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Thread: Leg pain following anterior fusion L4-S1 -- Need opinions please!

  1. #1
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    Question Leg pain following anterior fusion L4-S1 -- Need opinions please!

    Hi everyone -- Need advice please -- I am 56 years old and had my surgery in two stages -- first was posterior fusion from T3-S1 back in December 2011. Had a slow but steady recovery and feeling pretty good by April, when I had 2nd surgery to bolster the fusion at the bottom: anterior fusion from L4-L5 and L5-S1 with bone morphogenetic protein (BNP). Felt fine initially, but three days post-op developed intractable left leg pain. I was put on a steroidal taper which helped a little, but pain returned. Went for a CT-myelogram which showed all was fine. Still have this sciatic-like pain down my left leg. I was told that 10-15% of patients develop this leg pain following anterior fusion surgery and that it was consistent with pain starting 3 days post-op and it should go away in 4-6 weeks. I am told it is due to an inflamed nerve and once the nerve calms down the pain will go away. I am about 5 weeks post-op now and pain is still there. I keep it under control with 1 gapapentin (300 mg) in morning and a half a Percocet at night. I am also taking herbal anti-inflammatory pills and hopefully that will help also.

    Has anyone had this kind of result following surgery? Did it go away in 6 weeks? I am very frustrated because I had no pain before surgery (had the surgery because the curves were increasing, not because of pain) and feel I should have not had the 2nd surgery at all.

    Thanks for any input at all!

  2. #2
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    Has your Doctor checked for bone spurs?
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

  3. #3
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    Leg pain following anterior fusion L4-S1 -- Need opinions please!

    Yes -- the myelo-CT showed nothing abnormal. That is why, with it being somewhat relieved with the steroid taper, they think it is due to an inflamed nerve.

  4. #4
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    Susan--
    I didn't initially have leg pain. So my case is probably different. I've gone through bouts of it however. I've discovered it happens about every 4-6 months. My last one was March/April. Usually something triggers it--last time it was working outside on flower beds. It is always right hip and leg. Eventually, it goes away. I've been pretty used to hip pain for years and years but the throbbing leg pain that's always worse at night isn't fun.
    So, you might just be going through some leg pain initially until the nerves get themselves routed. Hopefully, that pain will decrease. Good luck! Janet
    Janet

    61 years old--57 for surgery

    Diagnosed in 1965 at age of 13--no brace
    Thoracic Curve: 96 degrees to 35 degrees
    Lumbar Curve: 63 degrees to 5 degrees
    Surgery with Dr. Lenke in St. Louis--March 30, 2009
    T-2 to Pelvis, and hopefully all posterior procedure.

    All was posterior along with 2 cages and 6 osteotomies.

  5. #5
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    Hi Susan

    I had my anterior first, then was flipped over 2 days later.

    Nerves can be real buggers and can take a long time to heal.... I took 3 hot baths per day for 3 months for pain control, 106 degree HOT water, and it worked well. It was total pain relief in 30 seconds. Drink plenty of water if you do this.

    Try to take things real easy, real slow for now....try not to agitate or aggravate it so healing can occur. You are still early in your anterior recovery.

    I hope things heal quickly for you, I battled crippling sciatica before my surgeries and know what you are going through.....

    Hang in there. Deep breaths!
    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

  6. #6
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    Thanks for your responses, I really appreciate the different perspectives and encouragement. I am still hopeful this nerve pain will leave "on time," and still hoping to hear from someone with a similar experience to mine to see if the pain did indeed go away. Thanks again!

  7. #7
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    Hi Susan,

    I broke my rods in January and underwent a A/P revision (8 hours, all on one day). The anterior part was done from the side, with XLIF's done at 2 levels (L2/3 and L3/4) through the psoas muscle. I experienced left groin and upper thigh pain that I was told was due to irritation of the nerves related to the anterior approach. It was never extremely severe, instead it felt like a very sore area that might go away if I could just figure out how to stretch it or something. The pain did go away within 6 weeks or so.

    Good luck, I hope that you continue healing and your pain will soon be gone.
    Gayle, age 50
    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)
    2010 VBS Dr Luhmann Shriners St Louis
    2017 curves stable/skeletely mature

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

  8. #8
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    "I am very frustrated because I had no pain before surgery (had the surgery because the curves were increasing, not because of pain) and feel I should have not had the 2nd surgery at all."

