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  1. #1
    Join Date
    Jan 2008
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    Oregon
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    The pop that was heard around the world

    Hi guys,

    I am 14 months post-op T8-sacrum/left pelvic fixation and have overall been doing quite well. I work at an active, demanding job, and I swim laps and work out in the gym regularly. I have had minimal back pain, aches and pains that are easily controlled with tylenol and advil. I did have some pain on and off for the last few weeks in my lower back, nothing too out of the ordinary.

    Two days ago (Tuesday) I was at work, feeling fine, and I was leaning over just a little to put an EKG electrode on a patient. I felt and heard the loudest pop you have ever heard coming from my lower back/right side, followed by severe pain. The other staff in the room all heard the pop, as did the patient. Apparently after I left the room the patient asked if a circuit breaker for the room had blown, the pop was that loud.

    I was taken to the ER where I had lumbar x-rays that cleared the hardware. My husband came and took me home with my new percocet prescription. I was told to rest and use ice. I called my surgeon's office yesterday and talked to the PA, who was able to review the digital x-rays. She thought the x-rays looked ok and thought it could have been my SI joint popping. I do not have an iliac screw on the right, so that seemed like a reasonable possibility. Then she called back later, and my surgeon wants me to come in Tuesday for an additional full-spine x-ray as well as a bone scan to check for subtle or concealed fractures.

    I am starting to have a decrease in pain although it is still pretty significant when I move. I am hoping that all will settle down and everything is clear. This whole episode was pretty unexpected and scary.
    Last edited by leahdragonfly; 08-15-2015 at 04:02 PM.
    Gayle, age 49
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    5/10 VBS Dr Luhmann Shriners St Louis
    5/16 6 yrs post-op, 24*T/ 22* L, mild increase in curves, watching

    also mom of Torrey, 12 y/o son, 16* T, stable

  2. #2
    Join Date
    Nov 2010
    Location
    British Columbia
    Posts
    918
    Oh my Gayle, that must have been so scary for you. Can't believe it made such a noise that it sounded like a breaker blowing. Tuesday is not far off. I hope everything turns out to be okay and take it easy until then.
    Son 14 y/o diagnosed January 20th. 2011 with 110* Curve
    Halo Traction & 1st. surgery on March 22nd. 2011
    Spinal Fusion on April 19th. 2011

    Dr. Krajbich @ Shriners Childrens Hospital, Portland Oregon



    http://tinyurl.com/Elias-Before
    http://tinyurl.com/Elias-After

  3. #3
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,794
    Hi Gayle...

    I've seen several x-rays of people whose screw or rod breaks were almost invisible on X-ray, so wouldn't rule that out yet. Hope whatever it is, the fix is simple.

    --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.

  4. #4
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
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    Thaks Elisa and Linda.

    Linda, curious if the broken hardware was not really apparent x-ray, how was it detected? My first suspicion was certainly a hardware break due to the loud noise followed by pain.

    Thanks,

    Gayle
    Gayle, age 49
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    5/10 VBS Dr Luhmann Shriners St Louis
    5/16 6 yrs post-op, 24*T/ 22* L, mild increase in curves, watching

    also mom of Torrey, 12 y/o son, 16* T, stable

  5. #5
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,794
    In at least one case I know of, it was detected in the OR. I think that in others, it was seen in CTs or other imaging.
    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.

  6. #6
    Join Date
    Apr 2010
    Location
    Waterloo, IL
    Posts
    1,690
    Gayle,
    I hope that whatever made the popping noise is minor. Who would think that after 14 months that something could go wrong?
    Karen

    Surgery-Jan. 5, 2011-Dr. Lenke
    Fusion T-4-sacrum-2 cages/5 osteotomies
    70 degree thoracolumbar corrected to 25
    Rib Hump-GONE!
    Age-60 at the time of surgery
    Now 66
    Avid Golfer & Tap Dancer
    Retired Kdgn. Teacher

    See photobucket link for:
    Video of my 1st Day of Golf Post-Op-3/02/12-Bradenton, FL
    Before and After Picture of back 1/7/11
    tap dancing picture at 10 mos. post op 11/11/11-I'm the one on the right.
    http://s1119.photobucket.com/albums/k630/pottoff2/

  7. #7
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,160

    acute pain flair up

    I injured my back on July 21st at home. I was squatting down and reaching far forward for something, and felt a painful pop (not as loud as "the pop heard round the world" when I broke my rods) in the lower right side of my back. The next day it was sore but not terrible, until the evening when I started having severe, disabling back pain after swimming. I went to bed, and the next morning was still in very severe pain in the lower right side. I went to Urgent Care and had x-rays which were cleared by my surgeon. The pain was severe enough to keep me unhappily in bed for two days, at which point I improved enough to gradually resume my activities.

