, I would ask them to make sure my amnesia meds last longer than average, I don't want to remember waking up in Post Op (PACU), I want to remember waking up in my room.

    I am 5 days post op, please make sure you do have someone at home with you to bend over and grab stuff that you do not realize you need. There is a lot of fear even on my part as a nurse and patient, and I hope you have a successful surgery.
  • #o I am so scared. I am asking for Dilaudid, because Morphine does nothing for me. I hope they keep on my Duragesic patch. This is my 6th abdominal surgery and second lumbar surgery (like Janiski I had a failed Lami at 4-5 with disc that was supposed to be removed but fragments are still all over the place. }. I also have a lot of bone slipping.

    Did you guys take any pajamsa, underwear, to the hospital. I am taking a robe, slippers, etc. Did you take any pillows, blankets from home.

    Janiski - when did you first start walking outside? Amberstar- how is the pain at home on day 5? what are you taking? Is it managed? What can you do?

    I heard chewing sugarless gum can get your bowels started up again? I am thinking about bringing some. They let me chew it after my colon resection to try to get my colon moving again.

    Amberstar - you cam home only 2 days later? That was so fast. Were you walking by yourself or with a cane?
    Did either of you have visiting nurses?

    They mentioned I may go to rehab? It depends how I do. It is going to be a long haul I think.
    Janiski, How long until you really felt you could go out, and be human again?
    I am praying for you Amberstar and Janiski - you are so strong - you are such an inspiration.
    God bless both of you!
    Mary Anne

    Take care and God Bless,
    Mary Anne
  • I was walking outside as soon as I got home. It wasn't much, only to the end of the driveway the first few days.

    I have never liked walking but when it was all I could do it became a lot more desirable. I thought to make it more fun I would get a pedometer to see how far I was walking. The first few days I thought it wasn't working because all I could do was shuffle and it wasn't enough movement to make the pedometer work!!

    It is important to get up and walk every few hours even if it is to the end of the driveway.

    I went back to work after 3 weeks. I was in pretty good physical condition before the surgery and I know that helped. Because I had another fusion 7 months after the 360 fusion it is hard to say how long it took to recover from the 360. One never recovers 100% but I would say it took over a year for me to start feeling like my old self.

    There will be times when you think you are never going to get better and then bingo it happens. It is a real patience game and you just get used to your new spine and its limitations. You find ways to do things.

    Good luck I will be thinking of you. Please let us know how you are doing.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • ~X( Thanks For your help. I am not in the best of shape. I am not overweight or anything, just not muscular. I have been in so much pain for so long.

    I just hope I can come home quick and start recovering fast. I will start walking asap when i get home. Not getting much sleep tonight. lol. Take care
    Mary Anne
    Take care and God Bless,
    Mary Anne
  • Couple things - as hard as it may be, try to wean down from the medications as soon as you can. If you start with dilaudid, try to go down to percocet soon, then lortab and so on. That brings me to my next point.

    Rehab from surgery kicked my butt. It's one of the most challenging things I've ever been through. I felt dang good for about three months. Then one day during rehab I started having a different kind of pain from what I originally had and it's never gone away. The reason I said you want to wean off meds as soon as you can is because if this unfortunately happens to you, pain medications will be in your future. You don't want to have a tolerance built up to the strong stuff since you may end up there once again.

    Don't mean to scare you! But things can happen...just keep that in mind. The best advice I can give you is to listen to your body and don't push things. Doctor's and PT's learn about this stuff, but we live through it. We know what it's like to go through it so listen to your body!

    I also did have a brace I had to wear. I wore it for about 6 weeks while not in bed. Once I began water therapy at 6 weeks, I didn't have to wear it any longer.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Everyone is different and so are the surgeons. I have never had to wear a brace after any of my surgeries.
    Also drugs will be different with different docs. I was not on any of the drugs mentioned by EMS guy.

    Hope all went well and you are on your way to recovery. The first couple of days are the worst.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • Thank you for all the advice. Recovery is easier knowing that I am not alone.
    My physical therapist has been coming to the house. I walk to the end of the block a few times a day with a cane. Every few hours I try to walk around the house. There are also some other exercises the therapist has given me. I am trying to reduce my pain killers but it feels like the pain intensifies every four hours or so. I am getting my stitches out tomorrow.
    I cannot reiterate enough as to how thankful I am to have the support from this group.

    Take care and God Bless,
    Mary Anne
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