Spinal Fusion of L1-L4: Managing pain, what works for you?

Posted by Nancy @nan57, Mar 25, 2016

I had spinal fusion of L1-4 about 15 months ago. Lately, I've had chronic coccyx pain if I stand or sit too long. It becomes unbearable if I don't use my TENS unit. I'm afraid to exercise since twisting really starts the pain cycle. I wake up every night with pain and use ice packs and Tylenol (and cross my fingers) hoping I can fall back to sleep. My back surgeon isn't really interested in my aftercare. Where do I go from here?!

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@martishka I agree with PT and I wish you the best. Gabapentin can cause memory loss and make you unsteady on your feet. I would ask about Lyrica. Both are meds that you must titrate on and off.

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@sasaka

Hi Martiska,<br />
<br />
I can't even imagine how you're caring for a 1 and 3 y.o. with that<br />
vertebral fracture. It must be excruciating. I'm glad my response helped<br />
you somewhat. Truthfully, having practiced in this field as a RN, I must<br />
tell you I never saw any of our patients return with a leak or another<br />
fracture. Good luck with whatever you decide.<br />
<br />
Sasaka<br />

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Martishka,<br />
I really can only describe the actual procedure to you. The physician<br />
inserts a needle into your back at the level of the fracture, feeds a small<br />
catheter through it until he can visualize (uses fluoroscopy) the actual<br />
fracture, then injects a small amount of adhesive directly into it.<br />
Afterwards you lay flat for about one hour before going home. I remember<br />
having considerable discomfort on the 1-1/2 hour ride home in the car, but<br />
as soon as I was laying down again it was gone. The next day I was fine.<br />
The fracture has caused me no more pain. However, I do suffer from<br />
spondolethesis which is a narrowing of the foramens where the nerves feed<br />
through, and arthritis in the facet joints. These cause me considerable<br />
pain when I stand or walk for any long period of time. It is not the same<br />
pain that I had from the fracture. It can be relieved by resting and pain<br />
meds. I certainly understand not wanting to give up the grandchildren time.<br />
Mine are about the same ages and the last time I visited them (4 hours<br />
away), it was difficult to pick up and walk with the youngest who weighs<br />
about 22 pounds. He's quite the wiggle worm and is a challenge for me. Good<br />
luck with whatever you decide.<br />

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<br />
Hello Sasaka, <br />
Thank you for the information about the procedure. One of my questions regarding it has to do with the diagnosis which is not conclusive. It states that there is either a "compression fracture and/or a prominent Schmorl's node." I was thinking that if it wasn't a fracture, but in fact , was the node, putting cement into my vertebra would be a bad idea! Knowing that they can clearly see the vertebra during the procedure would be very helpful. THe reason I don;t have a conclusive diagnosis is because my MRI was for the pelvic and abdominal area. I have had significant pain in the lower right quadrant of my belly in addition to the back pain. So the dr asked for an MRI of the pelvic area. The MRI found no worrisome masses and the radiologist happened to see 3 vertebra in it and one of them had an "acute injury within the past year". He said that the vertebra had nerves leaving there that wrapped around the hips and came over to the belly which could explain the stomach pain. He said that a dedicated MRI of the lumbar region would give more info. I am waiting to see if this will be the recommendation. It has been a long time dealing with this (over 5 months). Perhaps a simple xray could be conclusive. <br />
It doesn't seem like rocket science to me and I am hoping that someone will make the right referral! <br />
martishka <br />

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