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Pain worse following L4/5 posterior decompression/fusion

ianfreemaniianfreeman Posts: 4
edited 01/13/2016 - 3:24 AM in Recovering from Surgery
I had an L4/L5 posterior decompression and fusion with instrumentation procedure on Friday and am now home. The problem I have is that the pain I had previously - which the surgery is meant to cure - is now much worse.

I told the surgeon about this yesterday and he arranged for a swift CT scan which he told me showed that everything is fine and all the bits are where they are meant to be! I have little or no pain from the site of the operation - I am on a cocktail of drugs (paracetamol, codeine, diazepam and gabapentin) - but the original pain itself is bad. All is well when I am sitting or lying down but when I stand and walk it is excruciating at first and then lessens as I move about more.

I know from reading elsewhere on this site that this can occur in 10%-20% of cases, but I still find it very worrying, annoying and upsetting. I have an appointment to see the surgeon in two weeks, so let's hope things have eased off by then. I'd love to know if anyone else has had this issue and how it resolved. Many thanks in advance for your help and comments.

BEFORE you read the attached, read: The Recovery Phase

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Specific comments :

Personal Opinion, not medical advice :

--- Ron DiLauro, Spine-Health System Moderator : 01/13/16 09:22 est



  • dilaurodilauro ConnecticutPosts: 9,875
    the member community the easier it will be to address some of your questions.

    If not, more questions will be asked. For instance treatments, you do not talk about treatments. Have you had any besides the recent surgery? Normally, people have a long list of treatments, since most doctors do not like to operate until they are convinced that is the only option.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • hvillshhvills Suzhou, ChinaPosts: 732
    edited 01/13/2016 - 11:22 AM
    It's VERY common for patients to have a LOT of post op nerve pain... even more than before the surgery. I'm not sure how you came up with 10%. What you are experiencing is the continued inflammation of the spinal nerves... even though the surgery has released the pressure on them. Recovery and healing of the nerves is a very unpredictable process and it can occur immediately after surgery or it can take weeks or months... until the nerves calm down. I've had 2 fusion surgeries and in one case the nerve pain was gone immediately after surgery and in one case it took 4 long horrible months for the nerve pain to go away. The only thing you can do is be patient and take pain meds. In my case I took a daily dosage of time release Oxycodone and it made the pain a little more tolerable.
    Harry - 63 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
  • Do I take it that I will not receive any responses until I address the issues in the post that has been appended to mine? To be honest, I think I've provided all the relevant information that I can!
  • ianfreemaniianfreeman Posts: 4
    edited 01/14/2016 - 12:47 AM
    Wow, hvills, that is so reassuring. Very many thanks - I thought I was the only one to still have nerve pain after surgery! I am in the UK and the most commonly used drug for nerve pain here is Gabapentin. I am on 600mg three times a day, which helps the pain considerably. I am also taking paracetamol, codeine and diazepam, ostensibly for the pain from the surgery site although that is not at all bad even when not medicated.

    Basically, if I didn't have the nerve pain I would be very active. I am really disappointed that the pain didn't go immediately, but very grateful to you here for explaining why. Dilauro, I had previously had a series of injections over a period of around three years, some of which worked and some of which didn't, A recent MRI convinced my consultant that surgery was the best option.

    The recommendations I was given for exercise following surgery were basically walking. That would be fine if I didn't have the nerve pain, but I am going to do my best to get around, even if it's only a little.

    I found the 10%-20% mentioned elsewhere on this site - darned if I can find it again, but it was in an article. Still, now I've heard from you guys I'll stay positive, take my meds, watch daytime TV and hope the pain recedes. I'm seeing my surgeon again in two weeks.

    Very many thanks again. Your support and advice is much appreciated. I can't see a way in our profiles to let other members know were we are all located geographically, but just for interest, I am in London, England.

    Was this the article you were looking for Ian ?
    Liz, Spine-health Moderator
  • ianfreeman said:

    Was this the article you were looking for Ian ?
    Liz, Spine-health Moderator
    Yes, that's the one, thanks. It says "Decompression of the lumbar spine will usually relieve the patient’s leg pain directly after the back surgery. However, for 10-20% of patients, the pain will continue until the nerve starts to heal. In some cases, the pain may even be worse for a while after the back surgery because operating around the nerve root creates some increased swelling and this leads to pain." That's what made me so worried - I've always been a 90% person rather than a 10%! ;-)
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