Results 1 to 14 of 14

Thread: Do leg & back pain subside after Laminectomy + Fusion?

  1. #1
    Join Date
    Jan 2010
    Location
    Syracuse, NY, USA
    Posts
    157

    Do leg & back pain subside after Laminectomy + Fusion?

    Hi all,

    This morning I saw an orthopedic surgeon who recommended that I have a Laminectomy plus a Fusion, and with what he pointed out on the X-ray, it looks like the fusion would involve just about the entire lumbar spine. I've got stenosis and associated neurogenic claudication, plus what he called "severe lumbar scoliosis" (measured at 38 degrees; it was about 25 to 26 degrees in 2007/2008, so is increasing), and associated severe disk degeneration. I have compensatory curves of 19 degrees and 15 degrees in my thoracic spine.

    I was first given the option of having a Laminectomy (without an associated fusion) back in March 2009 after a particularly severe bout of leg pain. People on this forum (the non-surgical threads that is) warned me about having a Laminectomy on a scoliotic spine, indicating that it could lead to further destabilization.

    That's essentially exactly what the doctor said this morning; he said that if I had a Laminectomy at all, that I also needed a Fusion; he wouldn't even consider one without the other, as my spine is too unstable. The appointment was cut short by a call from another doctor he had to take, so I didn't get a chance to ask which Fusion procedure he would plan to use.

    At this point I get to choose between living with the leg and back pain for the rest of my life, with it getting progressively worse, or I can have major surgery. So I'm wondering if the major surgery (Laminectomy + Fusion) will lead to resolution of my pain to at least some degree. I've heard about studies which indicate that people's pain levels after surgery may not be all that different from people who didn't have surgery.

    If anybody has had Laminectomy + Fusion to address leg pain, did it help?

    -- Thanks,
    Mary

  2. #2
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,020
    Hi there,

    I am wondering what type of orthopedic surgeon you saw? I would strongly recommend you see an experienced spinal deformity specialist, one who sees lots of scoliosis cases. You can search for ones in your area at the Scoliosis Research Society website, www.srs.org.

    If this were me I would need to know a lot more detail about what type of surgery is planned, what levels, etc.

    My situation was somewhat similar to yours about 3 years ago, and I elected to delay surgery. Then my 38 degree curve jumped up to 47 in 2 years' time, and my stenosis and spondylolisthesis got worse. Last October I had a fusion T8-pelvis, which I am still recovering from. It was a huge surgery.

    Gayle
    Gayle, age 47
    Boston brace as a teen for AIS
    Oct 2010 fusion T8-sacrum w/ pelvic fixation, TLIF at L4/5.
    Feb 2012 major A/P revision for broken rods


    mom of Leah, 12 y/o, diagnosed Jan '08 with 26* thoracic JIS (age 6)
    4/08 26 degrees, brace 16 hrs/day
    9/08 17 deg. OOB - brace discontinued
    9/09 30 deg, resuming brace
    5/10 VBS Dr Luhmann Shriners St Louis
    5/14 stable 4 yrs post-op, 14* T

    also mom of Torrey, 9 y/o son, 12* T, decreasing spontaneously (from 19*)

  3. #3
    Join Date
    Jan 2010
    Location
    Syracuse, NY, USA
    Posts
    157
    Gayle,

    I live in Syracuse, NY. Today I saw Dr. Richard Tallarico at Upstate Orthopedics (http://www.upstateorthopedics.com/su...o.php?id=428); he is not a member of SRS, but specializes in maintaining spinal mobility and complex spinal problems. He does have a colleague (http://www.upstateorthopedics.com/su...bio.php?id=418) who is a member of SRS if that becomes an issue.

    Alternatively, I could always try the first surgeon I saw 2 years ago, who is a member of SRS (http://www.sosspine.com/thomas_r__haher__m_d_); that's the reason I chose him the first time around.

    Yes, I definitely need to know more about what Dr. Tallarico would do; I plan to schedule another appointment with him and bring my husband along (my husband teaches immunology in the medical school side of the same teaching hospital that Dr. Tallarico works for). I would want to know levels, the approach, etc. I would have asked those questions this morning had the doctor not needed to leave to speak with another physician.

    If you had leg pain before your surgery, has it been resolved now? What sort of issues continue to cause problems for you in your recovery?

    -- Thanks for your reply,
    Mary

  4. #4
    backissues Guest
    My situation sounds similar with the scoliosis, stenosis, degenerative disc disease, and so on. Having surgery without the fusion would lead to an unstable spine. I was appalled when I first heard this because I thought I could have a laminectomy without fusion. Though my problems were in the lumbar area, my fusion is from T10 to S1 for stability at both ends.

