Recent L5-S1 fusion

Posted by fine137 @fine137, Dec 22, 2019

Diagnosed with Spondylolisthesis about 30 years ago. Didn’t cause me much pain except for the yearly episodes of throwing my back out and being laid up for a week or so. But 2 years ago morphed into pretty much constant pain, especially when sitting.

Doctor finally recommended surgical fusion option and I had the procedure done 9 days ago. According to him it went well and he is optimistic on the ultimate outcome. I am fairly mobile, doing about 90 minutes of walking each day, but by the end of the day, when it’s time to go to bed, the pain becomes almost unbearable without meds. During the day there is pain, but it’s quite manageable. Why does it peak at night? Am I doing too much during the day perhaps? Or some other reason? I do not take pain medication during the day, but do have to resort to a pill at night.

Overall what does recovery from surgery look like, how long might it take for that whole area to calm down so that most of the pain is gone, even though it will be 3-6 months for the bone to grow? This recovery is not like any I have experienced before, meaning it feels plateaued where I don’t have marked improvement on a day to day basis, but rather plateaus followed by slight improvement. Is that normal.

I know my doctor should answer these questions, but while a highly respected surgeon he seems to have no time for these types of queries.

Thanks

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@upstatephil

Are you maintaining a diary? I found my diary to provide a useful set of recovery milestones which, as I slowly improved, provided great positive feedback that I actually WAS improving. The passage of time was surprisingly indistinct during recovery and my diary gave me a good time anchor: How did I feel a week ago? Two weeks ago? I commonly felt frustration with my recovery trajectory but nearly always felt better using the reference of my diary to "see" that I really was getting better. I've been following a general three-part recovery timetable: (1) Three months until I start to feel better (that was true). (2) Six months to be able to medically gauge the overall success of the surgery. (I meet with the neurosurgeon in a few weeks for that assessment). (3) 12 months to full recovery...hopefully sooner...Best wishes.

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Your idea of a diary is great and I started one yesterday. It certainly will be helpful.
I hope your recovery continues daily and thank you for your information and suggestions.

Best,
maddiemae

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@solom174

I had T3-5 fusion 3 months ago today. While technically I have improved since post-surgery when I could barely move out of bed, I cannot see a full recovery in my future and there has been no advice on how recovery to normal is to realistically proceed. As @upstatephil describes, recovery is not marked by trends you can see/feel moving forward, rather it is nebulous and often feels like you are going backwards - very inconsistent. I hope that there is such a thing as full recovery.

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I'm sorry you haven't felt much progress regarding your surgery. It is possible that there isn't full recovery but I would be grateful for 80 %.
I have a great surgeon with a wonderful nurse who is talking me through my concerns and worries so I'm very lucky in that regard. I see my surgeon on October 27th at which time he'll take an x-ray to see how things look. He's scheduled me for hydrotherapy beginning October 31st.
I hope you can get some relief and perhaps develop a relationship with your doctor.

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@upstatephil

Wow. It's way too early post-surgery to reach the conclusion you "cannot see a full recovery in your future"! Having a positive outlook and mentally picturing positive outcomes is an important aspect of your recovery journey. Banish negative thoughts and think "I will recover". I was told: (1) three months to start feeling better, (2) six months to feel more like myself, and (3) 12 months for full recovery. You're still pretty early on that general time-line. You can do this!

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Thank you for your message and intellectually I know you're right. I'm just coming from an emotional place. I'm anxious for my follow-up appointment with my surgeon. When he tells me everything looks good I will definitely feel much more positive about all of it. Part of my problem is dealing with the pain coming from my hip and knowing that I'm facing 6 more months of chronic pain.
Yes, I'm working on having a more positive attitude - a good thing for healing.
Best.

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@maddiemae

<p>Hi. Maddiemae here. I just had spinal fusion surgery, L5 S1.</p><p>Does anybody have insights into recovery?</p>

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Unfortunately my surgeon is very passive and unresponsive. I feel I am just being left to my own devices on recovery - once the surgery is over the surgeon could care less how I recover. I appreciate the exhortation to have a positive outlook, I will try, but I cannot settle for 80% or less than a full recovery. I am very determined to get into a better physical state than before this surgery which put me into a situation that I feel very uncomfortable and anxious about now.

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@maddiemae

<p>Hi. Maddiemae here. I just had spinal fusion surgery, L5 S1.</p><p>Does anybody have insights into recovery?</p>

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I truly do understand your anxiety and frustration. I have it, too. All of this has caused me to stay in bed and sleep way more than I should. I'm an avid reader but my pain level and frustration have prevented me from reading for about 3 months. I really want to get back to it because if I'm not sleeping I'm staring at the walls. I want to go outside to walk but I'm upstairs and maneuvering the stairs is tricky and my husband is not always available to help me. I'm using a walker and sometimes a cane depending on how badly my leg hurts. It's a huge challenge for me to have a happy attitude right now but I hope I can reach that place soon. This recovery is so long and so hard and it's just awful that you have a surgeon who doesn't care about you and your recovery. The surgeon's involvement is key to recovery, I think.
How long ago was you're surgery? Don't get me wrong. I'm hoping for a 100% recovery, too.
I hope things improve for you soon.
Best.

