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User offline. Last seen 1 year 21 weeks ago. Offline
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Laser spine surgery log

Hi all,

Underwent lumbar discectomy and neural decompression surgery on June 30,2009 after 17 years of lower back pain. Hopefully, some of my experience can help.

In a nutshell:
L3-L4 bulging
L4-L5 herniated/burst
L5-S1 herniated/burst

Opted for accurascope laser procedure at EDITED Cost $15k.

My right leg from the waist down has been numb since the surgery. Unable to walk without cane/crutch. I'm told the compressed nerves have been aggravated and is causing the numbness. 2 weeks to heal, 4-6 weeks total recovery expected. I start pt today, 1 week after surgery.

More to follow.

Doctors name and contact details removed by forum Moderator (paulgla). We do not permit publishing specific doctor's or institution names and contact details.

User offline. Last seen 1 year 21 weeks ago. Offline
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First round of pt was mild.

First round of pt was mild. It's going to be slow going as my primary focus is limited movements until the swelling in my back goes down. One more tomorrow, and then twice a week for the foreseeable future.

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good luck

hi and welcome to the forum! Wave good luck on your recovery.. Big Grin we are always here to help! Applause Jenny Smile

_____________

be impeccable with your word..

User offline. Last seen 1 year 21 weeks ago. Offline
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Thanks, Jenny!

Thanks, Jenny!

User offline. Last seen 1 year 21 weeks ago. Offline
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Day 8 after surgery - Spinal

Day 8 after surgery - Spinal headache

I woke up with a slight headache that turned into a nightmare commute. Thankfully I made it to work, only to lie down for an hour so someone could drive me home.

PA said it was probably a spinal headache, not a result of pt. Had to lay flat for 24 hours, lots of fluids.

I now understand what people who get migraines go through. Bonecrushing!!

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Day 9 and the headache

Day 9 and the headache lingers...especially when I sit for any extended periods. Fortunately, lying down is an immediate fix for the pain.

On the plus side, my pt exercise seems to be providing more feeling in my foot (pins & needles, sometimes pain).

longroadahead (not verified)
I am considering the

I am considering the accurascope procedure as well and wanted to see check in and see if you had another update?

User offline. Last seen 1 year 21 weeks ago. Offline
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update - Day 23

longroad,

Yes, I do. I apologize as time seems to get away from me. The numbness in my leg is still the big problem. Some days very painful (5-6), usually after pt, which I'm still going 2-3 times a week.

My gp has put me on a stronger anti-inflammatory than Aleve which will hopefully stop the pain and numbness. As a precaution, I have an appt with a neurologist in 3 weeks if it doesn't subside. My pt thinks it will be 6-8 weeks before I'll be back to normal.

The best news is my lower back is in no constant pain. I get a twang now and then, but waking up in the morning with no pain is amazing after all these years!

longroadahead (not verified)
Good to hear about your

Good to hear about your back. Hopefully, the numbness will go away. Please keep us updated.

Thanks!

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Coach Mike

Did the doctor say the headache was a side effect? That's brutal to have a headache that long... I get them several times a year.

Hope you feel better soon!

_____________

JEAUX - I am not a medical professional. BUT, I DID stay in a Holiday Inn last week...
Don't get your knickers in a knot; it solves nothing and makes you walk funny.
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User offline. Last seen 1 year 21 weeks ago. Offline
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Tomorrow is Day 30

Sorry to log in so infrequently. Day 31 is Friday, the day I can start lifting heavy objects again. I think I will still take it easy for a couple of more weeks.

jeuxbert-the headache was a spinal headache, can happen up to a week after the surgery. To my understanding, the myelin sheath around the spinal cord can be nicked allowing all the fluid to drain out. Lying down allows the the sheath to fill back up, but takes a couple of days. And should not come back.

PT today was brutal, pain in my foot is severe,and unfortunately for the first time since surgery, I have pain in my lower back. I'm blaming this machine that I call the back breaker. You lay face down and your head and feet are simultaneously raised. I went 75 times at 25 degree angle today.

My GP has moved me from myloxican (non-steroid) to prednisone (steroid) today to hopefully stop the inflammation faster.

Progress with my leg strength and numbness is very slow. I have to admit I'm getting a little frustrated. Hopefully, the next 2 weeks of pt will show real progress.

Thanks for reading,
coach mike

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coach Mike ~

I'm not sure if you can answer my questions, but here goes....do you know if it is standard procedure to start PT so early? Who is directing you PT? Do you have any further contact with the place where you had the surgery?