    Before the surgery, I couldn't walk or stand for more than 10-15 minutes. Now, I can stand and walk with no pain. I walked 1 mile today and can do more. I haven't done that for years.

    However, I am having complications with referred nerve pain to my upper abdomen coming from the thoracic area T8 and T9. It seems this is unusual but I have it. The doctors are trying to resolve it with steroid shots and medication. I am 15 weeks post op.

    Hopefully, the nerve pain will get resolved. I certainly am happy about the standing and walking. I used to lean over a shopping cart in stores. Now, I walk beside them.

    Good luck!

  5. #5
    Join Date
    Mar 2008
    Location
    New Bern, NC
    Posts
    1,435
    Mary,
    I too was unable to stand or walk for more than 5-10 minutes at a time. I chose the surgery without reservation as I couldn't stand to live that way any more. I had tried all of the PT, water therapy, cortisone shots, non-surgical decompression with a Chiropractor, to no avail. It was a no brainer for me. My surgery was a very complicated surgery and although I am not completely pain free, I basically have my life back. I still have nerve pain in my right let mostly which is controlled with Neurontin. You are in a tough place right now and my heart goes out to you.
    Sally
    Diagnosed with severe lumbar scoliosis at age 65.
    Posterior Fusion L2-S1 on 12/4/2007. age 67
    Anterior Fusion L3-L4,L4-L5,L5-S1 on 12/19/2007
    Additional bone removed to decompress right side of L3-L4 & L4-L5 on 4/19/2010
    New England Baptist Hospital, Boston, MA
    Dr. Frank F. Rands735.photobucket.com/albums/ww360/butterflyfive/

    "In God We Trust" Happy moments, praise God. Difficult moments, seek God. Quiet moments, worship God. Painful moments, trust God. Every moment, thank God.

  6. #6
    Join Date
    Jan 2009
    Location
    Virginia Beach, VA
    Posts
    456
    Mary,

    I spent 7 years being debilitated from my worsening scoliosis, I was only 33 at the time. I had three herniated discs...as a matter of fact by the time I had my surgery there was just bones sitting on top of bones. I had a 50 degree curve Lumbar curve and it was rapidly progressing. I had extreme siactica and terrible pain in my quads and I could not function very well. I was a personal trainer and body builder and I had to give it up.

    While it has really taken two years for me to feel like my back has healed from my surgery, all the pre-surgery pain was gone immediately. I also had severe migraines for a year because my scoliosis caused my head to shift off the atlas, so my head is crooked. Once I was able to talked after my surgery I first asked how many inches had I gained and oh my god my head doesn't hurt anymore even though the rest of me did at the time. Even once the migraines passed which was probably a year and a half before surgery I ALWAYS had a dull ache on the top of my head. I never knew what it was like to not have that pain.

    My suggestion to you is do as much rsearch as you can, research your surgeon(s) and options and go for it. You may have a different kind of pain post surgery but it will change over time (some people have none). I was told while the doc was 100 percent certain he could get rid of my pain I may have a new pain to live with....it still beat what I had before. It's not an easy recovery but worth it.

    Also plan your surgery, if you choose to have it, for when you can arrange full-time help for a while. I was very fortunate to have my mother in law live with us for 6 months because my youngest son was only one and I couldn't pick him up until then. I do have issues with my neck that they were hoping would get better with surgery....for a little while I had no issues but now I have herniated discs and stenosis, degeration so that's where all my pain is now....hasn't gotten as bad as my back at this time. It's hard to say if this is a result of my surgery or if it was there but not as bad 2 years ago. They never did MRI's on my neck. I do wish I had requested that they look a little more into that area but the doc felt if it was really to bothersome it may never progress so why both with it IF I didn't have to.

    Good luck and I think you'll find that if you are on this website enough you'll see MANY people who would go through surgery all over again despite the recovery and pain. Good luck with your decision making. Life is too short to live in such pain!
    Susan

    Diagnosed at 10, Boston brace from 11-13 yrs old.
    50* Lumbar w/ 5 centimeter shift to the left and slight rib hump...
    Surgery Date: April 15 and April 22, 2009
    X-LIF approach for disc repair L5,L4,L3,L2
    Posterior Approach for fusions L5-T5
    Dr. Fox @ Naval Medical Center Portsmouth
    Nice and straight now!!!!!

