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L3-S1 fusion 3 years post and still having pain plus new pain help ! Ideas?

martyjommartyjo Posts: 57
edited 06/11/2012 - 9:01 AM in Lower Back Pain
Hi, I am now 3 years post op L3-S1 fusion for spinal stenosis and herniated discs. I've got the rods and screws etc. I think 8 screws and 2 rods. I'm 62 years old and in mostly good health. I do my routine checks with my Ortho doc and he says I have a problem above the L3 more spinal stenosis and bulging discs. Because I still have pain every day since the surgery to begin with he has not pushed the surgery above as he said " Where do we stop".. Yeah, that's what I'm talking about. Sure I can go out and walk now but now before I take 3 Vicodin 5-325 and one muscle relaxer. I used to be able to walk only about 1/2 hour but can now walk quite a bit. The only problem is that I suffer days afterwards when I take long walks. My Ortho is not one to go heavy on any pain medication and I have not asked for much. I did tell him I do take up to 3 Vicodin at one time and up to maybe 6 a day - no more than that. I use Lidoderm patches also on my lower back which seems to be where the pain is localized. He's wanting me to remove the hardware and I say no way. I've never had such pain as when I had the initial back surgery. I'd never want to feel that again, or even wish it on my worst enemy. Recently I fell on my right side down a hill ( I'm the clumsy type) anyway, initially it was sore but now the lower back will not stop hurting. It wasn't a horrific fall over rocks and stuff just on dirt but I'm afraid that maybe I jarred something and my hips might be off? Or alignment might be off. I have an appointment in 10 days to see my Ortho and maybe he'll take an x-ray to see but OMG this burning pain in my left low, low back just above hip is killing me. Anyone out there had such a problem? Can it be the hardware? I'd go to a Chiropractor but I'm deathly afraid of them. I don't want them cracking me at all. Maybe some PT might help? I sure wish I could get some stronger pain medication so I can at least have a pain-free day but he's one to go about giving medications; also he wants me to get a steroid back injection, which I've had in the past , at least 6 and they never helped at all not even for a week. So why spend the money I'd have to put out on my part for something I know does not work on my back pain. So, anyone out there ... help!


  • maybe you should have your doc look at your si joint the reason i say that is that i had a l4- s1
    six years ago and shortly after id sa a year or so the pain started to get extreme and now am having my si joint treated upon my research anyway 75 percent of fusions involving s1 directly affect the si joint and is commenly miss diagnosed
  • to get your SI joint investigated. At the moment, since my last revision surgery, I've had continuing problems with back pain, but it is now in my right buttock and cocyx, and goes down my leg. I do have sciatica, but this pain is very different. So when I last saw my surgeon he tested me for SI joint pain and said it was positive.

    When I had the last MRI it showed degenerative changes already at the level above my fusion. My surgeon said this is common due to stress on the level above/below the fusion. Unless we do NOTHING physically, I don't think there's alot that can be done about this. I am very careful and protective with my back. I do not, ever, want another operation again.

    I had the revision surgery because the surgeon said it would help ease the pain. I had a screw loose (in more ways than one!). Afterwards, when I came round, the surgeon said that once he was in there, it was apparent the hardware wasn't good, so he had to replace 3 screws and changed the plates for rods. Maybe something similar could be causing your pain since your fell. At least when you go for your appointment soon, they can x-ray it to make sure it's all ok. The operation did not take the pain away.

    In May last year I had a steroid injection into the SI joint, but unfortunately, only got 24 hours of pain relief. I cannot sit for more than 20 minutes on a normal chair and walking (that I used to enjoy as it was the only exercise I could do after the fusion) is painful now. I'm on the waiting list for another SI injection, but with the NHS here in the UK, it can take many months. I'm quite happy to wait if it gives me a longer period of pain relief!

    My surgeon explained to me that when you have fusion surgery, your discs cannot absorb weight-bearing any more, so it transfers to the next available joint, the SI. It maybe something for you to discuss with your surgeon.

    I've not been able to work since September and have had so many problems with my managers. I've got a meeting with them this afternoon, and fingers crossed (very tightly), I pray they will allow me to return doing alternative duties. Realistically, I don't think I can continue in my present role with all the bending and having to work on the floor, so I'm hoping I can return to office work or something. I doubt it, because they've created so many barriers for me, but I'll see what they have to say before I get all defensive. Are you at work at present?

    You mentioned chiropracty and physiotherapy. For me personally, I still think that chiropracty a few years before the fusion made my back condition even worse. It's far too severe, in my opinion, with all the 'cracking' and manipulation involved. Perhaps physio would be a better option for you - or even hydrotherapy? Maybe you could try walking in the water - the resistance of the water will give you a good workout, and at the same time, the water will help to support you as it takes the pressure off the spine. It's just a thought.

    I hope your appointment goes well and they give you reassurance that the hardware is fine (after your fall). Will you please let us know how you get on?
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • i agree whith you never having spine surgery again i wont go there either ive had two lumbar and i cervical i also have si joint disfunction and just had a si joint injection las friday and still waiting for relief, in fact im having more pain now and the doc says its normal, well im not bying it because the told me i should have some relief within three days well its been 7 days and the pain is worse than before the injections. It some times feels that one should just leave the docs alone and move on but the pain just keeps me going back. i wonder if the docs rely on my pain for there buiseness,rock and a hard place for sure
  • I am fused L1-S1 and now I am having SI joint problems. I had 2 cortisone injections by a pain management doc and they helped for a short time which verified that it was indeed the SI joint. So the injections can be diagnostic.