_____________

I have no medical training. Comments are based on personal experience and lots of research and reading.
PLIF @ L4-5 with Peek cage, rods and screws Jan 2008
Lami-foraminotomy L5-S1 Jan 2009
Fusion L3-S1 coming up -- 1 June

User offline. Last seen 1 year 21 weeks ago. Offline
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pt

gwennie,
yes, pt is standard, and starting usually the week after surgery...at least according to my surgeon. I had it done in Dayton OH.

I don't live close to Dayton, so I call for advice and give them updates on what my therapist and gp tell me to do.

They told me I can come back for an exam if I want, but it's just not convenient.

I do have one symptom for the last week that seems to have them all perplexed, and thus the reason my gp wants me to go to a neurologist. Pain like an electrical shock shoots down my leg when I urinate. I know.. yikes!! Sorry to get graphic, but this is my experience.

cm

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Coach Mike

Only one comment -OUCH! - that would make you really not want to drink anything -- there goes the beer!

Hope the doc clears that up for you real fast!

Take care,

Judy

_____________

2010 Update: Sciatica resolved itself but still dealing with fibromyalgia symptoms that come and go. Walking 3 miles a day, fibro permitting.

2011 Update: Back to work since June.

Herniated disk (L5) no surgeries to date, super nasty nerve pain, left leg. 3 epidurals (Jan, Feb 09) (Short term relief) June 09, Second opinion from Ortho doc with new MRI -- not a surgery candidate -- referred to pain management doctor.

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Hi Delta, Thanks for the

Hi Delta,

Thanks for the sentiment! I've had 1 beer since the surgery. No other alcohol due to all the meds. I hope to be off them soon.

cm

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Update - Day 34

8 rounds of pt done, 5 more approved by my insurance.
pt gave me a portable neurotransmitter to place on my right calf due to no improvement after a month. Electrical stimulation 15 minutes at a time. Still can't stand on my tiptoes (with my right foot), and unable to flex my calf, which seems to be his biggest concern.

Today's pt was much more aggressive, I'm assuming because we are now on a deadline. Pain is above average tonight, but I'm going to skip the meds for a change.

cm

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6 weeks

Tomorrow is 6 weeks from procedure date, my personal goal to be back to normal........yeah, right!

I now realize it will probably be 6 months or more.

My leg is showing improvement in some areas at a very slow pace. All except my ankle reflex.

My visit to a neurologist last week was disheartening. He feels after a brief exam that I probably have nerve damage. I told him the surgeon checked for damage after the surgery and there was nothing except inflammation. The neuro said damage and inflammation are one and the same to him.

So I got my first conflict of medical opinions.

I have to get a new mri and an electrical mapping test done before the neuro will commit to any more thoughts on my situation.

I'm now at the point of having everything preapproved through my insurance before moving forward, so that's where it stands.

Pain is still bad on certain days, so I'm still on the pain meds. I'm done with the anti-inflammatories, at least for now.

Until next time,
cm

OkieAnnie (not verified)
Coach Mike

Did you not have any numbness previous to your accurascope procedure? Was the numbness a result of the procedure?

My neuro has let my situation progress to the point that I have numbness in both legs from the knee down, Sciatica in both thighs, drop foot in both feet, and a neurogenic bladder. So I already know I have damage that will probably not be reversed.

I had an L4/L5 microdiskectomy in June of 04 to aleviate sciatica down my left leg which worked fantastically. However following a total knee replacement in November of 06 everything seemed to get worse than it was before the diskectomy.

I am considering the accurascope procedure to simply stop the new sciatica pain, and to stop any further nerve damage, and I would love to think that things couldn't get any worse.

It is my hope that things are going much better for you now that another month has passed.
Annie Wink

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Okie Annie- I did not have

Okie Annie- I did not have any pain in my leg below the knee before the surgery. I am assuming the procedure has damaged some nerves, as my neurologist has suggested. I have a test coming that may shed more light on the issue.

cm

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Numb leg

Hi Coach Mike.

As I understand it, I'm not sure your surgeon and neurologist may actually have given you, 'conflicting medical opinions', because one of the ways in which nerves can be damaged includes 'inflammation' itself. I think they're actually saying the same thing, albeit using different jargon and medical terminology!

You say you're 'done with the anti-inflammatories for now'. Can I ask, was that your decision or the doctor's? The thing is, bearing in mind what the neurologist said, they help reduce the inflammation, which should help the nerves in your leg. If your doctor's the one who suggested it, perhaps you should discuss this with him - with a view to taking them again?

Val

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Val, The last inflammatory I

Val,

The last inflammatory I was taking was prednisone. When it ran out, my gp nor neurologist nor surgeon suggested going back on the aleve.