    I am so sorry that you are in such pain. That must be so frustrating since you were not in pain before and now you are in pain.
    I hope that some of the strategies that were suggested, especially the hot soaks work for you and that maybe with time that you are better. I felt your anguish with your current pain in light of not having pain before and now wondering if you should have had the surgery at all. This is what worries me also. I have not had surgery yet and maybe won't, but need to check the progression of my curve which was just diagnosed last August [I am 65]. I saw a woman in her late 70's at the clinic yesterday that was very bent over and in alot of pain from her deformity that maybe didn't have surgery and I thought that maybe she could have be me 10 years ago. I hope that you don't let regret continue to beat you down. You might have been a lot worse without the surgery. It's a crap shoot, I guess. Best of luck in beating the pain. I'll be thinking of you.
    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

  9. #9
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    Susan,

    I had severe nerve pain and weakness in my right leg after anterior surgery as well. It was very scary. I would say it hurt a lot for about 2 months, then started to settle down. The weakness took about a year of gradual improvement to resolve. The leg is just about normal now except for a very slight weakness and a little sensitivity on my right thigh -- kind of like a mild sunburn.

    It's hard to be patient with nerve issues because they're slow to heal, so I know how frustrating it can be. Hang in there -- things will get better!
    Chris
    A/P fusion on June 19, 2007 at age 52; T10-L5
    Pre-op thoracolumbar curve: 70 degrees
    Post-op curve: 12 degrees
    Dr. Boachie-adjei, HSS, New York

  10. #10
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    Quote Originally Posted by SusanG View Post
    I am very frustrated because I had no pain before surgery (had the surgery because the curves were increasing, not because of pain) and feel I should have not had the 2nd surgery at all.
    This is the classic example of why I say that adult patients without significant pain are often unhappy after surgery.

    The good news is that your symptoms are very likely to be temporary. Hang in there.

    --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
    ---------------------------------------------------------------------------------------------------------------------------------------------------
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  11. #11
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    Susan,
    I did not experience leg pain, so I don't have much to offer there--except my wishes for you that it is temporary. I just wanted to write because you said you were using herbal anti-inflamatories. I just wanted to mention that you might want to run that one by your surgeon. I know some surgeons don't want people on anti-inflammatories for the first several months after surgery because (if I remember correctly), inflammation is an important part of the fusion process.

    Good luck! I hope your issues resolve soon.

    Best,
    Evelyn
    age 44
    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.

  12. #12
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    Quote Originally Posted by Confusedmom View Post
    Susan,
    I did not experience leg pain, so I don't have much to offer there--except my wishes for you that it is temporary. I just wanted to write because you said you were using herbal anti-inflamatories. I just wanted to mention that you might want to run that one by your surgeon. I know some surgeons don't want people on anti-inflammatories for the first several months after surgery because (if I remember correctly), inflammation is an important part of the fusion process.

    Good luck! I hope your issues resolve soon.

    Best,
    Evelyn
    I agree. You must ask your surgeon about the anti-inflammatorys. They do interfere with fusion.
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

  13. #13
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    Thanks again for all the responses, especially the caveats on the anti-inflammatories interfering with bone fusion. The spine fellow did mention that Aleve or Motrin would slow down bone fusion but I didn't think that herbal products would be a problem, so thanks for that insight. So what is my choice? Interfere with fusion but get pain relief or slog through the pain till I am fused. Not much of a choice here. I will remain watchful and hopeful.

  14. #14
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    Quote Originally Posted by SusanG View Post
    Thanks again for all the responses, especially the caveats on the anti-inflammatories interfering with bone fusion. The spine fellow did mention that Aleve or Motrin would slow down bone fusion but I didn't think that herbal products would be a problem, so thanks for that insight. So what is my choice? Interfere with fusion but get pain relief or slog through the pain till I am fused. Not much of a choice here. I will remain watchful and hopeful.
    As there really is no choice in this matter, I hope that your pain will resolve itself soon.
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

  15. #15
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    Sunshine Coast, Queensland, Australia
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    Agree with others. The aim of going through this surgery is fusion so I would be very wary of anything that might have an anti-inflammatory response in the body. I hope you can find another means of pain-relief. Best of luck!
    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

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