Howdy friends
I'm facing an intense surgery For spondylolosthesis, disc degeneration and a 3 level fusion. First time around spinal issues. HELP. Need input
From folks who've had similar surgeries...wondering about pain and recovery protocols, time impatient and results you've had.
Thanks so much
Celaine
I had a 4-level (L3 through S1) a bit over 2 years ago. Pic attached. Ten days in the hospital; a week or two resting. Then rehab...about 6 weeks @ 2x/week. Most people go a lot longer and don't recover as quickly but I've always been a rehab freak and bounce back very quickly. Bike time, leg presses, etc. The whole point is to strengthen the muscles that support the back, especially the erectors. However, things like the quadratus lumborum (QL) and glutes are very important too.
The biggest thing is that you will be wearing your brace for a lot of months...three or four at least. One thing you won't be able to do is touch your toes again...LOL... Depending on the location, cervical, thoracic or lumbar, the recovery can be very different with various restrictions depending on location.
Pain... You should be on major opioids (hydrocodone or oxycodone) at the beginning. Note: Hydrocodone causes constipation in many, many patients. Go with the oxy instead. Ask for Percocet. Exact same painkilling relief (NIH says so); different base molecule. You should be on them for less than 30 days and then switch to Tramadol or 800mg Ibuprophen. Get off the heavy stuff as soon as possible. You can't be taking that crap and driving to PT. Big no-no. Addiction in that short a time frame is a non-issue.
PT... Gotta take it VERY seriously. And you're not done when PT time is over. This is a year-long recovery that will be all on your shoulders. Gotta hit the gym. Example: Golfers who have a fusion are warned not to even swing a club FOR SIX MONTHS and then re-engage slowly and gradually over the next six. Remember...FUSION means that the bones have to FUSE together. This takes time...you cannot mess with it and just return to "normal life". There will probably be lots of restrictions on bending over...you have to learn how to SQUAT to pick things up. Plus NO TWISTING!!!. To get out of a car, turn with your back straight and move BOTH legs to the ground...then stand up. Torquing your back is a major no-no...especially during year one.
I still wear my brace to do housework and gardening...it keeps me from even thinking about bending over. And no slouching in a chair!!! Get an ergonomic one that maintains good posture.
That should get you started. Yeah...it's some pain at the beginning. Manage it properly. I wrote this for my TKR group but it still applies...
https://patient.info/forums/discuss/staying-ahead-of-the-pain-563395
Hope this helps.
PS: It's not as "intense" as you might assume. You go to sleep, wake up, take your meds, go home, wear your brace, do rehab. Easy. Don't set this up in your head as something completely awful. You'll handle it just fine. Just avoid the Jedi Mind Tricks...
PPS: Just had a LATERAL one-level fusion (LLIF) above my old one about two months ago. Pic attached; they go in from your SIDE not your back. Overnight stay...zero rehab. That was sooooo easy and all the stenosis pain was gone instantly!!!
I had a multi level fusion just 6 weekw ago. 4 days inpatient. Doing very well. I only needed narcotics the first 2 weeks and that was due to my nerves becoming very inflamed. I had one round of steroids and that disappeared. I am wearing a brace which I have gotten very used to...easing into normal life, although much more tired and exhausted so I stop and rest a lot. My next dr visit is at 12 weeks and as long as the fusion is fusing I can probably wean off brace and begin rehab to strenghten core. The hardest thing for me is fighting depression which I think I get confused with the exhaustion becasue I was very active prior to surgery. I am more isolated than I was prior to surgery becuse I dont have the energy I need to do what I want to do. However thats the worst of it for me. I know this is temporary as I heal and increase my activity level. Good luck! I am glad I did it because the pain I had in my hips and legs are completely gone.
I have an appointment for consult with a Neuro surgeon on June 9th. My problem is my neck has stenosis from mod. to severe from the canal closing up and bone spurs. Straigthening of the cervical spine.?? Also 2 herinated disc and their is fluid going from herniated disc into the spinal canal. I have bone spurs from my neck and through my thoraric spine. And my lumbar spine has 3 bugling disk and DDD. My hubby and I have to travel 4 hours to the surgeon, it's the closet place that does this surgery. But they are doctors from Boston so I feel more comfortable with that. So this first appoinment is a consult, then surgery and then numerous trips after the surgery. This will take is going to be a long year. I also need surgery on my right hand (that's my dominate hand), how long will I have to wait to have that done?? I have more questions than answers but you and the other people sound experienced than I am. Thanks everyone!!! Have a great day!!!
