L4/L5 (Laminectomy and Internal Fixation) & Dynamic Stabilization L3L4 surgery

Hi everyone

Going to have my TLIF L4L5 & Dynamic Stabilization L3L4 surgery on 16 Jan 09 after getting a second opinion today. Both docs agree on the same thing as they think that it is better to have fusion on L4L5 after i reherniated the disk again. The first partial discectomy that I did in 1999 was a success and I totally had no sciatic pain for almost 10 yrs ...except for the occasional back pain which started the last 5yr. As my MRI showed that L3L4 has annual tears and had a bit of protrusion, both docs agreed that I should stabilize it with a dynamic implant which still allows the joint to move while supporting it, this way hopefully I have total relieve of the leg pain and hopefully solve my back pain as well. Hopefully this will be my last surgery ever.

Any one who has done this type of procedure before? Or any success stories?
Most importantly...when can I start my rehabilitation? What type of exercises, intensity and how long and how to progress? Any impt. things I should take note of? Thanks

Your surgeons will provide you or your physio with a protocol which will relate to what they saw and what they did during the op. This will also be modified by the post-op course of recovery so it is to early to give you an idea on that.

In terms of fusions, I have seen many and all with good results. Of course that depends on the segments involved being the cause of the pre-existing problem. It does however sound like a useful thing to do at this stage, especially if there are unleylying fractures to the vertebrae causing inherent instability.

All my post op fusion clients have gone on to totally normal lives and are back skiing, show jumping and other hard core activities, many within 6 months. Skiing for some even earlier. I have only had one recent disc replacement and this did well, though after a review surgery as the artifical disc in the middle fell out and ended up in his stomach. He was however dropped onto the floor transferring off the surgical table. The stabilised it with a screw and now he is totally fine. I also think that his was an experimental proceedure at the time and you are probably getting the latest implant.

We wish you well for the op, sounds like the results could be excellent. Do keep us posted :)

Hi
I am back home today after my surgery on the 16. I was surprise that i could go back so soon. The first day was terrible was in a lot of pain but mostly due to the GA and the cut...however most of the sciatica pain was gone except for some numbness and aching pain...Started walking yesterday. Any advice on exercises to strengthen my stomach muscles and back in these early stages? Thanks

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Originally Posted by redferrari

Hi
I am back home today after my surgery on the 16. I was surprise that i could go back so soon. The first day was terrible was in a lot of pain but mostly due to the GA and the cut...however most of the sciatica pain was gone except for some numbness and aching pain...Started walking yesterday. Any advice on exercises to strengthen my stomach muscles and back in these early stages? Thanks

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Hi, is a good sign that you can get walk early. Enjoy your walks but not too vigorous since its still recent post surgery. Try to walk with straight back and tuck in your stomach is adequately in strengthening your back and stomach muscle for the first few days. Ok get well soon.

thanks... was wondering if there is any one who had this surgery done. Just wanted to find out how is the leg pain after surgery? My sciaitic pain on my left leg & buttocks before my surgery was 10. There was no pain in my right. I could not sit and had pain all the time.

After the surgery the pain was a 3. But the pain is diffirent....more of a deep aching pain like you ran thousand of miles...no sure if you know what I am talking abt.....I am also doing Rehab and using a brace (doc orders) Just wanted to find out if this is normal to feel like this? I thought the pain would go away completely like it did in my first surgery.

Quote:

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Originally Posted by redferrari

thanks... was wondering if there is any one who had this surgery done. Just wanted to find out how is the leg pain after surgery? My sciaitic pain on my left leg & buttocks before my surgery was 10. There was no pain in my right. I could not sit and had pain all the time.

After the surgery the pain was a 3. But the pain is diffirent....more of a deep aching pain like you ran thousand of miles...no sure if you know what I am talking abt.....I am also doing Rehab and using a brace (doc orders) Just wanted to find out if this is normal to feel like this? I thought the pain would go away completely like it did in my first surgery.

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I would say the Sx you are experiencing post surgery are pretty much par for the course. May be another way to describe the pain is like someone kicked you in the area pretty hard. It should con't to resolve with time and care. Your residual Leg pain may take a while to improve but should cont to do so.

I meant to post the other day re your post op rehab...

Normally I don't recommend any strengthening ex until the 3 week post op. The rest of the rehab will surround ROM and REcovery of ROM (range of motion). Walking as tolerated. limited sitting and bending. Walking for exercise about 2 to 3x/day if tolerate. Pain is your guide at this point...if you are walking and pain starts or starts to increase it is time to stop. If you are sittting and you get uncomfortable .... time to get up and move...

Good luck...

OPI

thanks for the well wishes. Its now 10 days after the surgery. I feel great. Taking things very slow and walking as much as I can without overdoing it. The pain and numbness is almost gone except when I wake up in the morning or when i over exercised. Wearing the brace everywhere....seeing the doc in 3 days time (2 weeks after op) to see my progress and check on the implants.