Fusion surgery over.....

[mmglobal]

I had a client with only one hand... born that way. When he woke up in recovery room after multi-level cervical... he called the nurse over and said... "what did you do to my hand?" I don't think anyone thought it was very funny.

When my son had pneumonia and spent 4 days in ICU, we saw the bills go by for $30,000. The allowed amount that the hospital was happy to accept for $30,000 worth of treatment was $6,000. If we did not have insurance, they would have come after us for the full 30K. This all makes sense to someone.

I've seen many cases of fusions with billed amounts in excess of 150K and allowed amounts around 50K. I've also seen payout amounts in excess of 100K for both disc replacements and ADR. The worst case I've seen was a multi-level fusion that was done on a speculation basis. Someone I know has a lien against his lawsuit for more than $275K for a 2-level fusion that was poorly done. He's still disabled and pretty much bankrupt. If he ever collects anything... the first 275 will go to pay for a 60,000 surgery. This is not right.

[ans]

Oh is this so wrong. What outrageous prices for fusion. Also, for the short stay for pneumonia (must have been scary).

Imagine being stuck for #100K for an approved fusion. I'd contemplate jumping over Half Dome and providing fertilizer for trees.

[mmglobal]

What a coincidence Allan.... jumping off of Half Dome is on my list of things to do too!

[martyusa]

Originally Posted by mmglobal

300 Neurontin a day is not very high. I usually took 900/day and only occasionally took 1200. My pain doc wanted to ramp me up to 3600, but I could hardly tolerate the brain fog on 900. We don't call if Morontin for nothing!

I ceased taking the neurontin I was taking as I am trying to cut back on this crazy amounts of meds I am taking.

I am still getting a little bit of nervy back pain, but nothing like it was. I am assuming this is due to some damage done to the nerve root, either from the disc pressure or the doctor hitting the root during one of the injections with the pin.

However, I have been feeling very lethargic and my legs have been feeling like rubber over the past few days. I spoke with the PA and went over everything that has been going on. She will speak with the doctor and call me tomorrow. I'm not sure what has been causing this, but I have a feeling it's something else I am taking causing this. I'll wait on his call but I have a feeling it's my Toprol XL. We'll see what he has to say.

[martyusa]

After you have back surgery, Learn how to sneeze and cough a whole new way.

Leaning back a little bit, for me, saves me the sharp pain in my lower back and dropping to one knee after the surgery.

[martyusa]

Almost 3 months post op and I'm back to square 1 and then some. I have always had numbness in my toes during the onset of the sciatic pain down the right leg, but for the first time the past two weeks have been pure hell. My calf and the arch of my foot feels like a muscle cramp. However, the muscle is not tight and is not cramping. My big toe is has gone past the tingle and now hurts like crazy. I have started to develop some pain in the front of my leg for the first time. My back is always at some type of pain level, either dull and achy or sharp and burning. While it is sharp and burning, the pain shoots down the glutes and into the foot rather quickly and it's right back to bed to lie down. I am also having some overcompensating issues, but that is to be expected as well as some atrophy and muscle cramping/spasms thereof.

I am hoping that this is part of the recovery process, but I am beginning to doubt that with the symptoms getting worse as the days go on. I have my next followup Nov. 3rd with x-rays, so I would imagine that would be the indicator. We'll see what he wants to do and maybe PT will help. I can deal with the pain if I have the right combo of meds and rest, but that is no way to live my life. Now on the other hand if this is the way it's going to be, so be it. Just tell me the deal with no fluff and I'll adjust. I think I am past broken promises part.

I did question the Doctor blasting my nerve root during one of the
root injections and I was told that it would heal over time. I can't see how that would lead to the increase of pain now, unless it's easily irritated due to a combination of the injury and the little doctor mishap.

If anyone has any incite at all, I would love to hear it. Just no fluff, please. I'll will keep the board posted as we progress.

Thanks all and good luck.

[martyusa]

Well, I'm not coming out of the brace just yet. He would rather ween me out of it for a few weeks. CAT scan is schedules for more detail to see what is going on in there. The X-rays came back ok, but does not tell the whole story according to the doc.

I will be starting with 4 wks of PT to start to see if it helps with the problems that I am having now. Hopefully everything will be just fine and we can get back to normal.

