Revision of my lumbar fixation

[peanut911]

New to this site, can't find any answers so i though i'd give you a try, i had a morley webb fixation with metal work in 96 i had spondolilothesis a forward slippage of over 50% of the spine at L5/S1 although this made pain easier it was 3yrs before i felt human again, 2yrs ago pain started to worsen again, went for pain management have had lots of tests including cat scans &  mri they found i had quite a bit of nerve damage but this does not correspond with my pain which is on opposite side to nerve damage have had nerve root injection which helped for a few hrs but the pain returned the next day, my consultant has discussed the option of surgery & revision of my lumbar fixation which i may add i'm not keen on, he has placed me on a waiting list for a caudal epidural as it's a simple intervention i have agreed, i was advised to read up on revision lumbar surgary but as yet i have found nothing relevant to me... anyone out there got any thoughts .

[opus88]

Oh course all the best of luck to you....
Opus

[peanut911]

Hi Opuss88, please send my best wishes to kittyluv1, wishing her a good recovery.

thank you for your message i to have lower back problems along with my C spine, i'v just heard i have a appointment to have the metal screws removed in january from a spinal fusion i had nearly 14yrs ago, fingers crossed ....... next appointment for my C spine is in Nov my meds are co - codamol 30 mgs and paracitamol & nurofen when needed, also have just started taking pregabalin 50 mgs it's taken me ages to get a better drug this one is supposed to block the pain signals to the brain? have started with one a day for 3 days then 2 a day and so on till i'm on 4 a day, wish me luck, take care.x

[opus88]

hi I am so sorry for you're pain and lack of info in the UK
I have similar issues but with my lower back...I have read up on the injections and have decided not to try this approach.
Abt the only option I had was pain control, are u getting something for the pain?

I'm afraid Kittyluv1 is currently unable to answer you're post, from my understanding she has had extensive surgery herself and may be away from this post for awhile yet.

suggestions:
try googling 'cervical pain' or 'spinal pain' and follow the links for info
or try the website my pain management doctor referred me to www.painexplained.ca
you should also try the PAIN MANAGEMENT community on these forums, you would find alot of people there with similar problems.

good luck

[peanut911]

Hi again, had the caudel injection, no effect if anything it made things worse, am now on waiting list to have screws removed as they are steel screws & not titanium like the rods these can apparently cause irritation, & to cap things off i also have a problem with my neck i have a C5 right root compression with degenerative changes in facet joint at C4/5, C5/6 & C6/7 i have had C5 nerve root block combined with facet joint injections twice, but neither has worked, is it possible one is effecting the other as i'm in constant pain, what else is there if these injections are not working.

[peanut911]

Thankyou for your quick response, i live in the UK so we don't get as much information as you so i don't understand much technical jargon, my op was done from the back ....other surgery would be done from same site, my pain is constant aggrevated by anything out of the norm which is basically everyday housework, if i need to go shopping or do the garden then i suffer, i can't take most drugs i can only take cocodamol 30mg which is pretty useless and tends to make you constipated, during the day i take 2 paracetamol plus 2 nurofen together usually twice a day, i also take adcal-d3 For my bones & high strength chondroitin/glucosamine 3x a day, i'm feeling really down & seem to get no where as i don't get told what i need to know even though i ask, i also have trouble with my neck, i have a c5 root compression with degenerative changes in facet joints at c4/5 c5/6 c6/7 which again is constant pain, i agree with you about the caudel injection, would be grateful if you could give me the info you mentioned on article of revision surgary what concerns me is does it make a difference that i had mine 14yra ago and most people i found have had it within a yr of there instrument fixations, my dr says he can't see whats going on because of the metal work and what he can see looks fine but it does not explain the indent in my spine above the fixation the pain i get from there, he called it a lordosis, but did not explain even when questioned, my appointment for the caudel is 29th june so i will let you know how i get on.  Thank you again.

[kittyluv1]

I am sorry to hear of your recurrent problems following your fixation surgery.  Was the initial surgery done posteriorly?  I ask because I did find an article addressing lumbar fixation revision surgery that might help answer some of the questions you might have regarding secondary surgeries.  It was written for the Journal of Neurosurgery regarding outcomes of revision surgery.  A bit of technical language, but relatively easy to understand.
I gather from the article that revision surgery is occurring more frequently following posterior fixation (so don't feel alone in this complication).
The article states that revision surgeries tend to have less favorable outcomes than first time surgeries with the risk of additional scar tissue formation etc.  Based on the fact that your initial surgery had a recovery period of 3 yrs., I can understand your hesitation to have another surgery at this time.  Has the doctor told you the exact procedure he wishes to perform?  Does he want to try another posterior approach or do an anterior approach to lessen the risk of scar tissue formation?
Deciding on additional surgery is a very personal process and perhaps needs to be evaluated based on your current level of pain and your current activity level.  If the pain is compromising your ability to function, additional surgery might be appropriate.  
Being a post cervical fusion patient myself, there is always the risk of additional surgery being needed at a later date.  My initial surgery had an excellent outcome and my recovery period was without any significant complications.  If additional surgery was needed for me, I would probably not hesitate based on my personal experience.
In your case, it might be advisable to try the caudal epidural as a best and least invasive alternative.  If you do not have good results following the epidural, surgery can be considered again at that time.
Whenever there is evidence of significant nerve damage the potential for improvement may be less than hoped for due to the length of time the nerve tissue has been impaired.
If the doctor feels that your spine is well stabilized and there is no evidence of any further slippage, the nerve damage appears to be the driving force regarding any surgical intervention.  
Not sure if any of this helps you -- just wanted to let you know we can empathize with your situation.
Post with an update and let us know of your progress ----