More Surgery, Revision

[Brian McCarthy]

I had a hybrid Charite L3/L4, L4/L5 and ALIF L5/S1 fusion April 22nd last year and have had pain ever since. I've had more denervation, FJ injections, pain management and finally another discogram last week. Went for the follow up today and I now need more surgery. This time its L5/S1 Pedicle Scew Fusion, Sacroiliac Fusion and possibly partial removal of a sacrolised transverse process. At least this time it will be through the back and not my abdomen. But I'm still pretty scared. The last surgery took a long while to get over and as I still had pain all the while, it feels like I have never got over it. Has anyone had this type of operation and can tell me what the recovery was like and if it was successful please?
Mine is probably going to be wc 6th April.
Thanks
Regards
Brian

[ajj1001]

Sorry to hear you need more surgery. Its all a bit scary (just waiting for date for my revision). It must be so bad not having had any success from your first surgery. I can't yet comment from personal experience but all I have been told is that a postereolateral gutter fusion (which is what I'm having and sounds like you are having) is a much smaller operation to get over than the huge surgery you have already had.

alison x

[Lynda]

Hi Brian

I'm sorry you have this continued pain and are facing further surgery.

I have no personal experience of fusion but I'm sure Sarah will be able to give you some information soon...she had hybrid surgery last year and her fusion has failed as well, she is due for revision fusion this coming Monday. My understanding is that pedicle screws and rods provide immediate stability for the spine and the complication rate is very low.

Wishing you every success and look forward to hearing how you get on.

Kind regards

Lynda

[Alastair]

Hi Brian,
I'm sorry to hear that you're having further problems, the stabilisation should be fairly minor compared to your previous procedures.

I have sent you on an e-mail a copy x-ray of a similar procedure with another patient, I have not placed it on here for patient confidentiality reasons.
Best,
Alastair

[Gilly]

Hi Brian

Sorry cant help with info about revised surgery but really sorry to hear that you are having to have more done and that you havent had the success hoped for. Wish you the best of luck with your next op in April.

Love Gilly xx

[Lynda]

Hi Brian

Forgive me if this is too intrusive but I have been thinking about your forthcoming surgery and am curious.

Is it thought that the fusion at L5/S1 could have increased the movement and stress on the sacroiliac joints? Or is thought to be more due to the Bertolotti syndrome/enlarged transverse process and the effects that has had on the mechanics of your spine ?

Is this a minimally invasive/percutaneous procedure or an open surgery? Are both SI joints being fused or only one side? Either way I wish you every success.

Although this is a posterior surgery it still sounds very substantial especially with the SIJ fusion although as others have said compared to your last surgery you may find it a breeze. I think anyone in your situation would feel scared at the prospect Brian but try not to get too anxious about it, fusions can have outstanding results..which is what I hope for you.

Please keep us updated when you can, it will be interesting to read your progress. You're going to have some pretty impressive xrays, that's for sure.

All the best

Lynda

[Brian McCarthy]

Hello Lynda, Gilly, Alison and Alasdair
Thank you all for your comments – which are very much appreciated.
I’ll try to answer your questions Lynda as best I can. While last year's 3 level hybrid repaired the damaged disks, it apparently did not properly address the cause. As I think I have said before, I have two congenital anomalies that are the root of my problems. The first is Spina Bifida Occult which is not too serious in itself, but just makes you more likely to get back ache. The second is more serious and that is Bi-lateral Sacrilized Transverse Process at L5/S1 (AKA Bertolotti Syndrome). It seems they both have contributed to the way I am now.
The sacrilization acted to protect L5/S1 but in doing so apparently put much greater pressure/load/torque on L4/L5. As a result I ended up with having a microdiscectomy about 10 years ago. That in turn put added pressure on L5/S1 and L3/L4 ending up damaging them both - hence the Hybrid last year. I actually have some damage in L2/3 as well but not enough to warrant ADR. The sacrilization is still there and is causing some imbalance and a tilted pelvis, putting pressure onto the L5/S1 facet joint on my right side. So the mechanics of my spine are compromised with all this and is the root of the pain. That, coupled with the slight movement at the fused level is causing problems along with severe inflammation around the SI joint, which is also moving more than it should. So, the solution to all of this is the surgery I now have to have. Although the thought of more surgery fills me with dread, I really can't carry on as I am. I'm on constant medication which is only taking the edge off and it affects the whole of my life both work, social and sport as it probably does to most people reading this forum. I am managing to ride my bike occasionally but it does hurt a lot especially afterwards. Any running unfortunately now seems a long way off. Our social life is such that because I have to go to lie on the bed after trying to do a day's work, we never go out without it impacting on my pain levels. My work has suffered a great deal. I need to lie down for an hour around midday, work until about 4.00 pm and then go home to my bed again. Not much of a life.
I have been wondering how I am going to manage working afterwards while lying flat for a while and came across a device which others may find interesting. It’s called a Laidback Laptop and allows you to position and use a lap top while lying down. It looks just right for what I need so am about to order one.
Thank you all again for your comments and interest, I'll keep you posted as things develop - at the moment it is scheduled for the week before Easter, w/c 6th April.
Kind regards
Brian