  7. #7
    Join Date
    Oct 2008
    Location
    Orlando, FL
    Posts
    177
    as someone who underwent a discectomy/laminectomy, performed by a great and well meaning surgeon who was not a scoliosis specialist, I have to say absolutely do not have a laminectomy/decompression without stabilizing the spine.

    I had a disc that herniated and was crushing my L2-3 level nerve and was causing horrible, debilitating pain and my leg was giving out on me without warning at 25 years old. I had seen a scoliosis surgeon in my town for 8 months doing everything people have already talked about (steroid injections, PT, pills, etc) all without ever finding the cause of the pain. Out of desperation I went up to see a neurosurgeon who immediately spotted the herniated disc on an MRI the scoliosis surgeon had ordered, looked at, and told me there was nothing wrong. The neurosurgeon is extremely talented, and did a great job on my minimally invasive discectomy.

    However, because I was so desperate to get relief from the pain, I did not do enough research (and this was before I found this wonderful forum). My surgery was successful at first, but because the spine was not stabilized, the disc re-herniated within 2 months of the surgery.

    I ended up after another 9 months of seeing surgeon after surgeon before I found my current surgeon who deals exclusively with adult scoliosis. If I had found him first, I probably would have been saved the 2 subsequent surgeries I had to undergo.

    As far as pain reduction, I had what is considered "successful' pain reduction, in that I was off pain killers and able to resume much of a normal life after my 3rd surgery. Unfortunately my scoliosis continued to progress, and I started having sciatica in my other leg. I decided to go ahead and do the full fusion, not expecting much reduction in pain because my surgeon had said it may or may not help. I mostly did it to prevent my curves from progressing and causing more pain than I was already in.

    Thankfully, I had immediate relief from the new pain I had. However, my other leg is hurting quite a bit, to the point where I am now taking gabapentin for it. But this time the nerve pain medicine is actually helping, and my surgeon is hopeful because he thinks that even though my pain is pretty bad right now, if the meds are helping the nerve may finally be able to heal. But he also said it could be 2 years before I really see full healing, as my nerve has been so irritated.

    Anyway, just wanted to share my first hand experience with you, hopefully it will help you in your decision making!
    Rebecca
    Age: 28
    Dx w/ scoli @ age 12 S curves T-40* L-42*
    wore night bending brace as teenager
    Curves changed to 50's plus or minus
    herniated disc L2-3, Discectomy October 2007
    fusion L2-3 November 2008
    Revision L2-3 Fusion, Removal of hardware August 2009
    Curves measuring 52 T&L September 2010
    Fused T4-L4, all posterior December 27th 2010
    gained almost two inches in height

    Before and After Exterior
    Before and After X-rays
    My blog: http://herscoliosisjourney.blogspot.com/

  8. #8
    Join Date
    May 2009
    Posts
    3,656
    38 degrees is severe? by who's say so?

    i hope you go to see a top SRS surgeon before you have any surgery!
    please....go consult with a few top surgeons....

    i can see needing help for the discs...i have degenerative disc disease and it causes great pain!
    but my scoli is 42 top and 61 bottom of spine....and i don't even consider them such large curves....
    why is a surgeon recommending fusion for a 38 degree curve????

    there are ways to address disc problems without fusion...i would at least want to speak to a surgeon who could discuss other options before agreeing to a fusion to pelvis!

    jess

  9. #9
    Join Date
    Oct 2008
    Location
    Sunshine Coast, Queensland, Australia
    Posts
    3,160
    I see getting the best possible scoliosis surgeon as the most important step in this journey.

    I am clueless about laminectomies but I did have one (or 2? I thought he said laminectomies) with my fusion. I do know that before surgery I couldn't stand in one spot for more than 30 seconds before I was looking for something to lean on and now I can stand for hours.
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

  10. #10
    Join Date
    Jan 2010
    Location
    Syracuse, NY, USA
    Posts
    157

    Now have more info

    Having seen the surgeon again (back on April 15th -- been very busy with work since then), I now know that he wants to fuse me from T9 or T10 (above the worst part of my curve, and where the ribcage offers stability) to the pelvis. And the laminectomy would cover either L2 to L5 or L3 to L5, depending on what he finds once he gets started.

    I'm wondering how much flexibility I would have left after being fused from the pelvis to T9 or T10. He says that I've already lost so much flexibility due to my current state that it won't be that much different.

    I've had a task on my task list for several weeks now to call his office and say to go ahead and schedule me, but I keep putting it off. Sometimes because I'm too busy during the day, and sometimes because part of me keeps wanting to put off surgery as long as I can. But I know that if I put it off too long, it will just make things more difficult in the long run.

