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Back Problems Message Board

Back Problems Board Index

I see the problem with having to return to work. Everything I was going to write is really rather pointless because I think it is highly unlikely you will be able to recover further once you go back to your current job. And I also know that with the economy being what it is, people don't have the option to find other employment that would be more beneficial to their spines. But, I'll ask there any way your employer could switch you to a different position or modify your job so you aren't standing on concrete all day long?

I am not an expert on bone scans but I think it highly unlikely that it would reveal scar tissue. Scar tissue is soft tissue, made up of MRI is the best way to reveal it...but at this point, I doubt that is your main issue. I hope not because there are no good ways to deal with it.

For a couple years I was convinced scar tissue was causing my issues and I feel that I checked out all possible procedures, met with a variety of specialists, etc. and have followed various discussions on a variety of boards on this topic. There are no good options for scar tissue. There is no point in having surgery just to remove scar tissue because it will just grow back. Research is being undertaken all the time on various barrier products that a surgeon could use to prevent the scar tissue from making attachments (this is where the problems come in -- when it attaches or wraps around a nerve or organ)but thus far, nothing has proven to be effective long term.

Scar tissue is nature's way of filling a vacuum. Whenever something is removed, the body begins to lay down collagen in an attempt to fill up that hole or empty spot, or to protect that area. If the collagen fibers grow in all going in the same direction, it is like the tissue around it and doesn't cause problems. But if it grows in going in all directions, there are long tendrils that stick out every which way and it can begin to cause problems. This is an extremely simplistic explanation of how scar tissue can become a problem...but it helps me to understand the process.

I don't think scar tissue is your main problem. I think you've never had a chance to recover completely from the surgery. You've irritated the area as the months went by, probably resulting in inflammation. This is a vicious cycle. When the nerve is irritated, even after surgery, it sets off a whole chain of events that usually just lead to more pain and aggravation. It can become a chronic condition where the nerve itself can become scarred. When this happens, it ceases to be able to function in a "normal" fashion.

Not that it matters at this point, but I am surprised your surgeon would let you play golf so soon after your surgery. I think it is entirely possible that you have damaged the L2-3 segment, some component of it. It is primarily the L2 and L3 spinal nerves that innervate the quad and cause pain on the front of the thigh.

When someone is fused, particularly at more than one or two levels, the next segment that is able to move is forced to carry the brunt of all movement that body is making. The spine is not designed for one segment to have to take all the stress so it results in additional wear and tear, particularly to the adjoining segment. At the bottom, people often develop SI joint problems because the sacrum itself is fused and cannot move. The SI joints are the first moveable segment at the lower end of the spine. Your L2-L3 would be the next segment on the upper end.

Just to give you an idea of another timeline...I had a 3 level fusion a year ago June. It was my 3rd surgery. Surgery #1 was PLIF at L4-L5 which was successful, but did not resolve my pain. Surgery #2 was a foraminotomy at L5-S1 that I knew might or might not resolve my issues...but I felt it was worth a try. The recent surgery was L3 to S1, with reconstruction of the facet joints at L3. Both my surgeon and I regarded this as my last chance to resolve my issues. There wasn't anything left to do if this didn't work. As a result, my surgeon was extremely conservative with me. I wasn't allowed to do anything but walk for months. When we went on vacation in Aug. of that year, I was not even allowed to wade in the lake, let alone swim.

I started PT in Sept. took the month of Oct. off (but kept walking) and resumed PT in Nov. My therapist works exclusively for my surgeon, and has for 18 years. He has his PhD and teaches at the local university where I live. He was under strict orders from my surgeon to do NOTHING that irritated my nerves, particularly my sciatic nerve. As a result, working with me was very frustrating. When I finished in Dec. I ended up with fewer exercises than I started out with. We agreed that I would just go back to walking and not worry too much about doing stretches and strengthening at this point. That winter my plans got off track when due to a family situation, I ended up across the country. I didn't really get back to my home on a regular basis until August...when I decided to go back to PT. At this time (14 months post fusion) I was able to do more --the therapist could do a couple things without fearing my SI joint would shift out of position or my piriformis would be aggravated, etc. I was now allowed to swim on both my stomach and back...very exciting.

So, now we are up to date. It is now 17 months post surgery and I am still recovering, still making progress, and when I do too much, or conversely, when I don't do enough and sit too much, I can feel the difference. But everything is very manageable. I haven't been on any pain meds since 11 days post surgery. I suspect there will always be things I cannot do without them resulting in some pain....but I can now walk as long and as far as I want. I can stand without pain. I basically have no leg pain....Back pain was never a big issue for I am very pleased with my results. But, look how long it has taken...and I am still healing. My fusion is not yet considered complete. And my surgeon plans to x-ray me every year to see how the adjoining segment is doing or whether it is showing signs of degeneration.

Before my first fusion, I was a docent at our city's art museum. Walking or standing on the marble floors contributed to my initial issues, and on the advice of my surgeon and physical therapist I have decided not to return. It just isn't worth it to me.

Obviously if this were my employment, I wouldn't have a choice and I imagine, I would gradually develop nerve pain.

I guess I really don't have any point to telling you my story. I am surprised my recovery has taken this long and that I am still making progress 17 months later. I do believe that many surgeries that ultimately could have resolved an issue are only somewhat successful due to choices made during recovery (often choices beyond the control of the patient, too.)

Sorry this is long and rambling without really coming to a conclusion...but perhaps my experience will give you some things to think about concerning your situation, your recovery...maybe it will help in some small way.

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