Post L5S1spondylothesis back fusion TLIF with rods and screws
 

Hi my name is Emmie. I was dx with spondylolisthesis at L5-S1 in 2009. Kept slipping so in Nov of 2009 . I had L5-S1 TLIF fusion . Did well until april 2010. I started having horrible spasms laying down in bed or trying to turn over. I have gone to pain management dr. And he has injected S1 bilateral. He has injected L4-l3 . I have had the facet nerves burned trying to make this pain go away. I bend over to pick up or clean or ; because I work in operating room moved patients, it is difficult for me to straighten back up . I just had a discogram and all discs are intact. I have to just to sleep be on drugs. I hate taken medication but I am not sleeping. The side effect on one of the meds is insomnia . I can't win. My question is : due to previous surgery and having a pars defect why is my pain not coming from L4-L5 being u stable and I need to have my fusion extended? Any help out there?

Hello and welcome to ispine Emmie. I have had the same condition as you and ultimately ended up with a fusion as you did. I had a previous attempt to repair the pars fractures that did well initially but ended up failing. Don't give up!

Did the facet nerve burns help at all? Have you had any mri's or ct scans? Do you have leg pain? You might want ask you pm dr to rule out your SI joints as those areas are affected by l5-s1 fusions. Ask you doctor to try some different meds, finding right ones for you will make all the difference in the world.

Back
 

The right facet when treated I only felt deep intense pressure. When I had the left I felt the pulsation and burning very intensely. I have a very high pain tolerance and the left side pushed me to my limit. I have never had leg pain. The reason I finally had the original L5-S1 TLIF was I would be walking and the next thing I knew I was on my knees. It happened twice . No pain before or after just back gave out . One minute walking the next on the ground. My slip had progressed quite a bit between dr visits. So I did great after the surgery. 6 months later the spasms started when turning in bed. Yes my back was hurting at work when I would bend or turn a patient but again I just figured all part of the process I thought. I have had the MRI s the latest was the discogram with a ct to follow. I have yet to hear what the surgeon thinks. I follow up with the pain management dr on thurs. so it's all about the waiting for someone to make a decision. Seems to me it's either the construct is loosening or the level above is failing. Frustration building. Thank you for your reply and pray for your recovery.

This may be like closing the barn door after the horse has left but don't have surgery in the US. A good surgeon would have cleaned up the endplates and put in a good ADR like the ones they do in the free world.

Get those cockamamie screws and rods taken out and have a one of the good ADRs installed like the M6 by an ethical surgeon.

Arden
 

I had a generic or born with spondylothesis which basically means one level my L5 was slipping off s1. I dealt with it for two years. Also having a pars defect which is a support structure for your spinal coln. When I began falling for no apparent reason while walking I when I decided to have it fixed. I have pedicel screws and an interbody fusion that put me back into alignment. I did we'll until 6 months after surgery. Should the L4-L5 level been fused also mostly likely due the pressure which L4-L5 receives most of our spine load anyway. Hindsight. Now I go for the last dx block of bilateral sacral ilium joints to see if pain is coming from there. Monday will be the answer one way or other. I believe the screws have loosened in the sacrum. We shall see. Thank you for your reply

Hi Emmie
I don't know what i was born with but i do have a horrible spine. From C4 down to L4 and everything in between has been fused. i was never a candidate for ADR as my bone density is an issue.
If you are unsure of all of this, go and get a second opinion. Seems like you are having every test to diagnose where your problem is coming from. I recently had some screws pull out quite a bit and it was the most painful 5 weeks waiting for the hardwear to be removed. I was in a wheelchair.

Sounds like your surgeon is a good investigator. Do you like him or her?
We have all been in your place . Sorry i have no good answers.
judy

How is someone supposed to deal with a statement like, "...but don't have surgery in the US..."? I know many great surgeons here as well as some hacks. Overseas, I know many great surgeons and some hacks. There is no magic field around the US making all surgery here bad, nor is there one elsewhere making it good.

From what I've seen through the years, the pars fracture and resulting spondy leaves you little choice.... avoiding a fusion in this case is unlikely (assuming that it is highly symptomatic.) It does give me pause that you only had 2 of these episodes before surgery? However, if the system was too severely compromised, there was not much else to do.

Good luck! Please keep us posted.

Mark