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@maddiemae

Thank you so much for your reply and I hope you're recovering well.

Your are so right about the care and patience required for recovery. I'm so worried that I'm not keeping my back straight enough during this process. I'll find out on October 27th when my surgeon will take an x-ray to check it.

In addition to this I need hip replacement and this is causing no end of pain but I'll have to wait 6 months for that surgery.

I hope you continue to improve daily.

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@maddiemae Oh thank you. I am doing fine. My cervical surgery was 7 years ago.

Have you heard the saying about how do you eat an elephant? and the answer is one bite at a time! Recovery is like like where you take small steps and wait. The bones may not fuse for 3 months. That was how long it took mine in my neck to fuse so they were stuck together, and that is confirmed with an X-ray. During that first 3 months, my body was building the matrix (first with cartilage) within the scaffold (the bone disc implant) and beginning to populate that with cells that would start to deposit minerals to form bone. At first, just the spacer disc is fused to bone above and below it, but after a few years, it looks different when bone extends past the spacer and joins the vertebrae surfaces together. That is happening for you now on a bigger scale because L5 is a larger bone being fused to the sacrum.

It makes sense to wait 6 months at least to make sure the spine is fused because with a hip replacement, you'll need to be able to move for your rehab therapy. I'm guessing that right now, walking is difficult and painful.

Are you wearing a brace now to help keep your back straight? It's not so long until your follow up with your surgeon. Will your surgeon be sending you to rehab after your fusion process has begun?

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@maddiemae

I'm sorry you haven't felt much progress regarding your surgery. It is possible that there isn't full recovery but I would be grateful for 80 %.
I have a great surgeon with a wonderful nurse who is talking me through my concerns and worries so I'm very lucky in that regard. I see my surgeon on October 27th at which time he'll take an x-ray to see how things look. He's scheduled me for hydrotherapy beginning October 31st.
I hope you can get some relief and perhaps develop a relationship with your doctor.

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Hi. I had laminectomy and l4 To s1 fusion and unfortunately both failed. They tried everything, water therapy to try to get better range, and it worked but as soon as you walk out of the pool and your weight comes back down on your body it was like a ton of bricks. So my advice is just take it ready coming out of the pool. And hope it works better for you

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@maddiemae

<p>Hi. Maddiemae here. I just had spinal fusion surgery, L5 S1.</p><p>Does anybody have insights into recovery?</p>

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I feel for your situation, and I hope for your full recovery as well. I have never been through this kind of ordeal and agree that surgeon involvement would be helpful in recovery as I feel I am without a tether. I guess there is no harm in being positive notwithstanding the challenges and lack of clear path to recovery. I just know that the one thing that will make me positive for real is the elimination of the ongoing pain, mobility limitations and sensation of a lump of cement in my spine.

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@maddiemae

<p>Hi. Maddiemae here. I just had spinal fusion surgery, L5 S1.</p><p>Does anybody have insights into recovery?</p>

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I agree that improvement is difficult to measure - it seems so incremental and maybe it is. My biggest concern is that every time I move I'm afraid I've broken something. Just did it a minute ago and I imagined feeling metal moving. And I'm with you on the chronic pain thing. It's hard and I don't think anybody would disagree with that.

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@jenniferhunter

@maddiemae Oh thank you. I am doing fine. My cervical surgery was 7 years ago.

Have you heard the saying about how do you eat an elephant? and the answer is one bite at a time! Recovery is like like where you take small steps and wait. The bones may not fuse for 3 months. That was how long it took mine in my neck to fuse so they were stuck together, and that is confirmed with an X-ray. During that first 3 months, my body was building the matrix (first with cartilage) within the scaffold (the bone disc implant) and beginning to populate that with cells that would start to deposit minerals to form bone. At first, just the spacer disc is fused to bone above and below it, but after a few years, it looks different when bone extends past the spacer and joins the vertebrae surfaces together. That is happening for you now on a bigger scale because L5 is a larger bone being fused to the sacrum.

It makes sense to wait 6 months at least to make sure the spine is fused because with a hip replacement, you'll need to be able to move for your rehab therapy. I'm guessing that right now, walking is difficult and painful.

Are you wearing a brace now to help keep your back straight? It's not so long until your follow up with your surgeon. Will your surgeon be sending you to rehab after your fusion process has begun?

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I've come to understand that this seems to be a 3 month at a time process. I'm so anxious to see my surgeon on the 27th for my follow-up. I just need reassurance that I haven't done something awful to the fusion.

Yes, lots of pain still. My doctor hasn't given me a back brace yet but I think he will and hydrotherapy begins on the 31st.
Thanks for your support.

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