    I am trying to manage it with pain meds but having problems with getting the right one. I do NOT want to have the SI joints fused.

    Some people have no problems after a fusion and others end up with problems at the level above or below. In my case since I build bone well and am fused well I have a block of bone now sitting on my SI joint which was part of the problem with my spine originally.

    Good luck and keep us posted.

    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.
  • Well, i thought I had sciatica or some sort of problem with my hip after I took a tumble on 3-10-12 but after a MRI I find out I have a huge herniated disc at L2-3. This is just above my fusion . I am fused L3-S1. So I've been in horrible pain. I did finally get some Hydocodone 5mg 2-3 pills every 4 hr. NEVER AGAIN. That stuff is awful. I hallucinated all night. My whole body violently shook at night, I was vomiting . I only took 15 mg at a time so it was a total of maybe 8 pills for the day but that will be a day I won't soon forget. Thank God they didn't have the 10 mg he ordered for me. I think they could have killed me. So I am managing with my Vicodin 5-325 3 pills every 3-4 hrs and Robaxin and not moving around much. Taking Ibuprofen 200 mg 3 at a time. I have to go in for a epidural injection this coming week Tuesday,in the past injections have never worked for me at all. But I will give it a try before I succumb to surgery, although I know I will be heading there before I know it. I cannot live with this pain and spasm. When my back was bad before I would just curl up in my lazy boy and get comfy for a bit while I let the pain meds work. Now, no lazy boy and no chair that I'm comfortable in for any length of time. Can't sit, can't stand. I'm hoping to up the vicodin to a higher Dose. Anyway, all of this from just a simple fall down a hill.I'm scared of the epidural, I'm scared of surgery, even if it's a small one. My luck it would not end up that way. They will find more when they "open me up" just like before. It was to be a simple surgery and 5 1/2 hours later and blood transfusions I'm fused at 3 levels. I was just getting back into walking again up to 5-8 miles at a time. It's summmer. I don't want to be laid up. I can't clean my house. Has anyone out there just had one disc operated on? I'd like to know what they did. My herniation is really big. I'd like to know if they suck out the disc what happens then. Is it bone on bone? Do they fuse that one? I'm really angry at myself for being so stupid and falling. I miserable because there is so much I need to do around the house and I'm lucky to peel myself off the toilet, pull myself up from a chair or walk from one room to the next. I'm also scared about my left leg and foot (which never had problems before) well, they are numb and tingly. I already have permanent damage on the right leg and foot. I trust my doc / surgeon , I just want to hear from others about the disc surgery at one level and how theirs turned out. Maybe some encouraging words? I don't mean to complain. I just am mad at myself for letting this happen and now I'm paying big time for this.
  • Sorry to hear about your fall and resulting problems. And I agree hydrocodone is terrible!!

    I have a similar story I think. I am fused L1-S1 but it didn't happen all at once. The latest fusion (L5-S1) happened last march. The vertebrae was slipping forward and pressing on all the wrong things.

    When they got in they discovered the disc was in too bad of shape to save so they had to stretch things so they could put in a replacement one. I don't think they will leave you bone on bone.

    The problem with having a fusion, and even more so with multiple level fusions is that the level above and below can become weakened since there is a lot of stress put on them.

    Trusting your surgeon is important and I also have one that I trust.

    I would assume your numbness and tingling is from the bad disc. Those were the problems I had when L5 started sliding forward. The surgery definitely fixed the problem.

    Talk with your surgeon, do research on the internet. I feel the more I know the better off I am.

    Good luck and keep us posted.

    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.
  • Hi, I's nice to hear that others have had similar problems such as mine. I sure wish I knew when to do. Forget the injection? Go ahead and do the surgery? Prior to me having this recent injury I was told that the disc at L2-3 was bad ( spinal stenosis) but my doc figured that surgery would be my option not his. Now... well, I don't know. If they fuse the L2-3 do they attach it to the others? I know he wanted to remove the hardware some time ago as I have great bone growth at the fusion sites but I think that will leave me in alot of pain I don't need. So, I'm back to L2-3. I would assume they remove the disc? or do they just remove the herniated portion? I think these are questions for my doc and me but I just don't know. He's not the type to rush into surgery for anyone. If you can get by then he's ok. I don't know if I want to go day by day getting by whatever that is. How much pain did you have after the one discectomy? I saw a video and it looks like a small incision. Maybe not so bad for what I will get which is pain relief. I guess we'll see. I guess I have to try the injection just to say it worked or not and then go from there. I'll keep you posted
  • I think doctors always go the conservative route first before surgery. Injections etc and then when all else fails it is surgery.

    I started out with just L4/L5 fused and then when my spine started collapsing in on itself I had L1-L5 fused. The screws from L4/L5 were taken out (a nice little souvenir) and a new fusion was done.

    With L5/S1 I just had a small incision, at the base of the big one I had from the first fusion which was 360.

    As far as removing disc or just herniated part I can't answer that. I would assume if part of it is bad the whole thing is weakened. Of course more is always known once they get inside. I did not know I was having the disc removed and replaced til after it was over and the surgeon told me the next morning.

    Like you I am good at growing bone so my fusions are good and solid.

    Again, keep me posted. Its never easy to choose surgery but being in chronic pain is worse.

    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.
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