post surgical lumbar fusion with anterior diplacement

[auntposter]

I have been in pain management for 7 years and the pain is persistent and I have radiculopathy and spondylitheisis,  a doctor put cadaver bones in the anterior portion of my spine when I had a work related fracture of the body of L3, the anterior portion is just hanging in there all a big scarred mess. There is no fixing I have been told.  There are 3 levels of titanium rods posterior and 2 levels of slipped out cadaver bones and I have sciatica and have been on the same pain management regimen for 7 years. A few years ago I was told there was nothing they could do to fix me and I can walk and am having more balance issues, but I have occasional sacroiliac joint pain and the leg pain gets really bad and having been on the same dose of pain meds I just suffer and my pain is at 4,5 6; with 60 MS contin twice daily and 15 mg MS  IR,  4-6 times a day and valium 10 mg twice a day for spasms;  as  never having asked a question here before what else can be done. I am having more balance issues and I am working on my masters in nursing education. I walk as much as possible and now am training a service dog for balance assist. Any other suggestions?

[philnoir]

you are certainly correct in that the other levels with good vertebrae and ligaments can benefit from PT. But the unstable level(s) due to lysthesis may be at risk during manipulation.

Only his/her doctor can make this judgement.

[BetterGetBetter]

Good point ("...PT may not be entirely appropriate with severe lysthesis.").

I was thinking along the lines of minimal therapy for muscle strengthening (to manage/decrease stressors on the fusion), to reduce probability of the remaining "good portion" of the spine going bad.

And, OP ("Auntposter"), I am glad you are reaching out on this forum, and hopefully on other forums, too. Many times, folks in the situation you are in (the pain, the complexity of the surgeries, etc.) feel like becoming complacent and giving up, so kudos to your good attitude.

All the best.

[philnoir]

Sounds like the fusion never took.

Surgical technique evolves and improves with each year. You owe it to yourself to have another surgical eval.

Talk to your pain doctor about rotating your opioid -- perhaps to Oxycodone / OxyContin. This is a different type of opioid that may give you increased analgesia at equal doses.

Also, have you tried one of the anti-seisure medications, or the so-called GABA analogues to treat your neuropathic pain? I'm speaking of pregabalin, gabapentin, and lamotrigine.

PT may not be entirely appropriate with severe lysthesis.

An interventional pain doctor may have a specific nerve block that might alleviate some of that pain.

Finally a pain psychologist may have other alternatives for you.

Best wishes. Keep searching

[BetterGetBetter]

I would *definitely* speak with my doctor about physical therapy. There are different styles of physical therapy, some work better for some people than others. This isn't really a "recommendation" (only your doctor has the qualifications to select a style of PT for you), but you could google this search phrase:

physical therapy mckenzie method

And, that will give you a sampling of what to expect from one "school" of physical therapy.

I think attitude is important. For me, my mind is always thinking, "how about this," "how about that," "I wonder if this will help," "I wonder if that will help." That keeps my mind "fresh" and open to trying new things. Even if your doctors say nothing more can be done, you just have to rely on drugs the rest of your life, that doesn't mean YOU have to stop reading, and learning, and trying things out.

Again, please make sure to run everything by your doctor, because you don't want to risk doing a "therapy" which ends up hurting you and making you worse... Like I said, there are different styles, schools, and techniques, and, out of the dozens, or even hundreds, of styles of therapy, there should be one that suits you more than others.

And, remember, even though your doctors (or you) may feel like giving up, your body is busy every day fixing, repairing, working (that's what scar tissue is -- your own body trying to fix things), so your body is changing every day. Every 7 years, every single atom of your body is exchanged with a fresh new atom. Did you know that? So, please never feel "stuck" with anything. Keep fresh. Good luck!