The pop that was hear around the world

[babyboomer16]

It's hard not to worry!

Hi leahdragonfly,
I agree that we are worriers! We have so much riding on this surgery and then all the recovery and THEN
the rest of our lives that depend on everything holding together! Some have very good luck and some not so much! It's hard to carry all these things by ourselves, so this is a good place to find understanding people and some of their stories and difficulties. From that, sometimes, you can make some discisions
about your issue at hand!! I think a cat scan is a must to get a better picture. And sounds like that's the next step. I hope something will be found so you can go on to the next step, and have a little piece of mind as to what's happening. Good Luck!,, Linda B.

[leahdragonfly]

Extreme pain and both rods are broken

Last week was very discouraging with 3 days of bedrest and a Medrol pack offering no relief. I went back to work yesterday and the pain increased severely in the afternoon to the point of being out of control. I went to Urgent Care again where they repeated x-rays, which show that both rods are broken just below the L5 screws. I can't believe this is happening again.

Of course now it is the weekend but I will definitely call Dr Hart's office first thing Monday. I also have an appt to see Dr Hart with a CT scan Thursday, so at least I won't have to wait too long to know the plan. Good news is the pain is not bad when I take it very easy, and I got some Percocet to have on hand if needed. All words of encouragement are welcome!

[Pooka1]

Gayle! I am so sorry! I was hoping it wasn't broken rods again. I hope they can figure out why this is happening.

Thinking of you.

[mabeckoff]

After breaking the L5-S1 rods twice, Dr Bederman went in from the front and put a cage in to reinforce it.

After that, I did not break that area again

[PeggyS]

Oh, Gayle - how absolutely frustrating! Sending prayers for a quick & lasting solution. May you be blessed with lessening pain, as you wait. Take care.

[titaniumed]

I am so sorry Gayle, you must be crying your eyes out......

I have read that the L5-S1 is the hardest level to fuse....Let us know what Dr H thinks on a plan to get you fixed up.

Didn’t he go down and address that level with a cage or spacer from the front?

Ed

[leahdragonfly]

Ed, I had L4-S1 fused when I was 17 for high-grade spondylolisthesis. Because of the anatomy and need for decompression (in 1984), no hardware was used, and I had to wear a body cast for 3 months. I did well for many years, but when I had my scoliosis fusion in 2010, Dr Hart said they checked and L5-S1 was adequately fused but with a thin fusion mass. L4-L5 had a long-standing pseudoarthrosis from my teenage surgery, so this will be my third pseudoarthrosis. The pseudoarthrosis at L4-L5 was displaced and had a spondylolisthesis at that level, which was causing severe spinal stenosis and must have destabilized my scoliosis. Pain from that whole trainwreck is what led me to have surgery in 2010. I had two cages put in via XLIF during my revision in 2012, but the cages were above that level.

I am pretty shell-shocked to be in this situation again, that is for sure, but I have every confidence in Dr Hart to get me fixed up. I am trying to stay positive at this point.

[titaniumed]

Gayle, You and I both had low end problems.....and probably from the very start. Mine from ski jumping so much as a kid with plenty of hard landings on the east coast ice.

How did they fuse you in 1984? Did they go in from the front? I am not understanding “thin fusion mass” unless this means from the back.

I also have confidence in Dr Hart. He will re-evaluate and plan accordingly.

Try to take it easy...Deep Breaths

Ed

[LindaRacine]

Hi Gayle...

Sorry to hear that you're headed for more surgery, but at least you now know the cause, and are hopefully going to be out of pain soon. If your CT is scheduled for before you see Dr. Hart, I think it might be wise to call his office to ensure that he still wants you to have it.

--Linda

[green m&m]

So sorry to hear that Gayle.

I am at least glad you won't have to wait long to see Dr. Hart.

[susancook]

Gayle: So sorry that you need more surgery, but I am confident that Dr. Hart can help you.
I wonder about an infection.
Dr. Hart reinforced my hardware with rods in various places. I think that I have 4 rods now.
Let me know what I can do to support you.
Susan

[mabeckoff]

So sorry to hear about your problem

Melissa

[JenniferG]

Oh no! I'm so sorry to read this. I hope Melissa's words give you food for thought and that Dr. Hart can take whatever measures are necessary to fix the problem permanently. Thoughts are with you.

[babyboomer16]

😢😢🙏🏻

Gayle, I am so sorry you have yet another problem to fix!!! I know how hard it is to face these problems over and over. From what I hear about Dr. Hart, and with you having a great stoic personality, you can do this and know we're all behind you cheering you on. We have no choice but to keep our heads up high a carry on! Even though things get so frustrating. Hoping for an informative and encouraging appt. with Dr. Hart~~~ Linda

[leahdragonfly]

Hi all,

my husband and I had a very pleasant and informative visit with Dr Hart. As usual he took plenty of time with us explaining everything in detail, going over imaging and symptoms, and discussing options. He never rushed us in the least, which is always so amazing to me!

So here's what Dr Hart said: after looking at the x-rays again very magnified, the rods were probably broken (right beyond the L5 screws) but minimally displaced back in late July after the original injury. He pointed out a small defect in the outline of the rods but it was very subtle. It was more noticeable on the x-rays taken a week ago, when the x-ray tech took an additional angulated shot which demonstrated the breaks more visibly. I had a CT scan right before seeing Dr Hart, and he showed us how everything from the revision has healed and fused well front and back in the lumbar. There are no apparent failed fusions or pseudoarthroses, and in fact he was very happy with how everything from the revision has healed, which makes the broken rods puzzling. There appears to be adequate posterior fusion at L5-S1, which was fused but uninstrumented when I was a teenager. However, he told us that sometimes things look like they are fused solidly and rods can still break. My understanding is he feels that since the front of L5-S1 has never been fused, there must be potential movement there that is enough to break the rods and cause pain.

He also noted that my SI joints are very arthritic, so he wants me to have them injected to either rule them in or out as pain generators. If I felt great and the injections take away all pain that might change things with a planned revision, I guess because the broken rods themselves aren't a danger.

Over the course of the conversation Dr Hart wanted to take a conservative approach and didn't think I needed to rush right off to surgery. However, he does think I need a major revision to fuse the lower level securely once and for all. The revision would be anterior and posterior. Open anterior, 4" vertical incision to the side of the belly button with a vascular surgeon to access and expose the front of the spine. Put a cage in L5-S1. The posterior he would leave my thoracic alone as it is fine. He would reopen from L1 down, remove the broken rods at the current connectors around L1, replace all the screws with slightly heavier ones and replace the rods with heavier ones. He said the hardware has evolved since I got my last set. He would also put in iliac screws on both sides considering my situation. The SI joints may be formally fused as well pending the results of the injections. Surgery would be similar in rigor to my last, which was tough but not as bad as the original. He said about 6 hours of actual surgery, so probably similar to last time where I was in OR for 8+ hours.

I was feeling pretty ok talking with Dr Hart about all of this, and my husband agrees completely with the plan. But I woke up in a cold sweat in the middle of the night after the appointment terrified about the surgery! Everything seems worse in the middle of the night. It is hard not to be anxious as this point. Trying to take lots of deep breaths.

I was excited to return to work yesterday and did pretty well all day, but I was exhausted by the evening and the pain is back pretty bad today. I really need to work as much as possible up til surgery to preserve my sanity, FMLA time, and my finances. It's strange how I can have a day like yesterday where the pain was really minimal part of the day, then pain levels shoot up again. Days like today make it much easier to consider the surgery.

We shall see how the next week or two unfold, and Dr Hart asked me to keep in touch about how I'm doing. I feel so lucky to have him as my surgeon.