    Now, over 2 weeks later, the pain is not resolved. It is very localized to the lower right side. The left side does not hurt. It is present but not bad when sitting or lying down, but sharp and easily reproducible with specific motions. These motions include straightening up after bending forward, and any type of leaning back. Once the pain is flared up, putting weight on the right leg while walking down stairs is also very painful, as is any type of twisting such as getting in the car. It feels like I have a spear sticking through my back when I do any of these motions, or after. Tylenol with Advil and laying on a heating pad help relieve the pain, but it comes immediately back with the above motions.

    I know injuries take time to heal, but I am starting to worry that I am not improving much. I contacted Dr Hart's office yesterday and they want me to schedule an appt and CT scan for 2-4 weeks which I can cancel if I improve. They also prescribed a Medrol pack which I will start today. Not looking forward to it as I have heard horror stories of people having insomnia and other bad side effects from steroid tapers, and don't want to gain any weight haha!!

    Any advice or encouragement would be appreciated. Ed, are you out there?
    Last edited by leahdragonfly; 08-08-2015 at 10:13 AM.
    Gayle, age 49
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    5/10 VBS Dr Luhmann Shriners St Louis
    5/16 6 yrs post-op, 24*T/ 22* L, mild increase in curves, watching

    also mom of Torrey, 12 y/o son, 16* T, stable

  8. #8
    Join Date
    Aug 2015
    Posts
    27
    You specifically asked for Ed? I'm new here, is he a doctor? Hope it's okay if I answer some of your questions. I had a flare up after surgery and was on a merlo pack. It was only 7 days. It did not cause insomnia for me but I was given medication to help me sleep. The small amount of time on the pack did not cause weight gain. It also gave me pain relief which returned a week or so after the pack wore off. I'm really sorry if I wasn't supposed to answer.

  9. #9
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,160
    Dear Jamie,

    Thank you so much for your reply, I really appreciate it! I definitely did not mean to give the impression that only Ed could answer. Ed is a seasoned scoliosis veteran here who offers very practical advice with a good helping of humor added in, and I mentioned him because I recall he had some sort of severe soft tissue injury some years back.

    I would love to hear advice or encouragement from anyone.

    How long after your surgery did you have your flare up? You mentioned the pain came back after the steroid pack, but did it eventually heal?

    Thanks again for your quick reply. I appreciate it!
    Gayle, age 49
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    5/10 VBS Dr Luhmann Shriners St Louis
    5/16 6 yrs post-op, 24*T/ 22* L, mild increase in curves, watching

    also mom of Torrey, 12 y/o son, 16* T, stable

  10. #10
    Join Date
    Aug 2015
    Posts
    27
    Oh that's good to know about Ed. I'm sorry to hear he has been through so many revisions. Poor guy! To answer your question. They did the ct scan and could not find anything. After the doctor was sure I was fused, he removed my iliac screws. My pain was not from an injury, it just started on its own. I just wanted to let you know how the steroids worked and about the sleep. Hopefully yours will resolve once the steroids bring down the inflammation. Take care!

  11. #11
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,524
    Steroids? You will get your house cleaned with your tons of energy!

    So sorry about your fall. You seem to be doing a correct management strategy and I love your very specific descriptions of movement inducing discomfort. They are freq helpful to surgeons and pain management folks.

    Let me know if I can help you. I am in Central Oregon for a week now and will be back next Saturday. If you need a place to stay, we are near the SE end of the Ross Island Bridge.