[martyusa]

CAT SCAN results:

Impression - Some degree of fusion of the posterior element bony fusion masses are present at L4-L5. The hardware appears intact without evidence of fracture or loosening.

Stable appearance to a right subarticular disc protrusion at L5-S1 touching but not compressing the right S-1 nerve root.

History - status post lumbar fusion from L4-S1

Technique - Axial images of the lumbar spine obtained. Sagittal ans coronal reformats obtained and reviewed

Contrast - none

Comparison - Disogram from 2/27/2008 and radiographs of the lumbar spine from the lumbar fusion of 8/01/2008. Also MRI of the lumbar spine of 07/02/2008

Findings - Alignments: within normal limits

Postsurgical changes: Bilateral rods and pedicle screws are noted from L4 through S1. he pedicle screws show no encroachment on the central canal neural foramina. There is no evidence of hardware fracture or loosening. There is deformity to the left lamina at L5-S1. Area fusion of bone material is seen between the facets and transverse processes at L4-L5 and L5-S1. On the right side there is evidence of fusion of the bone mass in the craniocaudal dimension. It does not appear fused with with the facets and the spinous processes. On the right side, there is partial fusion of the right fusion bone mass.

T12-L1 Within normal limits

L1-L2 within normal limits

L2-L3 Minimal disc bulge and mild bilateral facet hypertrophy. No herniation. No central canal stenosis. The disc bulge causes a minimal degree of inferior narrowing both neural foramina but without impingement of the L2 nerve roots. Unchanged from MRI of 07/02/2008

L3-L4 There is a mild broad-based disc bulge. No disc hernoation. No cantral canal stenosos or subarticular recess narrowing. Disc bulge causes a mild degree of the foramen are both neural foramina without impingement of the L3 nerve root. Again unchanged from MRI

L4-L5 There is a mild broad based disc bulge but no herniation or subarticular recess narrowing. The disc bulge causes mild urinary both neural foramina without impingements of the nerve roots. Unchanged from MRI

L5-S1 There is a broad-based disc bulge with a right subarticular disc protrusion touching but not compressing the right S1 nerve root and right subarticular recess. The disc bulge causes mild inferior both neural foramen without impingement of the L5 nerve root. Unchanged from MRI

Paraspinal soft tissues: Grossly normal


I have been coming out of my brace for a few hours a day. I find it to be a bit uncomfortable at best. I can definitely feel the weakness in the core muscle group and a bit of a confidence problem without the brace. Too much activity without the braces brings on the right leg problems with the sciatica in the glutes, outside and inside on the hamstrings and some serious pain in the calf and big toe. The outside toes still feel numb, but no pain. Also I have been getting quick sharp pains in the left hamstring. These episodes only last about 5-10 seconds but almost bring me down due to the fast intensity of the onset. Only brief on the left side and not getting past the knee. Sitting too long or walking too long still brings on the right leg symptoms with or without the brace.

I will say that the sharp stinging burning pain the back has stopped and is now just a dull achy pain. (I am assuming from recovery and muscle atrophy)

I have lost almost 40lbs weighing in at just under 180lbs. Hopefully the first 4 weeks of PT will help but this all to rest before we move on.

OK, Mark....I need this broken down in English.

Thanks in advance

[mmglobal]

Marty... sounds pretty good. You have a bunch of 'mild this and that'. You have a bunch of 'no evidence of this problem or that problem.' You have a bunch of 'fusion masses forming".

Great news that the sharp burning is gone. I hope to hear that you keep improving week after week... then you won't notice it weekly, improvement will sneak up on you without you realizing it.

I hope that the things noted, disc protrusion touching S1, are not significant in an immobilized spine segment. You'll have to ask the doctor about that. There may be some possibility of chemical irritation even when there is no mechanical irritation, but I would hope the risk of that is low.

"There is deformity to the left lamina at L5-S1" I'd ask the doc to explain this. This may be notation of a normal post-op defect and be absolutely nothing.

I don't understand: "The disc bulge causes mild urinary both" - did you type word urinary wrong?

Obviously... this all comes with the approproaite "I'm not a doctor" qualifiers. I can be way off base on all of this!

Mark