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Sciatic pain after lumbar fusion
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MedHelp Member's Question

Sciatic pain after lumbar fusion

by MariaStan, Jan 12, 2006 12:00AM
I am a 61 year old female in good health except for my back. Two months ago I had a posterior spinal fusion L3,4,5 with titanium screws and a laminectomy. This was after a year and a half of severe sciatic pain primarily in my left hip and leg. I wear a brace and my activity has been pretty much limited to walking and lying down with minimal sitting.  Overall I'm doing pretty well except that I have some residual pain in my left leg especially late in the day, and I still have shooting pain (although not as severe as before the surgery) when I cough or sneeze.  Should I be concerned?  Is this common with a fusion? I meet with my neurosurgeon next week and I would appreciate your opinion? Thank you so much.
Doctor's Answer

by CCF-Neuro-M.D.-PW, Jan 16, 2006 12:00AM
The main reason for doing this type of surgery is to prevent neurological disability, for example the loss of muscle function that could have come from that nerve root or spinal cord being damaged/compressed for a long time. I do not know if you had evidence of nerve damage by exam or EMG preop.



This does not necessarily mean that the pain will go completely, and there will be pain for a period postop .Sometimes a bone or disc fragment may remain in the surgucal space and cause residual symptoms. This can be evaluated with an MRI. Otherwise there may still be some nerve root (but not spinal cord because of the space created by the surgery) compression at that or another nerve root. You neurosurgeon should be able to tell from his examination and/or a postop MRI scan. If you develop weakness or clumsiness in both legs or inability to pass urine, this should be evaluated straight away in case of spinal cord compression.



Good luck
Member Comments (12)

by my_aching_back, Jan 14, 2006 12:00AM
To: MariaStan
I had the same surgery and it sounds like your doing great.  I still had a walker at 2 months and I was 37.  I still get some sciatic pain but not very often after 2 1\2 years.  The thing I notice the most is I can feel the rods.  The best thing I found for sitting was a glider rocker with a good cushion (thanks to my father-in-law who also had the surgery).  I can sit for hours with no problems.  At this point I can bend over and almost touch the floor (never could touch it in the first place), gardening (although I now use all long handled equipment, even for a small shovel or hand trowel, I also sit for weeding), I can mow the lawn with a small break but I can't start a pull mower.  Bending foward no matter how far if I do it for long periods causes me to be sore for a day or two. My kids help alot for lifting and carrying things like laundry and groceries.  I was given a 20 pound lift limit permanently so no getting the giant dog food bags without help.  Stairs at times still are a problem especially when I have either been sitting or standing all day, at times I need help to get up them.   I think the worst part of it is having to ask for help from my kids that I should be taking care of and depending on other people for things I have always done.  But at 2 months I think your doing fine.

by MassRN, Feb 04, 2006 12:00AM
I had a double level fusion of L4-S1 just over a month ago.  I am experiencing severe leg pain from my left hip to my foot.  I also awakened from the surgery with my left foot feeling as if it were wrapped tightly in an ace bandage.  The backs of my thighs have decreased sensation, and I cannot feel when I have ended a bowel movement.



I've had a CT scan and MRI, both of which are fine.  My surgeon says this is nerve inflammation and that it will go away.  I'm in such agony that I'm now going to the pain service at the hospital.  They are giving me Lyrica and Elavil and I have had two Lidocaine Challenge procedures.



Have any of you experienced these problems post surgery?  Did the problem resolve on its own?  How long on average did it take?  Right now I'm worse off than I was before the surgery, although I had no quality of life before and I had to do this.



Help!  I'm finding it hard to cope.  Still mostly using a walker because the left foot feels unstable; not walking the 6 miles I should be working on.  I'm basically housebount.  I'm only 52 and I need to get back to work someday soon, I hope.



Thanks for listening.

by cyndi57, Feb 12, 2006 12:00AM
Oh My...I have found someone with similar problems. I am 48 and have had 6 lumbar surgeries and the most recent was a double lumbar fusion (L4-5, L5-S1) with spacers. I also awakened with severe pain in my right foot as though someone had it wrapped tight with throbbing, burning, and couldn't stand to have the sheet touch it, temperature is very warm, and my right hip has been on fire since. It has been 2 years now and finally am getting somewhere. I have had a triple phase bone scan of my foot, followed by and MRI of my foot and have found fluid in the ankle/foot and bone marrow edema. Local doctors feel that it stems from either the fusion or the hardware in my back. I am scheduled to see my back surgeon Thursday the 16th in hopes for possible medical options. My hopes is to possible have the rods removed as I feel them in my back and the pain radiates through to my stomach, around to my hip, and of course my foot is continuously on fire. Oh...I also have RSD now which has caused severe dryness/cracking of the skin on my foot, and hair growth on my toes on the right foot...YUCKY HUH! I thought so too. I am frustrated, but am not stopping without a darn good answer and may move on to other surgeons if need be. Don't give up! I will keep you posted!

***@****

by MassRN, Feb 15, 2006 12:00AM
Oh, my but I don't want to ever have a back surgery again!  Am going for my post op visit on Friday, having spine x-ray, then am seeing the doctor at the pain clinic.  I will be having my third "lidocaine challenge" test, where they put in an IV and give you lidocaine along with saline to see if it stops the pain. They have a pill form of the medication will they will give you if you "pass" the tests.  I was also put on Lyrica and Elavil for the nerve pain and to help me sleep.  Thankfully the Elavil, at only 10 mg. has given me the sleep I so badly needed.  I still need my walker in the morning as my legs hurt so much and feel so weak.  I don't feel better until early afternoon after I have taken my narcotic meds along with Motrin, tylenol and the Lyrica, and I have to have a couple of doses of the tylenol and Lyrica in me before I am relatively pain free.



Now I'm getting really concerned about the numbness in my read end and the problems I'm having with my bladder and bowel function; not knowing when I am finished with either.  I know it's called "saddle hyperesthesia" but I've not been able to find good info about it on the internet so far.



My foot does not feel any different than it did six weeks ago when I had the surgery.



I wish you luck.