So it may have been an assumption on my part since none of them spoke up. I have just started taking the aleve again, my own decision.

As far as the conflicting opinions: The terms may be interchangeable, but it certainly wasn't presented that way by the pa after the procedure. He specifically said at the postop that the surgeon tested for nerve damage immediately after the surgery, and there was none. When I pinned him down a couple of weeks ago he suggested that the procedure could have exposed existing nerve damage, but not caused it. A nice song and dance.

The fact remains that I never had any problems below my knee before the surgery, including any ankle reflex problems.

cm

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2 month update

Hi all,

2 months after the surgery- numbness and pain persists. Improvement is hard to notice from week to week.

I had my last pt session last week. My choice as I was doing most of the work at home anyway. I still have my neurostimulator for another month. Have been using it about 4-5 days a week. Don't know if it's doing anything, but I keep trying.

Have also started Vitamin B supplements to help the nerves heal. This has caused my right leg to start swelling during the day, so I backed down from 2 tablets a day to 1. The swelling isn't so bad now.

My biggest disappoinment so far was the updated MRI the neurologist ordered. I was expecting to see major changes in the pics of my bad discs. Both the MRI tech and I could not notice any changes in the new pics from the ones from January (before the surgery).

She did tell me however to wait and see what the neurologist says. I go back to him for a test the first week of Oct.

At this point I've done enough reading to realize that I will probably be limping for the next 1-2 years. I'm going to keep working hard at the pt and hopefully it will not be that long.

Anyone asking for a recommend to the procedure I had is not going to get one from me. Leg pain and numbness is very likely. How long it lasts is the variable. Roll the dice if you absolutely have to.

cm

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Paul, Thanks for the

Paul,

Thanks for the thoughts. I have an appt in Oct with the neurologist. I have not discussed with anyone other than the MRI tech yet.

She was just doing me a favor by discussing the pics........off the record so to speak.

cm

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Hi Coach ~

Were you looking at the films with the tech and comparing them to old films. side by side? I would certainly think you'd be able to see any changes, even if you didn't know exactly what you were looking at!

Usually with an open surgery to correct what you had, you would have felt relief right away, If the nerve was badly compressed prior to surgery, it can take a long time to come back.

It is very disheartening to end up with new or different pain from before surgery.

I guess all you can do is give it time, keep walking and hope the nerve heals. Not having an ankle reflex is not the end of the world. I don't have one in my right leg and I can't see that it makes much difference. It just makes any new doctor you go to test it many times because he keeps thinking he can get a twitch out of it.

Try not to be discouraged. You are still early out of surgery. I know you didn't meet your expectations of being well in six weeks' time...so you'll have to readjust your expectations. Keep a positive attitude, and keep working. There isn't much more to do at this point.

Hang in there!
Gwennie

_____________

I have no medical training. Comments are based on personal experience and lots of research and reading.
PLIF @ L4-5 with Peek cage, rods and screws Jan 2008
Lami-foraminotomy L5-S1 Jan 2009
Fusion L3-S1 coming up -- 1 June

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Thanks for the words,

Thanks for the words, Gwennie!

We were looking at side by side pics, both from cd roms. Any change was so minor, we couldn't see it.

Can you run without your ankle reflex? I cannot, and that is making a huge difference in my life.

Like you said, I will keep trying and hope and pray for the best.

cm

Bart54 (not verified)
Hi, Mike. I just discovered

Hi, Mike. I just discovered and joined this site yesterday, and have yet to intro myself. But I wanted to tell you how much your sharing your experience means, especially to me, since I am very seriously considering this same outfit's procedure. I happen to live in the other ( non-Dayton ) city where they operate. In my case, it would be two procedures, both lumbar and cervical ( a real mess! ). In any event, I'll be listening carefully, so thanks so much for sharing. Best to you, always.

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Good luck, Bart.

Good luck, Bart.

Z06
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Covered by insurance?

Was that laser surgery covered by medical insurance or did you spend $15K out of pocket?

_____________

• The only valid excuse you have to give up is if you are dead.

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Cost

Z06,

I paid out 15k. So far with surgery, meds, pt, mri's and other pros, I've spent about 20k.

I have a high ded hsa, and the insurance portion stinks.

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hi Mike ~

What have you been told about your ankle reflex? I really don't know if I could run. I must admit I haven't tried! I think when I was out in the yard with the dogs, I did something that resembled running, so I think I could.

I guess I really don't know that much about how reflexes work and what it means when they cease to function.

