45 years post-op spinal fusion w / harrington rod.

@mayomayo Welcome to Connect. I am sure a lot has changed since your spine surgery. All surgery creates scar tissue internally in the fascia. I am also a spine surgery patient, but mine was a single level cervical fusion without hardware. What has helped me a lot before and after spine surgery is my physical therapist who does myofascial release therapy or MFR. This can break surgical scar tissue in the fascia and release the stuck fascia that keeps our bodies from moving properly. Of course movement changes with rods on your spine and that has limited the rest of your body too. MFR gets fluids circulating better within the body as well as allowing the waste products to be removed. If it's stuck the tissue gets dehydrated and painful.

Here is part of another post I had written that explains what the fascia does. This is just physical therapy and you may want to try it. There is a provider search on the MFR website. It has helped me a lot. Currently I am rehabbing my ankle after a bad fracture and 2 surgeries. I had limited mobility all summer and have had to use MFR to break fascial adhesions caused by sitting too much.

I wanted to explain that what bathes your cells is the lymph fluid and it carries nutrients as well as waste products. The blood cells are inside the circulatory system and the smallest capillaries have walls that are only one cell thick. The lymph can leak out between these cells. Your body is also constructed within a connective tissue framework, the fascia that holds the cells of the organs together. Fluids must be able to pass through this to supply the organs. When there are fascial restrictions, it cuts off this exchange of nutrients and the waste products accumulate in the tissue. The fascia is also a conductor of electricity and signaling throughout the body. The lymph collects and drains back into the circulatory system where it gets filtered as the blood goes through the liver and kidneys where wastes are processed and eliminated.

The fascial tissues can be remodeled with myofascial release which does literally remodel and rearrange the fascia as it converts into a semi liquid state and slides on itself. In our MFR discussion, you can find a video that shows this happen in living tissue. You will find the video at this page.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/?pg=5#chv4-comment-stream-header

I think aging isn't responsible as a catch all for fascial dysfunction. Instead, it's our habits of being sedentary and eating foods that cause inflammation that create the symptoms of "aging". It is inflammation driving it, and it you reduce inflammation through healthy choices, you slow down that process that everyone accepts as aging. The fascia gets stuck to itself and stops having the ability to slide.

Another note of interest that I saw was in some Mayo news and research to regenerate heart tissue that showed a photo of a perfectly formed white heart. It might have been in the Ken Burns documentary. The heart muscle cells had been removed through some process and what was left was the fascial framework of the heart or the "scaffold" on which the heart was constructed. When you see that, you realize how extensive fascia is because it surrounds all the cells of the organs in our bodies and it holds the circulatory system where it belongs as connective tissue. The fascia actually is an organ itself which they recently named the interstitium in recent literature.

Our Myofascial release discussion.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Hello, I also had 2 Harrington rods inserted in 1982, then wore a body brace for 6 months. Cut to 1993, pain worsened, new doctor tried to get rods out, could only get 1/2 of one (btw- at some point between '82 and '93 that rod had broken in half). He then inserted 6 screws, which forever altered my posture tilting me forward. This past October 2020 I had a Nevro SCS system installed. (Spinal Cord Stimulation) A unit about the size of a man's huge wristwatch was placed in me between back & butt. (You get to choose which side!) There is a rubber paddle - it looks like a drink coaster - with an electrical charging wire that you place on your skin over the implanted device. You do this daily for 20ish minutes. The rest of the time you plug the other end of paddle into a charger that plugs into the wall. It will take a while to find the proper setting, the charger has settings from A through F, and 1 through 7 for each letter. The different settings do not indicate raising the output higher, the settings are for different patterns that are sent out. It blocks the pain from reaching your brain. It does work. I had a trial unit that had a 360 degree spread and I felt relief right away. The permanent unit has a narrower, more directed spread so it takes a few weeks to find the setting that works for you. Right now I am on letter B, number 3 and I am beginning to hurt less. If you like, I will post updates.

This is the site I was looking for. My husband has artherities throughout his spine and in pain all the time. Injections do not help much but I read Abbott labratories launced a new device IonicRF Generator, the first radiofrequency ablation device that uses heat to target specific nerves and block pain signals from reaching the brain. Studies has shown that a single treatment can releave pain for six to 12 months. I don't know if this is out in the market yet. Also Medtronic's nerve spine cord stimulator shows long term results releaving back pain. Anyone heard of these? Does Mayo Clinic use these? The reason I ask because my husban was told any surgery to his back woul make him an invalid. Looking for different options beside injections. Flying to Mayo is not that easy either.

Wow, you seem to know your stuff. Thanks for sharing.

Yes please keep up posting updates.
I am scared to get spinal surgery. Most of the cases I've read about seemed to have gotten worse sooner or later.
I was also informed that I would need someone to live with me, a caregiver, for at least a week or two for assistance with every little thing, e.g., going to the bathroom, sitting up.

Thank you for this thorough explanation of how the fascia works throughout our body. Can fascia be remodeled through therapy even if it's been stuck for a long time (i.e., 10 years)?

I had a microdiscectomy in 2010 and the surgeon tore the dura. This resulted in the accumulation of chronic pain, a disability retirement at age 56, and intervening years of learning to live with daily pain without taking opiates. Thanks to the Mayo Pain Rehab 3-week program, I've been off opiates for 3 years.

I make myself go for walks and do my PT exercises. I say I "make myself" because being active ratchets up my pain, but I know it's essential to keep moving or I'll get more and more debilitated.