I've had 10 hand and wrist surgeries (trigger fingers, carpal tunnel, cysts, etc.) over the decades. They have never been a big deal for me; fast recoveries...although I don't know your diagnosis. 46 years in IT is a lot of keyboard time...plus I'm a bass guitarist (started in music in 1959) so that's a lot of hand use.
One- or even two-level spine issues can now be done LATERALLY. I'm not a doc so I don't know what the requirements are for qualifying for the lateral LLIF procedure. Do your homework and talk to a few neuros. If yours doesn't do the procedure, get a consult with one who does. Posterior entry fusion is 10 days in the hospital, wearing a huge brace for months and lots of rehab. My LLIF was one hospital overnight, no brace, no rehab. HUGE difference...again, if you qualify.
Bone spurs can be fixed by simple laminectomies. I had one at L4/L5 literally "crushing" (doc's word) my sciatic nerve root. Walked out that day; inflamed nerve pain gone in less than a week. Those are easy.
So... I had the L4/L5 laminectomy, a full fusion of L3 through S1 for a "junkyard" spine plus the LLIF at L2/L3 for stenosis. Nothing cervical so I can't speak to that...just my experiences. The biggest thing is to find a GREAT neurosurgeon...you may have to see a few before you get all your answers and come to a decision. If the guy/gal doesn't do LLIFs as an option for you, see someone else. These have been around for a decade. Search TouTube for "globus lateral" for a cute animation. AMAZING technology. (Don't get freaked out by the "retractor"!!!) A General Surgeon is employed to open you up from the side (get all the muscles and organs out of the way) then the neurosurgeon goes in, destroys the current disk, inserts the EXPANDABLE device, cranks it open with an Allen wrench, backfills it with a bone graft from your hip and then the GS does the close. 90 minutes. An hour after waking up, I was sprinting down the hallways and zipping up and down stairs with zero stenosis pain. Since they retract the nerve roots at your specific site, you will have some post-op nerve pain for a few weeks. Your LLIF site will determine which nerves will be affected. My L2/L3 fusion gave me expected nerve pain on the top of my quads...but that's for L2/L3 only.
Attached are pix of my big fusion and then the LLIF. You can see from the lateral LLIF pic that the posterior edge is wider than the anterior. The mechanics of the device allow the neuro to adjust the height of both front and back edges thereby retaining a natural curvature of the vertebrae in the final result. Very cool... Do the research...make good choices.
That's all my spine and hand work. I also have an artificial hip and a metal knee. Between those and the spine, I'm paying for playing hockey for 45 years...wouldn't change a thing. The problem is my playing days have been long gone. Can't do that with 4 1/2 pounds of metal in me...with one more knee to go. If you get the spine work done, just like me you will be the TSA's worst nightmare at the airport!!! Every bell and whistle will go off. Be prepared!!!
Hi Celaine;
I had spinal fusion (L4 L5) a year ago. My surgery went well...1 night after surgery was a nightmare when the meds wore off. I was put on a morphine drip that didn't help at all. First 3 days are difficult & painfull as they want you up and walking asap.
I really wish they would give stornger pain meds during this time...why do we have to suffer? Makes no sense.
Get a grabber (reaching tool) makes life easier than asking someone to constantly pass you things.
Hope you have someone to help you when you first get home from the hospital. Full recovery takes about 6 weeks which is what most surgeries take.
Follow your Dr.'s orders & you'll be fine. Good luck!
I'm 15 weeks post op 3 level lumbar fusion. Recovery is a slow process. do as much as you can prior to surgery to accomidate for recovery,no bending ,lifting,or twisting.
I hired a housekeeper & some one to help with my cats. I moved all need kitchen supplies to waist level as well as my bedroom & bath items. I purchased 2 grabbers. It was hard for me to ask for help as I'm used to being so active & independent. Icouldn't drive for 4 weeeks. It's important to have support person you can count on.