    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  12. #12
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,531
    Jamie

    Luckily, I have had no spine revisions....and my scoliosis surgeon doesnít take any credit, he just shakes his head in disbelief of my success .....I have had many doctors shake their heads for different reasons. Maybe I just pick shaky doctors? I donít know ? (scoliosis forum humor)

    I have had to do 5 surgeries total for various issues....2 of them for gall and kidney stones. Cholecystectomy, and Laser lithotripsy. That and a shoulder re-build from a devastating ski crash 10 days before my scoliosis surgeries. I had A/P surgeries for scoliosis and did a massive anterior ALIF with stacked L1-Pelvis partial corpectomies. That anterior was a serious procedure along with cancer exploration.

    There are no doctors that post on this forum except for one, and he isnít all that active.....There is a scoli surgeon that posts on the Austraila forum, and none on the British forum that Iíve seen.

    Gail

    My surgeon gave me a Medrol pack (Methylprednisolone) for my 2 cervical herniationís along with Diclofenac 2 years ago in April 2013. It took 30 long days for that pain to cease. For cervical herniationís, this is the cats meow because I dodged ACDF surgery.

    My L4 soft tissue injury was 22 months post, 1Ē intense circle of pain 2 inches off center that resolved itself on its own after 2 weeks. Imagine that! We actually do heal! What a concept! That was during my second year leading up to ski season, so I was pushing things harder getting in shape for skiing. Dr Menmuir attributed that as a soft tissue injury and was issued no meds.

    Even though we recover and can lean over, its not a really good idea to continually test ourselves. I still squat to pick up things, but donít want to post about hearing about any pops of my own. Thank goodness Iím going deaf in my old age! I also do not lift at work......no more, I always ask for somebody young and tough like a Marine Corp drill sergeant. ďWho here is young and tough?Ē They usually come running....and I remind them that they arenít as tough as me. They know, and I get a kick out of it.

    You have had a history of pseudarthrosis.....I think that given this situation, that being extra careful in the future would be a good idea.....I would stop the bending over. Ask Dr H about this matter, about your history and see if you can get any input. Depending on the surgeon and the patient, this communication level will vary since they donít want to scare. Since you are a medical professional, I think you will or can get the real answer....Fusion mass does not always have the integrity we need to exert a high amount of force. Rod breakage is proof of this.

    Lets hope this isnít the case again.

    Do you still have any braces laying around? I would lend you mine, but I made a planter out of it and would have to do a transplant if you needed it. (more scoliosis forum humor)

    Lets hope this resolves quickly through rest so you can avoid that CT scan.

    Ed
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  13. #13
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,160
    Is it possible to crack or fracture the fusion mass without broken hardware showing up?

    Today was my second day of 5 on the Medrol taper pack, and I had severe pain this afternoon and evening after working for several hours. I am also taking Tylenol and meloxicam (a NSAID). The only relief once the pain sets in is sitting quietly or laying down on a heating pad. The pain can flare up quickly and be severe, like a spear is sticking through my back. I am really starting to worry, so will try to take it easier. Unfortunately I finally threw out my post-surgical brace a few months ago, somewhere after the 2 year mark.

    Let's hope tomorrow is a better day.
    Gayle, age 49
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    5/10 VBS Dr Luhmann Shriners St Louis
    5/16 6 yrs post-op, 24*T/ 22* L, mild increase in curves, watching

    also mom of Torrey, 12 y/o son, 16* T, stable

  14. #14
    Join Date
    Aug 2015
    Posts
    27
    I remember my Dad asking my spinal surgeon about the strength of my fusions. I remember the DR telling my Dad my fused spine was stronger than anyone who is not fused. Hopefully that thought is still correct. Just remembering hearing that as a kid.

  15. #15
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,794
    Hi Gayle...

    I'm really sorry to hear that you're experiencing pain once again. I hope it's temporary. I remember seeing some advanced imaging of what clearly looked like a crack in the fusion with no associated broken rod. I don't know if the person ever went on to break their rod(s).

    I also think it's entirely possible that you've got another broken rod that just hasn't shown itself yet. We had a patient who heard the pop, but whose xrays showed no break. It wasn't until several months later when the break finally showed up. When we blew up the original xrays, you could actually see a very, very faint line, but the rods were not displaced at first. Hope that doesn't make you worry more.

    --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.

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