L-3 To S-1 Decompression & Fusion

I had L3 thru L5 facetectomy, foraminotomy, fusion, lamination & instrumentation (along with donor bone - the whole 9 yards) and I now have enough hardware in my back that I swear I pull 5G cell signals like crazy 😂 Just come sit next to me next time you need to get a strong signal 😂

All kidding aside, what I will tell you is that it went extremely well for me, however I was a wreck by the time I got on the table. I woke up one morning with no feeling below the waist, and before midnight that night I was beginning to recover in my hospital room. I was very fortunate that my neurosurgeon was available that day, since it happened the week between Christmas & New Years.

When you wake up from surgery, you *must* remember (and this holds true for any pain, not just this surgery) is *WHY* you are hurting. When there is pain, try to draw a stabilizing breath, and remember *why* you hurt. You will hurt because you had a big surgery. There is a long incision in your lower back so that your new hardware could be installed, and because of the fusion you will have to move differently. If you have arthritis, that may cause other pain because you will move a little differently after surgery. You will likely have a drain in the incision at first, and the stitches may feel weird, itchy or even tight.

It can feel scary when you have new physical sensations like that right after a big surgery.

Just remember why you are hurting and/or why things feel different. And know that the most kind thing you can do for yourself is to remember that it’s OK to hurt after surgery; that’s expected. Keep in mind that to get better, you will have to move; you need to literally get the blood flowing to help your bone graft heal. Get up, get out of bed. Go to the bathroom. Move as much, and as independently as you can. Use the walker; they don’t want you to fall, and as annoying as it can be, it’s for your safety, and to help protect you and your shiny new hardware. Follow all of your surgeon’s instructions - especially the part about weight limits on what you can carry and lift; you want your fusion to fuse completely, and that takes time and proper care for that bone to grow in.

The scariest part for me was the ride home from the hospital, but my family was prepared, and we took a nice, slow drive on city streets to get home, and they had plenty of towels from home to help me get in a comfortable position, and roll up to create bolsters to help hold me securely.

My healing time, and my experience is a little different than most because I have several conditions that conspire to sabotage my surgeon’s good work. Nevertheless, I am a success story because my neurosurgeon and my rheumatologist worked together to support me through my healing process.

I was very fortunate; I recovered my sensation, and afterwards I was still able to walk. My surgery was literally 3 years (almost to the day) ago, and while it was scary to think I had to have emergency surgery, I had a very good outcome. My bone grafts all fused perfectly, my hardware is still exactly where the surgeon put it, and so far (knock wood) I don’t have to go back for another round yet. (next time higher up; they tell me it is all but inevitable) But I worked to make sure that my success happened. I self-managed my pain, and used all of my coping skills, logic and determination to get back up out of bed, and keep going.

You can too.

Good luck.

Edited to add a bunch of stuff I thought of today:

In case you were curious, I was 60 years old at the time of my surgery.

It's OK to use pain medication post-surgery. I was shocked that I didn't need it as much as I thought I was going to. The stitches were more of an annoyance than anything, and as soon as they removed the cath - even while the drain was still in the incision - I was getting up and walking around, going to the bathroom, taking increasingly longer walks in the halls. For me, the procedure relieved other pain that was significant, and so waking up after surgery and not have that pain made the surgical pain feel less significant.

Because it is a major surgery, you will most likely have to measure urine output for at least a day or two, and you will have to be able to move your bowels as well before you will be allowed to go home.

You will most likely be given a GIANT back brace to wear at the hospital. Follow the instructions carefully, and wear it as prescribed; it's important. If they send a walker home with you, ask for the PT department at the hospital to come and make sure it's the proper height for you; it makes a big difference.

My first post-op appointment was 6 weeks after surgery; I was not allowed to lift or carry more than 5 pounds for approximately the first 3 months, and not more than 10 pounds for the rest of the first year. You will be x-rayed at every post-op appointment to make sure your hardware is still in place and has not shifted.

I was not allowed to drive a car, or ride in a car for the first 6 weeks (not counting the trip home from the hospital). It's because they don't want you to operate a vehicle under the influence of pain meds, and also they don't want you to be in an accident during that time since it could literally wreck your back permanently.

Pro tip that I wish someone had told me: Get an all-cotton pullover bra (no metal of any kind) for x-ray day - or - a tight fitting cotton t-shirt works as well.