When do you see your doctor to discuss your new MRI? If the inflammation is sufficiently down post-surgery, you should be able to see the changes that were made. I can certainly understand your frustration.

Gwennie

_____________

I have no medical training. Comments are based on personal experience and lots of research and reading.
PLIF @ L4-5 with Peek cage, rods and screws Jan 2008
Lami-foraminotomy L5-S1 Jan 2009
Fusion L3-S1 coming up -- 1 June

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Gwennie, Neurologist

Gwennie,

Neurologist suggested it was damaged by the surgery. He won't know for sure until I have another test done in Oct.

I'm spending a week in aloha land, so maybe that will work a miracle.

Try to run with your dogs and let me know how it works out. My dog is a rhodesian ridgeback, 80#, and he can knock me down quite easily now.

Good luck,
cm

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hi Mike ~

I'll just try running alone, thank you. I can't even walk with my guys -- they are Bouvier des Flandres and are each over 100 pounds and not perfectly trained, I am sorry to say. The one and only time I took one for a walk since my second surgery, I ended up in a face plant on the asphalt road! I landed on my face and badly bruised one knee, but my back was OK. I just lay on the pavement for awhile, taking inventory...am I still alive? OK. Is anything broken? Can I move? other than scratching one lens on my glasses, and having a floor burn on my cheek, and the bloody knee, I was OK. So now I haven't tried walking even one of them since. We play in the yard instead, and hubbie walks them.

What exactly are your symptoms now? I think it is really hard to say whatever is going on was caused by the surgery....nerves are really unpredictable....but I personally know how frustrating it is to wake up from surgery and have pain or problems you didn't have prior to surgery! I've been working almost two years now on one of my "new problems." GRRRRR.

_____________

I have no medical training. Comments are based on personal experience and lots of research and reading.
PLIF @ L4-5 with Peek cage, rods and screws Jan 2008
Lami-foraminotomy L5-S1 Jan 2009
Fusion L3-S1 coming up -- 1 June

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2 100 pounders? Sounds like

2 100 pounders? Sounds like you and hubbie need to saddle up and just enjoy the ride!

My numbness is mainly down the back of my leg, with a lot of pain in my foot. 4-5 on good days, 6-7 on bad. I'm trying to take the pain meds on those days only. Averages about every other day. Still using the stim every other day as well.

How about you? What's your pain level 2 years later?

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3 months

Went to see a neurologist for 2 tests yesterday. Nerve conduction and an EMT.

The nerve conduction was basically electrodes shocking various points on both legs. Uncomfortable, but bearable.

The emt was needles placed in various parts of my right leg and back. The ones in the back were the worst. The needles sent a signal to a laptop and would create noise with any nerve conductivity. Not surprisingly, there was no sound coming from my calf area.

My leg and foot numbness have not improved significantly, so I'm looking forward to the results in 3 weeks.

In the meantime, I have realized that I walk better without shoes. I went and bought a pair of the new shoes that have rocker soles, and they seem to help.

Until next time,
cm

dancingcupcakes (not verified)
Hey Mike

Any updates???

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Hi

Hi Dancing,

None other than the above. I'm still patiently waiting for my nerves to heal.

Sorry to hear you cannot dance. I know your frustration with not being able to do the things you really like.

I originally hurt my back skiing (snow and water) and playing softball. I was still playing softball up until 2 days before my surgery. I can still coach, but I miss playing more than I ever thought I would.

At this point, if I get my ability to run back, I'm going to run marathons.

I hope you can dance soon,
cm

Extacy (not verified)
North American Spine

I am 72 year old male with 20 years of continuing back problems. CT Lumbar showedscoliosis to the left. scoliosis w/ convexity to left. Grade 1 anterolisthsis of L4 and L5 degenerative changes identified,L1L2 disc space narrowingL2L3 narrowingawith vacuum disc phenomena. Disc bulge estends to annulus. L3L4 same as L2 some facet arthropathy. L4L5 grade 1 anterolisthesis. Disc narrowing her ane L5S1. Severe lunbar spondylosis and mostly constant pain softened by Hydrosodone.

Question. Anyone out there that have used North American Spine and your reactions in relation to my problems? Thanks

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Extacy -- Welcome to the board --

There is a fellow who is on the board from time to time named BuckeyeBack who had surgery there recently. You could try sending him a personal message.

_____________

I have no medical training. Comments are based on personal experience and lots of research and reading.
PLIF @ L4-5 with Peek cage, rods and screws Jan 2008
Lami-foraminotomy L5-S1 Jan 2009
Fusion L3-S1 coming up -- 1 June

madar (not verified)
Tests results back?

