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    Bone Fusion Surgery
    delyour posted:
    I had bone fusion surgery on June 25, 2012. I have been dealing with lower back pain and sciatica since February 2011. At first my doctor's discovered a herniated disc at the L5-S1 level. My doctor's suggested therapy. They were against back surgery. However, the pain got worst. My primary care physician recommended a neurosurgeon whom she knew personally. He discovered via an MRI that my spine was slipping and was causing most of my pain. He said the only way to fix the problem was via bone fusion surgery. He also said I had bone spurs and of course the bad disc. I am eighteen months post op and I have the same pain as I did before surgery. The only improvement has been the fusion and my spine is not slipping out of place anymore. I worked hard in therapy over the last year and half. I have been on a pain management regiment. I even took the epidural recently and the pain did not subside but my pain med doctor once to do a series of three shots. I am not interested. I exercise everyday. I am still in physical therapy. My issues are I cannot sit for long periods of time. I cannot ride in cars, trains or buses without exiting in extreme pain. I see a psychologist once a week because I have become angry and disappointed in how this surgery has changed my life. I am a 48 year independent filmmaker who cannot even walk over an hour or sit for more than 40 minutes. If I get aggressive in therapy or sit, walk or stand longer the pain becomes unbearable. There are times where I just want to lie on the ground. I do not sleep well at night unless I take a motrin or vicodin depending on the level of pain to cut down on the pain to sleep at night. My biggest concern has become the pain in my left buttocks/hip where I can barely put pressure on my foot to walk. I don't know what to do. I have done tons of research and one thing points back to Failed Back Syndrome. My PT also thinks that my scar tissue is not loosening enough to try and be more aggressive in therapy. She has tried deep tissue massages but its so painful I can stand for her to touch me. I have been in aqua therapy as well. Does anyone have any suggestions or is this what I to look forward to the rest of my life. - Delyour - Tired and in pain
    cweinbl responded:
    Sorry to hear about your continued pain. I've had a similar experience, after three disc herniations, four failed spine surgeries, DDD, advanced osteoarthritis, massive fibrosis, central canal stenosis, osteophytes and collapsed vertebra. I'm now in intractable chronic pain and I'm unable to sit or stand for more than a few minutes.

    The success rate for spine surgery today is about 60%. I'm guessing your surgeon didn't tell you this. But it's true. You can read about the efficacy of all major forms of spinal interventions here:;12;699-802.pdf . You'll see the deplorable failure rate of spine surgery.

    Scar tissue (fibrosis) can adhere to spinal nerve roots. This can cause at least as much pain as before your surgery. Technically, you can remove fibrosis with surgery, although it's considered unethical because at least as much will grow back. There is also a procedure called Lysis, in which a caustic substance is injected into the thecal cavity. It's rarely successful.

    One can also develop a bone spur after spine surgery (osteophyte). The only way to deal with that is to surgically remove it. But the osteophyte might be too close to a nerve root or the surgeon might have to remove your fusion to reach it. As you might imagine, the outcome might be worse than you have now.

    Injections rarely help long-term, as you will see from reading the research above. Sometimes a needle will impact a spinal nerve root leading to a permanent increase in pain. This happened to me.

    I went through two comprehensive pain management programs; tied every possible non-invasive treatment, including systematic relaxation, meditation, Yoga and biofeedback (I can reduce my pain by about 15% at any time with biofeedback alone). You can try acupuncture, hypnosis, PT, kinesiotherapy and TENS. Try every possible combination of long-acting and short-acting medications (in combination). Try off-label drugs, such as Gabapentin and Pregbalin. Definitely use an anti-depressant, because it will reduce the reuptake of plasma serotonin, which is one of the body's own pain-fighting chemicals.

    The best resolution is often a result of using a wide variety of the above-mentioned treatments at the same time, especially with a long-acting opioid (Kadian, Oxycontin, Fentanyl Transdermal, etc.) AND a short-acting opioid (Hydrocodone, Oxycodone, etc.) for breakthrough pain.

    Few of us will be pain-free. We'll have it for the rest of our lives. The solution is to manage pain, so that we might be able to handle a few of life's daily activities.

    Finally, being in chronic pain is an exercise in perspective. I was a vocational rehabilitation counselor for 7 years. I worked with paraplegics. quadriplegics and people with terminal illnesses. Many of these people will never be able to live at home, sit, stand, walk, feed themselves or care for their bodily needs. I might be profoundly disabled and in constant severe pain, but at least I can do everything mentioned above. I'm the lucky one.

    Visit a local nursing home or rehabilitation center and spend a little time with those poor horribly disabled people, unable to do the simplest things that we take for granted. Then, your perspective will improve.

    We live in an age of miracle cures and modern medicine. But spine surgery still has a deplorable success rate. Those of us with a bad outcome are left to deal with a career unfinished, chronic pain, less income, fewer friends, less excitement, lost hobbies and a reduction of normal family life. But we're still light years ahead of others who cannot sit, stand, walk or care for themselves..

    Good luck.

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