What to expect post laminectomies?

[lal209]

Hello! I am scheduled for posterior laminectomies of the T3-4, T5-6, and T9-10 with fusion and instrumentation on 4 Sept and then of the L2-5 sometime in Oct depending how the first procedure goes. I had a ACDF of the C4-7 back in Nov 2011 and had good success with it and a fairly easy recovery. I was told that this would be much harder because of the amount of muscle being cut, but that this is fairly routine surgery and most people are back to work in 6-8 weeks. I haven't been able to find much information on just what to expect during the recovery (limitations, pain, etc.).

After reading some of the posts here, however, I'm now concerned that I'm rushing the surgery. MRIs revealed degenerative discs with some compression of the spinal cord at the levels listed above. I have a fair amount of pain and often feel as though I'm having a heart attack and am short of breath (after a heart cath back in April all concern about heart issues were laid to rest). My concern, however, is increasing numbness and weekness throughout back and legs. Physical therapy made the pain worse. Epidural and facet injections provided limited relief, but only for a few weeks. Although the pain, etc. is livable right now, I'm concerned that waiting until I'm truely dibilitated could result in permanent nerve damage (which is what happened when I waited too long to have the ACDF and I have permanent tingling down my left arm and hand). The neurosurgeon is one of the best in Central FL and has a reputation for not doing unnecessary surgeries. The pain doctor also said that there was little he could do to help and that anything he did would only be a bandaid and surgery was inevitable. That said, I haven't had many of the tests mentioned throughout many of the posts here.

So, am I rushing the surgery? If I do go through with it, what should I expect as far as what I can/can't do afterwards and for how long? All thoughts would be appreciated. Thanks from a newbie to this (or any) forum!

[Maria]

That seems like a lot of levels re laminectomies. Between that many levels having surgery and then the instrumentation at the lower level it sounds like you'll have a long recovery. I didn't think it was that common to to lamis on the thoracic levels (tho then again your symptoms and findings may well warrent the proposed degree of surgery).

I'd surely not submit myself to this degree of surgery without a 2nd opinion and probably a 3rd and 4th as well.

I'm not that familiar with thoracic problems however so hopefully someone will hop on here that has more knowledge and can better answer your questions.

[lal209]

Thanks for the response, Maria! I'm thinking about postponing in order to get another opinion (or two) just as you've suggested. I'm worried now about the 'domino effect' I've been reading about, but I also worry about waiting too long and letting more possibly irreversible damage occur. I'll let you know what happens....:-)

[Maria]

Unless you have something really awful going on that hopefully would have been revealed in your diagnostics to date then waiting for a few consults won't make that big of a difference.

Remember that should one have loss of bowel and/or bladder (incontinence) tone, loss of function of an extremity or loss of tone, extreme unrelenting pain or complete numbness of an extremity then these are emergent reasons to be seen and taken care of.

Often we feel like we are getting much worse by waiting and/or could get much worse tho a decision made out of haste or lack of research could be one that would create more suffering so I urge people to really research their options and get 2nd (and then some) opinions with top notch spine surgeons that are able to be objective.

Utilizing Mark (mmglobal) as a resource person/advocate was probably the best decision I made in my spine care in the last 10 years.

[lal209]

You're right. Appreciate the reminder re the signs for urgent action. Interestingly, there have been some complications with the insurance approval so I may have to postpone anyhow. I have an appointment with another Dr on Weds and will get a 2nd opinion then. Thanks again for the support -- it's nice to have people with experience in this to reach out to!

[Maria]

Sure re support.. no prob tho do want to also add the flip side of sometimes waiting over a few years is that generally the degenerative process continues and while it may not present any noticable added pain (or so one thinks) this process may mean elimination of a once viable surgical option.

Case in point... in 2003 I was eligible for a 2 level ADR surgery and in 2006 because of facet changes at the L5S1 area doctors instead offered a fusion at L5S1 and ADR at L4.

I think I saw my Primary Treating ortho about a year ago and he said now I'm not eligible for anything to do with ADR since I've waited so long...

Well honestly I really don't want to have more spine surgery if I absolutely don't have to...

so there's waiting and there's waiting... each of us are different about what we do and when tho I must admit I had gotten a fair amount of 3rd surgery surgical opinions all pretty much in agreement about what to do. I just started to feel better by the time surgery was auth'd so opted not to do it (even tho I'm sure via films and such my spine looks much worse).