If you have someone to help you (spouse, adult child, sibling, paid caregiver) plan in advance to make your post-op life at home as easy as possible. Bring things down from upper cabinets, and bring things up from lower cabinets. Make a clear path for the walker you may need to use around the house. Everything you can do to prepare before will be something that post-surgical you will really appreciate after!

Last thing I wish I knew before surgery: Front closing bras will be your new best friend; get a couple before surgery. A close second will be soft, roomy elastic waist pants/shorts, especially for the trip home from the hospital and for your first couple of outings after, including your first follow up visit.

Let us know how your surgery went!
 
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Thanks for your reply & tips.........And words of encouragement.

What were your symptoms pre surgery? Did you recover from them post surgery?

Thanks!
 
I had no symptoms that had been attributed directly to that issue; ironically, I had an appointment booked with my neurosurgeon for him to look at my recent x-rays to see if he thought it was time to do the surgery. We were originally scheduled to meet about 4 weeks after my surgery.

About a month before the appointment, I woke up that morning with no feeling below the waist. None. Oddly, I could still walk, and toilet, but I could feel nothing. (It was the weirdest thing I have *ever* experienced in my life). Needless to say, I did not pass “Go”, I did not collect $200 - I went straight to the ER, and was taken almost straight to surgery, with only a stop at the MRI.

After the surgery, he told me I was very lucky; most people who have such a sudden, complete onset don’t have a complete recovery. And they literally have no explanation for how I was still able to walk and toilet independently that day; by all reckoning, I should not have been able to.

I was completely recovered when I woke up in my hospital room. I had full return of sensation, and no other symptoms.

But I cannot stress this enough: My experience was *my* experience. What happened with me was a fluke, a one-in-a-million thing. Not everyone gets back full sensation. Not everyone gets rid of all the tingling, or shooting/burning pain. It just depends on a *lot* of factors.

Please listen to what your surgeon tells you - if, for example, they want you to discontinue a particular medication before surgery, do it. If they want you to do a certain series of exercises prior to surgery, do them the very best you can. If they tell you to only eat blue jello… maybe ask why, but, sure… do it. Give yourself the very best chance at the very best outcome.

Also know that how your body handles the intrusion of surgery - mostly the resulting inflammatory hit - can reflect on what you experience when you wake up after surgery. Even without my usual anti-inflammatory medication, (which I had to discontinue for 6 weeks post-surgery) I self-managed my pain with mindfulness & extra-strength Tylenol.

As much as we both wish I could, I can’t predict how things will go for you, or what your outcome will be. I can only tell you how it went for me.

Your mindset will have an impact on how quickly you recover, how your pain is managed and how you go forward after surgery. Give yourself the gift of optimism and positivity. It can go so much further than you can believe!

You’ve got this!
 
Thanks Again for your reply.
My surgery got pushed back-again-till 1/12/24.
Anyone else with a similar surgery that wants to share their experience?
Thanks Again.
 
I had a L4-L5 laminectomy, Discectomy, and decompression almost a year ago. No fusion. I’m pretty young (30s) and woke up one day with total numbness, weakness, and burning in my leg. I was in so much pain! Multiple physicians said it was one of the worst herniations they have seen. Surgery went great and I was at WDW 2.5 months later.

I still have some numbness on the inside of my foot. They think it won’t come back at this point but it doesn’t affect me.

The hardest part of recovery is the restrictions. No driving, bending, lifting etc for several weeks. Follow your surgeons pain management plans and complete any physical therapy ordered! I’m sure it will go smoothly.
 
I had a L4-L5 laminectomy, Discectomy, and decompression almost a year ago. No fusion. I’m pretty young (30s) and woke up one day with total numbness, weakness, and burning in my leg. I was in so much pain! Multiple physicians said it was one of the worst herniations they have seen. Surgery went great and I was at WDW 2.5 months later.

I still have some numbness on the inside of my foot. They think it won’t come back at this point but it doesn’t affect me.

The hardest part of recovery is the restrictions. No driving, bending, lifting etc for several weeks. Follow your surgeons pain management plans and complete any physical therapy ordered! I’m sure it will go smoothly.

Maybe it’s something in the water here in Oklahoma… 🤔
 



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