Coach Mike,

I hope your test results show something curable... did you get them back?

Thanks for sharing your experience, it is so very difficult to know whether a new procedure is good or not.

Michel

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Neurologist update

Hi Michel,

Sorry it took a while to update. Neurologist put me off a few weeks.

Tests showed definite nerve damage S1-L5. No surprise there.

I asked him multiple questions but the main one: Do you think it's permanent? was answered with "I don't know. I won't know for about a year."

Other comments he made:

1-the tests showed that the nerve could heal
2-nerve tissue can heal, but will never again be 100%
3-there is no way the nerve damage was there prior to the surgery without showing symptoms (as the pa had suggested)

He referred me to a neurosurgeon. No new drugs or anything. His #1 recommendation, physical therapy.

I started back last Monday. Go to the neurosurgeon to see if there is a surgical option in 2 weeks.

Take care,
cm

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Neurosurgeon update

Hi all,

Neurosurgeon informed me that it is too early to try a surgical remedy. Again, a year to a 18 months needs to pass. Then it would at first be exploratory to look directly at the nerve tissue.

His pertinent comments:

With nerve damage, I probably won't notice any difference in sensation for at least 6 months (THIS ONE I LIKED!!!) I'm at 5 months with very little change.

Keep doing physical therapy

The calf and ankle reflex is controlled by a combination of S1 and L5(different % of control in each individual)

MRI shows gray shading on both of these, indicating scar tissue

Prescribed Lyrica for ongoing pain

I feel I'm at the top of the food chain as far as medical pros go, and am amazed at how little is known about the procedure I had. One of the last things the neurosurgeon pointed out to me was that it was performed by an anesthesiologist, not a surgeon.

cm

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Lyrica

Coach,

Sorry to hear of all the difficulties. I am new to all this but am currently on Lyrica as one of my pain meds pre-surgery.

All the meds don't provide total relief but they help.

Lyrica can cause you to be a little goofy and nausious.

Good Luck.

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Thanks, lookin. Good luck

Thanks, lookin. Good luck to you as well.

cm

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coach updates

Coach,

any updates?

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Hi Coach

I've been considering the Accurascope procedure and during my investigations (over the last year) I've found the best site for information is facebook. If you don't have a facebook account you might want to consider getting one. If free and easy. Most of the people I've touched base with have positive things to say about the procedure. I've only encountered one other, like yours, that's exhibiting the same types of issues. His problem, like yours was because they nicked a nerve during the procedure. As of Aug-Sept 09 they've stated using advanced nerve monitoring techniques and the incidents of nerve nicking has almost been eliminated. At least that's what the doctors told me.

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accurascope update

Coach,

Any updates?

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Thanks for the info. How are you doing?

Hi Coach,
Sorry we haven't heard from you about any progress in your recovery. I hope you are doing better.
I wanted to thank you for sharing your accurascope experience here. I'd been considering it after my traditional open lumbar fusion surgery left me in worse pain than before (it's been 15 months now).
The accurascope buzz seemed too good to be true, and based on your experience, it is.
Nerve damage and a dural tear. That's pretty rough. I must say I'm not totally surprised as the scope pokes around the anterior epidural space, which is loaded with nerve roots and right next to the dura. It seems risky to go in there with a laser that, while it can blast herniated disc material and scar tissue, also can damage nerves in the area and nick the dura, causing the cerebrospinal fluid leak that produced your crushing headache (I experienced the same after my fusion surgery).
Well, I guess you won't be giving a glowing testimonial on the company's Web site. And to think, you spent $15K out of pocket.
Please update us on your progress.
Best regards,
P

_____________

L4-S1 360-degree fusion + instrumentation, laminectomy 10/2008 and 01/2009. XLIF L3-L4 10/2010. History of chronic low back pain following auto accident 1999. ESI L5-S1 6/2008 (no help). Bilateral SI joint injection 4-2010 (no change). Norco 10-325 one half twice daily. Physical therapy 4 years. Returned to work for two months starting March 2011 but am back out due to bad flare-up.

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What can I say?

Nothing. No updates here.

Sorry, I took this long to say it. It's been 1 year, 2 months, and 13 days after my procedure.

My calf does not function, the back of my leg and most of my foot still feel as if they are asleep.

I still walk with a pronounced limp, but have discovered how to mask it. Unfortunately, this requires using other leg muscles in a way they were probably not meant to be used, so new pain pops up now and then.

Also, depends on the shoes I wear. Barefoot is still the best.

I thought I was taking the safe route. I was wrong.

I still plan on seeing the neurosurgeon in January, and possibly the exploratory surgery.

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