11 Weeks Post ALIF - still have back/leg pain - is this normal?

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healthyfocus

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Hi Everyone,

I had Anterior Luraber Interdiscal Fusion (ALIF) surgery on January 4th at the L5 S1 vertebrae as a result of a herniated disc that I had lived with for 20+ years. The surgery went well, although the space between the two vertebrae were so compressed after all this time that the surgeon had to jack the vertebrae up to make room (the space was 7 mm and the spacer they used was 13 mm). They were able to take a core of bone from the vertebra above and used 4 screws to keep the spacer in place. Waking up from the surgery, I had a lot of pain from muscle spasms.

The recovery has been challenging, but from the second week I was walking and by the third week I was using an elliptical absent of the arm motion as that would be twisting. I have worn a hard plastic brace (goes from the tail bone to just under my arms) all day long and have, for the most part, not lifted any more than 5 lbs. This is really hard with a 2 yr old and 3 yr old. There were two times where I was in excruciating pain and thought the fusion failed; once, going up north, 6 weeks after the surgery, the frost heaves were really bad this winter and it was like hitting a speed bump every 15 seconRAB - this really set me back and put me back in the prone position for a few days. The second, is when I picked my son up last weekend in an emergency situation - I had not choice. Again, 2 days prone on ice. I have alternated heat and ice every night and morning and often times throughout the day. In terms of going back to work it took 4-5 weeks before I went back in and really took it easy. The only other time I find a set back is if I use the elliptical too much.

My problem/question is this: 11 weeks after the surgery, I am still in a lot of pain right in my lower back. It is almost as if the surgery did not improve it. Could this be because my core is so weak having not used it in 12 weeks? And, could it also be because I have not stretched any muscles in 12 weeks?

I also awoke from the surgery with leg pain. Prior to the surgery, I never had leg pain – only back pain. Both legs were in pain and nurab after the surgery. Now it is limited to the right leg and I take 1800 mg of neurontin which really helps tremendously. Another question; does this leg pain (burning and tingling) eventually go away? My surgeon said it is because the nerves are stretched (they had to really arch my back to open the spine and pull the compressed disc out.

My fear is that perhaps the problem was not the disc and is something else? I am also in fear that perhaps the fusion did not work.

I go back in to see my surgeon on April 3, which is 3 months post op, to see if the fusion is on track through an x-ray and to then get cleared for physical therapy. I'm very hopeful that PT, stretching and aggressive core strengthening will make the difference. If not, I do not know where to go from here (should I see a neuro surgeon as my surgery was done by an orthopedic surgeon?). If the fusion did not take, we will have to do another surgery from the back with all the accompanying hardware (I’m trying not to even think of this as a possibility).
 
Hello ~

I had a PLIF at L4-5 on January 7th, so I know something of what you are going through. Given that you were in pain for 20 years prior to surgery, I think you have to assume that you will have some ongoing pain as you recover. My surgical assistant told me that I was on my stomach, on the operating room table, for four hours in some rather "unusual" positions as they worked on me, trying to free up the nerves, etc. The nerves are tugged on with retractors so you can imagine that they can become angry after surgery, and they heal very slowly. They only heal at the rate of about an inch a month, and this occurs from the surgical site out.

I think you are being a bit impatient regarding the fusion. Without any instrumentation or BMP, your fusion is going to take longer to heal. At this point it is too early to tell what is going to happen. Some people fuse very quickly; others can take up to a year, some even longer.

Unless you noticed a big change in pain after picking up your son, I think I'd wait until you see the doc again. PT should help as you start working your core muscles again.

There are a nuraber of us on the board that have had a fusion since the beginning of the year. You can read through some of those posts to learn of our various experiences. I believe everyone is still have some pain...and we all have been told by our docs that it will go away as the nerves heal.

Hope this helps a little, and that you'll feel better soon.

xx M:cool:M
 
wow that great no instrumentation,my doctor told me he doesn't believe in it since it breaks easy,etc.
 
Honey,
I am so sorry you are having so much pain...
I can relate to your problem since 3 momth ago i had my second fusion surgery (total 4 levels fused) with a lot of other work to my back was done.

I am in a lot of pain too. I went for second surgery only to improve situation but as of right now I doubt that it did work. My meRAB go up in strenghts and quantity, my pain is raising more and more, spreading to the areas where i did not have pain before.

Even though it can be very frastrating, you still have to have hope, everyone heals differently and on their own time and pace. You may do very well in couple of month, nobody knows.
I was told many times by my DRs that it can take up to 2 years for the nerves to heal. So we have plenty of time still, correct?:)

Good luck to you, hope very soon you will start to feel better, don't forget spring is almost here: warm weather is our good friend!!!
 
I am very impressed with what you have been able to accomplish since your surgery. Just remeraber that this is major, major surgery and you want to push but not overdue. If you overdue, it will set you back several days/weeks. I hope I don't sound negative but just want to warn you from my personal experience.

Have you by chance tried any water therapy? Walking a pool or stetching out in a hot spa? These are things which are easier on your back because the water takes the pressure off your spine.

I wish you could luck and welcome to the board.
 
Hi,

Thanks very much. And, you are correct, it is very easy to get complacent and over due it. I have a 'type A' personality, which doesn't help much. Each time I have over done it, it is a minimum of 2-3 days of severe pain and then it starts to feel better and before I know it, I'm back where I started. Very frustrated.

I haven't tried water therapy. but I just heard about a course from a co-worker focused on water therapy for back injuries. I'm going to reach out to them tomorrow and check it out.

The elliptical helps, but that too, if I over due it, causes pain too (I try and limit it to 20 mins). I was walking, but I have hallux rigidus, so that didn't work out. I had surgery last year to clean the joint out and shorten the bone behind the joint, but it didn't work. I'm now looking at an implant or a fusion - another story for another board! It is a bummer, because walking is the best thing for a back.

I'm staying opimistic!

Thanks again!
 
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