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New to Forum: L5/S1 ALIF October 2014

edited 12/15/2014 - 12:23 PM in New Member Introductions
Hello all,

My name is Jason and I am new to posting on this forum. First, let me say a big thank you to those who have posted before me. I have been scouring for information on this forum for just about a year now and have appreciated being able to find out so much information from everyone else's experiences. What has prompted me to post today is that I am experiencing something that I can’t seem to find information on. To give a little background:

I fell in 2005 and began having low back pain and sciatica. After 5 years of off-and-on physical therapy, I decided to have surgery. In October 2010, I had a laminectomy and discectomy at the L5/S1 level. I had relief from pain for almost 2 years when the pain returned and with a vengeance. An MRI showed that the disc had degenerated to the point where the vertebrae were regularly making contact and scratches on the vertebrae could be easily seen on the MRI. I decided at that point, with the advice of an orthopedic surgeon, to undergo ALIF surgery at the L5/S1 level.

Post-surgery, I immediately experienced extreme cramping in my right leg. The cramping faded with pain meds while in the hospital, but my right leg and foot still felt cold to the touch and appeared white, especially when contrasted with my left leg. I was released from the hospital after 1 night with this condition continuing and was told that as long as I wasn’t experiencing loss of mobility with my right leg and foot that would be fine.

I gradually started to feel better after the surgery for the first few weeks. My right leg and foot remained cold and white, but it was more of an annoyance. Then at about the 4-week mark, my right leg started cramping again and has continued to worsen. Right now (6 weeks and 5 days post-surgery) my right leg and foot are cold to the touch, appear, white, and off and on throughout the day and night it feels like I have a charlie horse starting at my right hip and intensifying behind my knee and at my calf. I am concerned that something else may be wrong. If anyone has had the same experience, or know which forum to forward me to, I would appreciate it. Thank you!


Welcome to Spine-Health

It would be very helpful if you could provide us with more details. Here are some questions that you
should answer:

  • - When did this first start?
    - Was it the result of an accident or trauma?
    - What doctors have you seen?
    - What Conservative treatments have you had? Which ones?
    - What diagnostic tests have you had? And their results
    - What medications are you currently using?
    - Has surgery been discussed as an option?
    - What is your doctor’s action plan for treating you?

Providing answers to questions like this will give the member community here a better understanding
of your situation and make it easier to respond.

Please take a look at our forum rules: Forum Rules

--- Ron DiLauro, Spine-Health System Moderator : 12/15/14 16:23

L4/L5 Discectomy October 2010
L4L5 ALIF October 2014


  • LeeLeeMccDeeLLeeLeeMccDee Boston MAPosts: 101
    Hi Jason, experiencing "unexplained" pain and post-op complications is scary and worrisome but I believe more common than not. I had a two level a/plif Nov 2013 and unfortunately have not done as well as was expected for a few reasons. Did your surgeon give you an initial explanation for the coldness and whiteness of your leg? The cramping sounds a lot like spasms which can be extremely painful and physically exhausting. Have you asked or are you on any type of muscle relaxant? Also, have you been walking or doing other types of physical activity that may have caused swelling and/or strain on surgical area; ie tissue, nerves muscles etc.? Sorry for all the questions but it may be helpful with Forum advice.
  • Thank you, Ron for volunteering to moderate this forum and for adding the prompts to my post. I realize now that in an attempt to not bog people down with too many details, perhaps I included too few. Here are some more specific responses to those prompts:

    My back and leg pain began almost 10 years ago directly after I tripped while I was hiking and fell on my side. I have had back and leg pain since with complete relief for a year and a half following a 2010 laminectomy/discectomy performed by an orthopedic surgeon. Prior to that, I had seen only chiropractors, physical therapists, and my primary care doctors. In 2012, following the return of pain after my 2010 surgery I saw a neurologist, a neurosurgeon, and an orthopedic surgeon, all in collaboration with my primary care doctor. I have been in and out of physical therapy since 2005, about 10 times lasting anywhere from 3-6 months each. Prior to my October 2014 surgery, I spent 9 of the previous 15 months in physical therapy. I have also had 4 epidural steroid injections this year, all providing relief for 2-5 days (most likely from the short-acting analgesic rather than the steroid).