I can "feel" the scar tissue in my right lumbar spine. It feels stiff compared to the left side. I'm wondering if any of that decade-old scar tissue can still be broken up to some extent. Any idea?

@elsa Hi Elsa. That is great that you are exercising to maintain your strength. Good for you! I think myofascial release can help you, and with many years of scar tissue, it will probably take longer. I also have thoracic outlet syndrome that waited about 10 years before I began MFR work and I have improved a lot because of MFR. My doctor predicted I needed 2 - 3 years of PT with MFR and it was during that time that my bulging cervical disc ruptured and collapsed so I hit a plateau and stopped progressing, but having done that work on my neck and shoulders made it easier for my spine surgeon because my muscle was not as tight, and I had an easier recovery from my cervical fusion. I started working on MFR again at about 6 months post op. It's like peeling layers of an onion to reveal the layers underneath and it changes as you get deeper. The fascia connects like a web through the body and I can also feel it moving down in my leg or hip when my PT is working on my neck or jaw. It also pulls across to the opposite side to the shoulder or opposite hip. Tightness has pulled my pelvis out of alignment from the tightness through my ribs that connects downward. The incision scar on my neck does get tight and can initiate a muscle spasm and periodically needs more stretching. If your body stops moving, things tend to tighten up again. I'm working on rehabbing my leg after an open ankle fracture that had 2 surgeries last spring. After spending 3 months of no weight bearing and sitting on the couch, I'm catching up again on some of the neck and shoulder tightness and working on strength and coordination for walking.

Some of what my therapist has worked on is a big scar on my ribs that is 50 years old that never had stitches by pulling on it. All of that connects to fascia under it. When my PT first started working on my neck, it was stuck together and she could not feel the individual muscles until I'd had about 2 years of MFR that was about 2 times a week. You should be able to feel some improvement soon after you start, and you'll progress faster if you work on the self treating MFR stretching that you can do at home. I've become good at inventing ways to stretch. Once you gain the body awareness to feel the fascia slide and move and where it goes, you can stretch to find that feeling and you just hold it and wait for the fascia to realign itself. When you first start therapy, it might take 15 minutes at first to start to slide, but as you keep working, it will start sliding within 5 minutes or so. Look for a John Barne's trained expert level therapist. There are also some John Barne's workshops for the public to teach the methods about once a year. John is an older guy, so at some point, he may retire. His website is http://www.myofascialrelease.com and there is a provider search.

I think you will benefit from MFR and it will help get muscles aligned better which will align the bones better like the pelvis. When that is off, it causes back or leg pain for me. The pelvis can twist because it has joints and is made of a few different bones. I know when I feel fatigue in half of my low back, it is because my pelvis is off, and it can make one leg seem too long or short. There are some PT moves to realign the pelvis. I've learned in my rehab that gluteus medius on the sides of my hips has a job to keep the pelvis bones from shifting forward, and mine fatigue with walking, but as I regain strength there, I get better pelvis stability. To answer your question, yes, the fascia can be remodeled and realigned after being stuck for years. I have done that myself.

Good for you for avoiding opiates. I never took a single one after I left the hospital after my spine surgery. I had pain, but it was bearable. My ankle fracture was actually much more painful and over a longer time than my spine surgery and I managed to get off the hydrocodone in 2 weeks and I only took a small doses as needed because it nauseates me, so that was not round the clock. I spaced out doses and waited until I had higher pain levels before taking he next one and I alternated with the Ibuprofin. You are welcome to join our MFR discussion. I started it to collect a lot of information as a resource, so the first pages have lots of links. Here is the link.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

@elsa, Good afternoon, I asked my MFR therapist (expert level by the way..which means years of training). Here is what she said."Absolutely, scar tissue can be broken up, no matter how old it is. It is tissue, it can be released." This is very encouraging for you. Please let me know if you want additional information although I see the @jenniferhunter has sent you a reading assignment.

May you be free of suffering and the causes of suffering.
Chris

Hi @nsainato, welcome to Mayo Clinic Connect. You'll find some information about spinal cord stimulator on Mayo Clinic's Adult Pain Medicine page here:
- blog posts and patient stories https://connect.mayoclinic.org/page/adult-pain-medicine/
- Neuromodulation https://connect.mayoclinic.org/page/adult-pain-medicine/tab/neuromodulation/
- Radiofrequency https://connect.mayoclinic.org/page/adult-pain-medicine/tab/radiofrequency/

You might also be interested in these related discussions:
- Comparison of Spinal Cord Stimulators from Boston Sci., Nevro https://connect.mayoclinic.org/discussion/comparison-of-spinal-cord-stimulators-from-boston-sci-nevro/
- Has anyone one tried the HF10 Spinal Cord Stimulation Device? https://connect.mayoclinic.org/discussion/hf-10-spinal-cord-stimulation-device-relieves-back-and-leg-pain/
- Spinal cord stimulation: Will Nevro help when Medtronic didn't? https://connect.mayoclinic.org/discussion/nevro/
- Has anyone had the Stimwave spine stimulator installed? https://connect.mayoclinic.org/discussion/has-anyone-any-had-the-stim-wave-installed/

I hope this helps with your investigation for alternatives to surgery.

I have a Medtronics spinal cord stimulator, permanently installed January 2020. It has made a very positive difference for me. I have had one multilevel fusion in 2011. Now I have severe stenosis at other levels and was offered another (2) level fusion. Just didn’t want to go through that again. My trial gave me positive results. For me it proved the right choice. I turned 70 this year.