[Lynda]

Hi Brian

Thanks for your excellent explanation of whats going on, which is so very interesting. I am so sorry you have had to endure the pain since your surgery for almost a year and you must be incredibly disappointed. Chronic pain wears one down. The solution to your complex situation sounds amazing ..how clever are our spinal surgeons..... it never ceases to amaze me how they do these things. I wish you every success and hope this is the answer to provide relief from your continues pain.

The Laidback Laptop looks very good, although rather on the expensive side for a laptop table but as with everything you get what you pay for. I am sure it will be extremely helpful in the post-op period and beyond.

Roll on Easter when you will be recovering and over the worst.

Best wishes to you

Lynda

[Ruth]

Hi Brian,

I'm sorry to hear of your ongoing spine troubles & really hope this forthcoming surgery brings you the relief you need. In your last post you mentioned you had some damage at L2/3 but not enough to warrant ADR. I have minor disc degeneration at L4/5 & 2 surgeons I have seen are reluctant to do ADR because of this but after a failed epidural & limited response to core strengthening I am having ADR on 20th April. I wonder how much damage your scan report showed at L2/3.

I had thought about ordering that laidback laptop table a while ago but didn't do anything about it. I'm not sure what the exchange rate is. It is priced at $99.99. I'd be really interested to see how you find it when you get it. I find lying on my back increases the pain in my spine but I have an adjustable bed & if I raise the foot end it is much easier.

I hope your operation goes well & you make a good recovery.

All the best.

Ruth

[Brian McCarthy]

Hello Ruth
the damage I had to L2/L3 was very visible on the discogram I had pre- surgery last year - it leaked fluid very easily through the tears. I was really dreading the prospect of another ADR and it was still very obviously damaged when I saw the images from the repeated discogram I had last week. The deciding factor appears to be whether or not it is a pain generator. I apparently did not scream too much when it was done at this level but made quite a lot of noise when probing L5/S1 and the SIJ. Just hope it does not get any worse.
Thanks for your thoughts and hope you feel better soon
Regards
Brian

[ajj1001]

Hi Brian,

Just a couple of things, though I'm sure you have thought about or tried most things. I used voice activated software to continue working on my laptop when I needed to have a lie down. This was paid for by Access to Work, (software, laptop and training) they also provided a desk that raised and lowered. They can provide anything that is needed to keep you employment. Have you been in contact with them? Would they fund you laptop desk? They are contacted via Jobcentre.

The only exercise I have been able to continue sporadically is water based - swimming, aqua jogging, aqua gym etc. I know its not running or real cycling but it does help in the feeling of normality and definitely helps with the pain when I am able to do it.

alison x

[Brian McCarthy]

Surgery is now confirmed for Tuesday 7th April. Don't mind admitting, I'm pretty scared right now, but it has to be done. Just hope the recovery is better than last time.
Thanks for your support and interest.
Regards
Brian

[Lynda]

Hi Brian

Not sure if you'll catch this but I just wanted to wish you all the best for tomorrow, will be thinking of you and hope all goes well and you finally get some relief from the pain you have endured.

Best wishes

Lynda

[sarahp]

Good luck Brian!
Ive just returned to the land of living after my revision surgery. I know that we have talked in the past as we have a similar problem with sacrialisation.
I really do hope that all goes well for you, and wish you all the luck in the world, we will all be thinking of you and will look forwards to hearing how everything went when you are recovering and feeling up to it.
Good luck
warmest regards
sarah

[Brian McCarthy]

Thank you both Lynda and Sarah
just packing and will be off in an hour. I'll be in touch again as soon as I get back home. At first it was 5 days but now its 7-10 days.
Thanks again for all of your support and interest
Brian