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Spinal Fusion

Started by anoziraspine on 03/05/2010 3:09pm

I recently had a microdiscectomy spinal fusion at the L5 S1 for an extruded disc. Wondering, typically how long surgery pain lasts and the typical length that I should use narcotic pain relievers. Typical length I should be off from work. Thanks.

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Hi Anoziraspine

Each person's recovery is different, but here is my experience, which might be of help to you.

I had an L4-L5 anterior fusion (ALIF) nearly 5 months ago. I needed to be on oxycodone/oxycontin and neurontin for a couple of months and then on a smaller dose of oxycodone for breakthrough pain if needed. I had operation pain for about 4 months which has gradually lessened with each month. Sitting for more than half an hour is still a problem, but I've recently been strengthening my upper body using 1 pound hand weights which has relieved the intense aching I was getting from L4-5 up to the thoracic area. I can only stand still for about 5 minutes and then need to move. I have been able to walk without pain for about 4 months and this has given me a freedom which I haven't had for over 5 years.

If you have strong pain, then you need to keep taking your pain meds. Review this with your doctor or pain specialist. Walk as much as you can as this will relieve congestion in the lumbar area and improve your circulation. I was given gentle exercises in the hospital and I do these most days to improve mobility and flexibility. Most important to observe the no bending, lifting, twisting restrictions and discuss with your doctor when you can ease up on them.

I 'm retired so don't have to go back to work. I had spinal surgery in 2008 and was off work for 3 months. Going by how I feel after this current surgery, I would have needed 4-5 months off. Some people are able to go back to work after a couple of months, but for others, it's around 3 months. For yourself, it's going to depend on how well you recover and your body will tell you when. Would encourage you to discuss this with your surgeon on your next visit. Recovery is a slow process and can be frustrating at times and we don't normally go back to what we were before chronic pain set in.

Hoping your recovery goes well.

Trish

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Trish,

Thanks for responding. Your answers do help. I am about 6 weeks post op. About 2 weeks ago after I reduced the strength of my pain medicine (currently taking Oxycodone 5/325 (2 every 4-5 hours) and Lyrica (2x per day) I noticed or developed a burning sensation in my feet-pins and needles type of thing with some numbness. The pain is mild with the current medicine thankfully, but its irritating as I sit here and it feels like my feet are in hot water. I still have some pain where the surgery was, but thats the least of my concerns at this point. I am walking about 20-45 minutes a day and will add some stretches.

As you wrote you can only stand for about 5 minutes, are you experiencing the same thing. Or anyone out there?

Thanks again,

anoziraspine

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Hi Anoziraspine

Re the burning sensation and numbness in your feet, as I understand it, that's the nerves waking up after being compressed for so long. I didn't get that, but did have strange nerve sensations in my left leg and such a restlessness and couldn't lie still for too long. I had to get up and walk, even several times up and down the patio during the night. That was the most frustrating part of my recovery. It went after a couple of months. Keep on your meds while-ever you're having the foot pain. After fusion, the body has to readjust and you may find that you have pain in an unrelated part of your body. It does pass.

That's good that you're doing that amount of walking. If at any time you feel that up to 40 minutes in one walk is too much, then space it out - say, 15 minutes in the morning, 15 minutes in the afternoon and another 15 minutes in the evening.

Once you get MUCH FURTHER into your recovery, then you can add core strengthening exercises. I've recently started them as well as some upper body strengthening. For now, you can do lots of the pelvic floor exercise just while you're sitting or out walking, and remember to breathe!

With the standing, I start gently moving from side to side, say when I'm talking to someone, and when that gets too much, then I either sit down or go for a little walk. For me, it's like I need to keep moving as much as I can. However, I'm fine sitting in my recliner with a pillow behind me - could do that after about 6 weeks.

Remember the hare and the tortoise story - well us spineys are the tortoise.

Trish

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Trish,

Thanks again for the information and encouragement, it helps considerably. And good luck in your recovery as well!

anoziraspine

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I had a L4-L5-S1 fusion surgery. I also had a burning feet after about 6 weeks. It felt like hell but there is hope! It felt so bad I thought the pain will never go away. But, medication helped. My doctor prescribe Lyrica (there are more cost efficient medications) and within 2 days the pain was gone.
Here is my doctor's explanation for why it happened:
During the surgery, nerves are irritated when the surgeon draws a bone graft. Those nervers later may cause "Burning feet" syndrome.

Yinnon

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Thanks Yinnon for letting us know what your doctor said about how the nerves are irritated during surgery and how sometimes we get burning feet.

Trish

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I am 6 months post-op from a anterior-posterior L2-S1 fusion with instrumentation. I am STILL experiencing sciatic pain-sharp pain going from hip thru buttuck to knee,sometimes to the foot. Weakness in the leg to the point that if I walk for more than 20 minutes,my foot startes to drag(if I go to the mall, I HAVE to bring a cane) While this is an improvement from PRIOR to the surgery, it still isn't much of an improvement.
My surgeon keeps saying that my problem is b/c the nerve is just "irritated" because of the previous compression. However a ct scan shows nerveroot compression at L5-S1. An EMG shows nerve damage at L5-S1. I have gone from taking 2-3 5mg vicodin a day to taking 5-7 10mg vicodin PLUS 2400mg of neurontin and 4500mg of robaxin a day. I have asked him about pain manegement and he said 'not now, if ever' My PCP feels that it IS time for pain mangement b/c I am looking at a long term issue here.
KNowing what I know now...I probably would not had the surgery-the only thing good out of it is I have gone from oxycontin and percocet to vicodin-but I am still in constant pain.

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Hi Lisa

I replied to your other post without reading this one which has more info. Sorry.

With such a BIG surgery, it's going to take a long time to recover. The nerves do get irritated when they operate and they are VERY slow to recover. I would go with what your PCP recommends. Perhaps you could have a root sleeve injection to help reduce the inflammation at L5-S1.

Are you able to exercise in the pool rather than walk on hard surfaces? Could you use a walker rather than a cane when you go to the mall? A cane can make you walk lopsided and bring more pressure on the spine. When walking on hard surfaces, might be better to only do shorter times, say 10 minutes several times a day.

Do you know if you are fusing or are fused yet?

Hope you can get some good pain relief soon.

Trish

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