Sciatic pain after lumbar fusion

[MariaStan]

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.

[CCF-Neuro-M.D.-PW]

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

[my_aching_back]

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.

[MassRN]

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.

[cyndi57]

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!
***@****

[MassRN]

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.

[intime]

I did not have a fusion, I had a laminectomy and discectomy, but I think I might NEED a fusion.  I had surgery in September 2005 and the leg pain is horrible.  No one can diagnose it.  I have a radiculopathy on my right leg.  I heard it can take up to a year to heal.  Anyone???  Answer here or email me at ***@****.

Tks for listening.

[cyndi57]

Followup on my situation:
I had 2 appointments, 2 weeks apart, and my surgeon gave me a local lidocaine and depo injection directly in the area of the rods where I had my fusion. I felt wonderful, from my back, through my hip, leg, and my foot for 45 minutes, and then all pain came back. After the second injection, the doctor told me that because I didn't get a better response that it wasn't just an inflamation (inflammation) around the rods or surgical area, that it was the rods inpinging on nerves and surrounding areas and my body was possibly rejecting the material also; therefor, we are scheduling surgery for removal of the hardware at both levels, but the titanium sylindrical cages will have to stay in the disc space as it is a good, solid, fusion now after 2 years. I am so excited to finally have them removed, the fusion/reconstruction of the lumbar area was necessary, but am now glad to get things out and on the road to the right recovery! YEAH! It pays to bug the daylights out of doctors until they finally listen, make them take all necessary tests, and get things accomplished...hang in there to all who believe that its not in your head!!!

[MariaStan]

Thank you all for your comments. It has now been 4 months since my spinal fusion (L3,4.5). I am almost fully weaned off of the brace, but my sciatic pain in my left leg continues. In fact, I believe it is getting worse especially after any activity or if I'm tired. I try to walk each day, but still avoid bending or twisting (per doctor orders). I am taking only Tylenol (about 3 times a day) and rest on the sofa when the pain persists. It is hard to see spring arriving and know that I won't be able to work in my garden... hopefully next year.  I see the doctor in three weeks, and will seek his help in resolving the residual pain.  Good luck to you all. Maria

[suzc]

Your experience is almost identical to my husbands.  He had disc replaced 3-4-5-S-1 on January 19th. Post-op, he had no feeling in his left leg.  It remains that way to date but he has excruciating pain that he describes as "electricity".  He is not sleeping, depression is seeping in that he has to fight mentally 24/7. Leg and toes jumping all over the place.  Surgeon has him taking minimal amount of neurontin, percocets (he hates), robaxin, and now ambien to sleep at night which doesn't work. Physical therapy came to the house for a while and now he will start at cora pt near our home. Surgeon states that nerve was compressed for so long due to workman's comp stalling for twelve weeks that it is inflamed and possibly will take up to two and a half years to come back if at all.  He also has drop foot from this.  I want to know, what is lyrica? Elavil? Any help that you or anyone else can give, maybe you all found remedies to at least sooth yourselves and distract from the pain.  Please post or email me at ***@****. My heart goes out to all. By the way, did anybody's doctor mention leg issues before surgery?  wondering why not if so common.  suzc

[diana123]

It is some comfort to find out that I am not alone.  I had 2 spinal fusions done L3-4 and L4-5 back in November 2005.  Well it did not turn out as I thought it would, I had to have a second surgery the very next day.  The screw had popped out right after my first surgery and when I awoke from the first surgery, the only thing I can remember was I was in severe pain.  They finally listened to me and did a MRI to find out that it had as they put it.... malposition the screw at L5.  I was in the hospital for 2 weeks from there due to the lack of movement the transfered me to a Nursing Home for over a month.  I had severe numbness in both legs, with burning in both legs.  When I arrived home I was walking with a walker and the burning was only in my right leg.  It has been almost 5 months now and I am walking with a cane, which I at this point am so greatful to even being able to walk at all.  I still have many problems which I cannot seem to get any answers.  My bladder in not right and I never know if I am finished with a BM,nor can I have one in a normal fashion!  I am now on Lrica,vicodine and Motrin,which gives me little relief.  I go to P T three times a week which is very painful for me mainly because I have a lot of pain in my calf area and I have a foot drop in my right foot.  I have not heard of anyone else having this problem with the screw popping out and resting into a nerve root and if it will ever heal?  I do see that the surgery alone with no problems have many outcomes as it is. As you all know I am not allowed to ask a question but often wonder just how often this kind of thing takes place?  I wish you all well and hang in there because it always can be worse!  You can email me @ ***@****

[alpsmith]

All of your comments have given me comfort that I am not alone.  I had spinal fusion with instrumentation L4,L5,S1 in Oct 2005 for severe spinal stenosis, spondylolithesis, and bulging discs.  The Pre-op pain was mostly lower back and down left leg.  Now, I have sever right leg pain, especially when standing and walking, and lying on either side.  The Doc says he cannot explain why the pain becomes so severe when I lie on either side.  The pain shoots down my right leg into my foot.  Sleeping is impossible without pian pills and sleeping pills.  I had MRI and myelogram.CT which showed stenosis, which the doc says is impossible since he removed the compression!  He sent me to the pain clinic, and had 2 shots for "inflammation".  they did not help.  Now, the pain doc wants to do an epidural.  I do not know where to turn.  I am so disgusted.  Any suggestons?  I have not been able to return to work, and that is also a difficult problem financially.

[Roka]

I had a lumbar fusion (L5) 7 weeks ago. I'm a very healthy 42 year old. Prior to surgery  I walked 1 hour a day and stretched with yoga. Since my surgery I only walk 20 minutes at  a time.  If  I lay down I get one or two  sharp  jabbing  pains in my left hip  . I wear my brace all day so my movements are restricted.   My leg muscles get spasms and I feel the need to stretch my legs. Is there anything I can be doing at home to soothe these aches with out jeapordizing my fusion? I feel realy stiff all over. The pain meds. I take don't  help the stiffness. I'm tired of taking these meds. There must be something I can Add to my daily routine or  do I need to be patient?!!!!!!!!!!!!!!!!!

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