    I have learned that the doctor I've seen does more of these laminectomy + fusion surgeries on adult scoliosis patients than anybody else in town, so if I'm going to go through with this, which seems likely, I do think he's probably the best guy here in town.

    My husband has a co-worker who also has a crappy back; I don't know what his specific issues are, though I doubt that they include scoliosis. That guy has seen a surgeon at "Hospital for Special Surgery" in the NYC area, and plans to go there for his surgery, after being told by them that he needs less invasive surgery than he was told here in town. This guy thinks that this "Hospital for Special Surgery" is the best place to go for back surgery; it was his cardiologist who told him about the place. What do you guys think about that place?

    I personally can't imagine going that far for surgery. I may be in New York State, but Syracuse is still over 300 miles away from the NYC area.

    -- Mary

  11. #11
    Join Date
    Jan 2010
    Location
    Syracuse, NY, USA
    Posts
    157

    I don't know why they think my scoliosis is "extreme" or "wicked"

    Quote Originally Posted by jrnyc View Post
    38 degrees is severe? by who's say so?

    i hope you go to see a top SRS surgeon before you have any surgery!
    please....go consult with a few top surgeons....

    i can see needing help for the discs...i have degenerative disc disease and it causes great pain!
    but my scoli is 42 top and 61 bottom of spine....and i don't even consider them such large curves....
    why is a surgeon recommending fusion for a 38 degree curve????

    there are ways to address disc problems without fusion...i would at least want to speak to a surgeon who could discuss other options before agreeing to a fusion to pelvis!

    jess
    Jess,

    I really don't know why this doctor says that my lumbar scoliosis is "extreme", or why a chiropractor I've seen in the past called it "wicked".

    I've got some 2-year-old X-ray images available online:

    http://home.roadrunner.com/~taffet/M...bar_Spine1.jpg

    http://home.roadrunner.com/~taffet/M...bar_Spine2.jpg

    I have some more recent images from February, but haven't uploaded them anywhere just yet.

    -- Mary

  12. #12
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,300
    Hi Mary...

    Hospital for Special Surgery does a lot of complex surgeries, but I agree that you don't need to travel a long distance for surgery if you've found someone local you feel you can trust. If you haven't already done so, my only suggestion would be to get a second opinion.

    I agree with your surgeon in terms of then flexibility issue. Much is made about the loss of mobility, but in truth, degeneration takes away much of ones flexibility. In my case, I was able to notice some loss of flexibility, but its not the end of the world. Vie been able to figure out alternate ways of getting things accomplished.

    Regards,
    Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  13. #13
    Join Date
    May 2009
    Posts
    3,656
    hey Mary
    my suggestion, just my own personal suggestion, would be to go to wherever you think the best top SRS surgeon is that you can get a consult with...
    i have flown 6000 miles round trip to consult at Cedars Sinai with Dr Neel Anand because of his specialty in minimally invasive lumbar surgery. i go back and forth all the time to my home city of NY for pain management tx, a 6 hour round trip now since i moved from Manhattan to northern CT 4 years ago....i make these trips even though they increase my pain while i travel...
    for major surgery, the more knowledge the better, is my view... is major major surgery!
    for now, i handle my pain, which gets intense in lumbar area, with oral meds and with pain injections with steroids...i have tried many types of pain management shots in lumbar area, but the best for me have been sacroiliac joint injections...no sense why they help there, but they do...not for long...so i am hoping my latest SI shots will last more than the 3 weeks they helped last time....
    my thoracic pain is not as bad...it is muscle spasming...i handle it with botox shots in thoracic area...the shots work well at freezing the muscles so they cannot spasm! they last for 3-4 months....the botox shots are covered by insurance, since they are not for cosmetic reasons...

    all in all i am just suggesting that there are alternatives to surgery, even if for a while, and also that it is important to get several consults to see if the top scoli surgeons agree on what they believe you need

    jess

  14. #14
    Join Date
    May 2010
    Location
    Indianapolis area
    Posts
    964
    I second this! We have competent scoliosis surgeons in my city, but I am driving four hours for my surgery to get one with an outstanding reputation who does all scoliosis, all the time. If I lived where you do, I would go to the Hospital for Special Surgery in a heart beat. There are just too many risks involved with this surgery to not get the absolute best surgeon that you can.

    Good luck!
    Evelyn
    age 41
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke, T4 to S1 with pelvic fixation
    Not "confused" anymore, but don't know how to change my username.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •