Failed lumbar fusion - input on my options?

Hi Chris. I was injured at work in 2007. I worked as a CNA. My resident was sliding out of her shower chair because at the time, slings stated under them. She weighed 245 lbs an I got under her to prevent her shoulders from further damage. It took about 5 minutes for my hall partner to hear me. Then 4 people ( PT men included) to get her off safely. Thankfully she was uninjured and unmarked but I kept working thinking I was ok. The next day however, not so. L4 ,L5 were damaged but took months of the wrong PT to get an MRI. Now, more damage. I've had eblations, cauterized nerves L4L5 fusion more PT, steroid injections off the top of my head right now. I am in constant pain. I was recently diagnosed with rhumotiod arthritis and my rhumotologist isn't happy that no one diagnosed this before. I couldn't take ibuprofen, aleave or such products because I had a DVT and on warfarin for years. I'm back to getting injections in the SI, and around the fusion but I can feel something adjusting and it hurts like hell. My Left leg goes numb, pins and needles like and there are days I can't stand up straight to even make a sandwich. Yes I wanted the fusion to work. I loved my job. Now it's just pain and anxiety. I'm sure there's a lot more and I'm willing to share All of it to just be able to walk to the corner. Thank you.

Good evening @nellie52starr and while I am at it......hello to @nanny23. It is great to see you @nanny23 and I hope you two can share some helpful treatments and opportunities. At this point it is time for me to leave you in very good hands........meet @jenniferhunter. If your condition is about the spine, then Jennifer is the person you want to know. Get ready!

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

@artscaping @nellie52starr @nanny23

That was a lovely introduction, Chris. I am a Mayo spine surgery patient. It took me a couple years of seeking help for my spine issues before I came to Mayo, and during that time, I read lots of medical information on spine surgery. I had a C5/C6 fusion for cervical stenosis.

Nellie, I would ask you if you have had any recent imaging of your lumbar spine and pelvis? That is the first step to find out what is wrong or if something has changed because you can sense something is different. I see that you had L4/L5 fusion and are getting steroid injections in the lumbar spine. Those injections carry risks and if done incorrectly, they can cause permanent problems. I had only one epidural injection done as a diagnostic procedure, but it caused me to have sharp burning nerve pain in my hand that lasted a few months. I think that I was having an inflammatory reaction to something in the injection or the pressure it caused because the fluid had nowhere to go. I had a compressed spinal cord prior to spine surgery. Are you seeing a spine specialist now or just a pain management doctor? Access to proper care can be more difficult when an injury is work related. You also mentioned a DVT, and when you are less mobile because of a spine problem and can't walk well, that puts you at higher risk of clots. My mom has had them repeatedly because she can hardly walk and she takes Eloquis for this.

Nanny, good for you for exercising! That is so important for the spine to maintain core strength to support the spine with good posture to prevent problems or try to keep them from getting worse. My spine surgeon said that was the best way to not need his help in the future. What helps me with this is riding my horse. I just trail ride and mostly walk which makes my back compensate for his walking motion. It's the same motion my pelvis would have if I was walking, but in bigger movements. I make sure to sit up straight with good posture, and the more I do this the better my back feels and the less effort I have. When you use good posture to stack your spine correctly, it takes so much less effort than slouching, and you put a lot less stress on your spine. Uneven stress can promote disc bulges if there is some weakness in the disc wall, and uneven pressure on the vertebrae can cause growth of bone spurs. Bones are very much affected by pressure. If a person also had something like osteoporosis, compression fractures can happen that cause a kink in the spine. That happened to my mom and she now has a permanent 43 degree curve at the level that happened in her lumbar spine.

You both may be interested in some articles at this website that cover in detail physical issues related to many conditions. This is the collection for the lower back and pelvis.
https://mskneurology.com/category/low-back-pelvis/
Nanny, have you had any second opinions about spine surgery? The recovery from lumbar surgery is harder because it bears most of your body weight, and surgery can make you better, but it can also make you worse. Not all surgeons are equally gifted. Often with lumbar surgery, there can be hardware placed, and sometimes rods to stabilize the spine held in by screws. The correct placement of the screws is important and has to have the correct angle, and depth, or screws can break or pull out from pressure. The surgeon has to assess the forces that will be applied to the spine because of the surgery and also the loss of normal motion because of the surgery. Bone quality is very important too as you may imagine. You have one chance to get it right, so make sure you get enough presurgical opinions to make an informed choice and hire the very best surgeon for the job. When you have spinal cord compression, surgery should be considered before permanent damage happens to the spinal cord. If the spinal cord remains compressed with increasing pressure from arthritic bone growth or bulging spine ligaments, the pressure can cause the nerve axons in the spinal cord to die resulting in loss of function to what it serves in the body below that level. You can also have stenosis or compression at the nerve roots that exit the spine between vertebrae.

Are you writing down a list of questions that you would like to ask your specialists?

My dr. Says I need the operation you had. Fusion L4 L5. Also a laminectomy. I had a hip replacement in September 2020 that went great. But found out I have bad arthritis in my back. I found physical therapy helped my back especially riding the stationary bike. If I do that I can tolerate the pain. I have to keep moving. I have spinal stenosis. I hope u too ou can find help to relieve your pain.

Hi. I do not have pain management available in New York on my insurance. I wish I could ride a horse again. I wish I could walk to the corner. Yes I see all kinds of Drs. As I said,vi have recently been diagnosed with RA. Just had CT last week. My only choice right now for any relief is the injections. I truly want this hardware out. One screw is moving causing further damage to tissue and muscle. It's not a pleasant feeling at all. I have never needed depression and anxiety meds before but now I do. I also have to take sleeping meds or I toss and turn or get up all night long because there's no comfortable position for me. I guess I just wanted to see if I was alone in this position. Yes I have been treated very poorly and disregard. I've been told.....oh my that's gotta be painful......and then, well, make another appointment after this that and another test......for years. YES it's painful. God.......I'll just sit here and cry my life away while some Drs say how painful it must be. Sorry, a lot of pain today. Its raining. I'm going to bed. Thank you.

Good evening @nellie52starr, nice to see you on Connect this evening. I am just wondering how you have been managing for 6 years . Was this a laminectomy? Was it in the lumbar region? What had you expected to happen....to be relieved of pain and discomfort? To have greater strength and mobility? In order to be able to respond from a base of knowledge, I will need a little more information so that I can introduce you to other members who may have walked down the very same road.

I have been fortunate to have had two spinal fusions....one lumbar and one cervical. Both have been life changers for me so I know it can be done.

I find it pretty amazing that you have been waiting for improvement all this time. There are ways to secure help and resources available especially from teaching hospitals and clinics like Mayo Clinic. Do you feel like you must stay with the same clinician?

Let's also get the test results out........are you ready for that by sharing them? What do they show you? Connect is all about learning by sharing. with other patients, And sometimes shouting encouragement helps to.

Do you live alone at this time or have help at home?

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

I had a cyst on my spine 20 years ago and had surgery to remove it. 14 days later I had surgery again to remove a blood clot at the same sit. In July 2022 I had a back fusion surgery when the pain got so bad I could hardly sit or walk. That fusion has failed. I now have four fractured vertebra for the screws used to hold the fusion were too large for me and the screws themselves are pulling out and pressing on my spinal cord. I was told I have to have another surgery,far more extensive where they cut the back and remove the ruined fusion and then cut the front to attach things. It is a two day operation, 16 hours under anesthetic and is scheduled for Jan.17 and 19. recovery is 3 to 6 months. has anyone else done this and how successful was the outcome?

I will be at Montefiore UPMC in Pittsburgh, Pa