    Even though my pain began in 2005, I didn’t have my first MRI until 2010, as my primary care doctor explained to me that because my pain was evenly distributed on both sides, it was likely muscular rather than structural. However, in 2010 the MRI indicated that I had a moderate sized herniated disc at the L4/L5 level. In 2012, my MRI indicated that the same disc had herniated further and that the disc was degenerated to the point that the vertebrae were rubbing on each other. The orthopedic surgeon I saw recommended ALIF surgery and I decided to go that route. I feel that the skill level of my surgeon was outstanding and that the procedure itself was a success.

    I am now 7 weeks post-surgery having the symptoms I discussed previously (some lower back pain and cold and white leg and foot). These go in and out and the past couple of days have been much better than on the day that I originally posted. For medications, I take one to three 50 mg Tramadol each day for the pain as well as one 10 mg Flexeril as a muscle relaxer at night. I am able to manage okay on these. I saw my doctor yesterday and he feels that the symptoms I am having are not typical for this stage in the recovery process so is ordering a new MRI.

    I have read a lot of the forums on here and have taken away from them that people have different experiences with pain following surgery, and sometimes I fear that I may have the chronic pain so many people suffer with long term and whom I deeply empathize with. It was really just the coldness and whiteness of my leg and foot, along with the leg cramping that I wasn’t able to find anything about. I am definitely not asking if this is normal; rather, I’m just curious if other people have had this experience.

    Thank you also, LeeLeeMccDee. I appreciate your words of comfort. To answer your questions: my surgeon did not give an initial explanation for the coldness and whiteness of my leg and the cramping, other than that they tested the nerve that was impinged upon during surgery and it appeared to be functioning properly. He was pretty concerned about it following the surgery, but then less so as I became more distracted by the incision and fusion site pain and wasn’t complaining of it as much. He did say from the beginning that if I experienced loss of movement control or loss of feeling in my foot to report it right away. I do think the cramping may be related to muscle spasms as you mentioned, especially since the Flexeril seems to help. My doctor shared with me that it may have to do with the trauma of stretching the spine in terms of its impact on muscles or perhaps shifting around scar tissue from previous surgery.

    As far as activity, I have tried to be consistent in what I do each day, spending some time in a recliner and I try to walk at least 2-3 miles a day. I did return to work part time last week, which has resulted in more time spent sitting in an office chair. Having had a few days to reflect, I do think the increase in symptoms may be related to returning to work and facing more constraints on when I can get up and move around. As I mentioned, the past couple of days have been better as I have cut back my hours again at work. I am also trying to take more time for mindfulness through deep breathing and meditation. I am hopeful that I can continue on the healing trajectory I have felt the past couple of days. The hardest part of recovering from surgery for me has been having good days followed by bad days. It dampens my spirits, as I am elated when I experience relief and then disappointment sets in when I find the pain has returned.

    Again, a big thanks to you two for providing feedback and guidance for how best to participate in this forum.

    L4/L5 Discectomy October 2010
    L4L5 ALIF October 2014
  • Hello - how are you doing now? I had ALIF L5S1 on 12-4-2014 to repair a Psuedoarthrosis from failed TLIF L5S1 in Jan 2012.
    I noticed my left foot and toes at various times were much colder than my right foot.
    I gave a digital thermometer and temps were usually 82-83 left vs 97.6 right ties and foot were white on left. The left leg and foot has always been my problem area.
    Not sure what starts this cold foot issue but usually starts when sitting position and will usually resolve after aprox 30min of walking.
    Neither my Nuero Surgeon or Vascular had any real answers. My surgery was around 5 hrs due to trouble removing old spacer.
    I am trying to figure out if this could be due to swelling in the surgical area due to all the prying of the disk area to get old spacer out and larger one inserted. Perhaps the swelling presses against veins running in that area. Also trying to determine if nerve compression can actually cause temp change in foot or if it would have to be a vascular issue. I have posted looking for any thoughts and was intrigued by your story. I am still having left hip,leg and foot pain as well as deep pain inside lower back.
    Hope your doing better and any info you may have found out
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