Off Topic: Spinal Fusion Input

Jo C.

Sorry to take this off topic. My DH is older; 81 and a Type II Diabetic. (He does not have dementia, but I feel a bit of concern re anesthesia effect on an elder.) He is scheduled for back surgery with Laminectomy and Fusions at multiple sites: L2,3; L3,4; and L4,5.

I am not greatly concerned re laminectomies, but do have quite a bit of concern re the fusions which are the greater challenge in multiple ways including long term outcome.

Have any of you or your LO had fusions within the spine? If so, I would like to ask:

What were the greatest challenges at home; both first days home and then a bit later?

What were some of the effective comfort and management measures at home?

What equipment either large or small that were very helpful?

Any advice based on experience that you can share?

Outcome, short term and long term?

Thank you so much for anyone with input; it is sincerely appreciated.

J.

harshedbuzz

I have a friend who had similar surgery in the lumbar region. I don't recall specifics for her aftercare as her DD took a week off to manage the aftercare. DD was an ICU nurse at the time-- lucky mom. Friend was considerably younger and very fit (walks about 5 miles a day, swims 4x/week, and was working as a lifeguard at 60) and did really well with it. She was back to dinners out with us in about a month.

One thing I do recall was that she elected to sleep on her couch for a couple months and that she needed an ADA-height toilet with arms.

HB

ETA: She lived in soft and baggy clothing for a while before getting back into her jeans and khakis. She wore a clam-shell brace for over a month.

PookieBlue

    Jo,

Every person’s situation is different. I had lived with severe pain decades having over 90% spinal canal narrowing and a very bad bulging disc. I had tried everything except surgery. The neurosurgeon was planning on putting in titanium screws and my recovery would take up to a year. However, I was sole caregiver for my DH and taking care of him would have been impossible under those circumstances. Plus, I would have had no one to take care of me.

My research showed that the vertebrae above and below the fusion would weaken and that recovery from the surgery is long and arduous. Personally for me, I decided the risk outweighed the benefit.

My sister (who had previously had her neck fused) said she would never do it again. She and I both had Regenerative Therapy for our chronic back pain. The outpatient procedure we both had was PRP Platelet Rich Plasma. They also treat these conditions using your own bone marrow which is more expensive so we chose PRP. I was only in bed for 24 hours and then back on my feet.

I had mine in Beaverton Oregon (Restore PDX) now located in Lake Oswego, and she had hers in Denver Colorado. Six months after the procedure my pain level dropped from a constant 8 to 10 down to a 2 and many days no pain at all

    PRP procedure was not covered on Medicare, but I was able to use my HSA Health Savings Account. It has been almost four years since my procedure and I still have pain free days. I have had to do more heavy lifting than I should as my DH is not able to help much so there are days when I overdo it, but any pain that results will subside if I make myself take it easy.

    I’m not certain how many regenerative clinics are available across the USA, but the centrifuging done is not comparable between clinics. The clinics associated with Regenixx I believe were the first and have the best results. I am so glad I opted against the screws in my back. 

Ed1937

Jo, I have no experience with that, but I do want to support you. Your concerns about anesthesia are understandable. I already told my doctor that if something happens to me, just let me go. I don't want to spend the rest of my life recovering from surgeries, or dealing with dementia myself. Sorry for what you're dealing with here.

Jo C.

Thank you to all who are kindly responding. DH's' surgery is full on go. He is in such painful dire straits it is awful. The procedure is robotic minimally invasive. Acute home recovery will be about six weeks with PT at home. Tissue heals earlier, but the fusion bone grafts will be completely solid in six to twelve months. He is expected to have immediate relief and complete restoration of legs from pain, etc. The back may have some discomfort from time to time after tissue healing, but not at this level. When researching the impact of fusion upon other healthy vertebrae, evidently the new technology and items used are far less likely to do that than older methods, but we shall see.

I of course, have my RN Mamma Mia genes in full gear. Have been making some purchases getting post-op equipment as much as possible. He actually bought himself a powered recliner/lift chair as back procedures post-op initially hinders rising from a chair; it can be painful for awhile.

It is hard on him. He spent decades as a police detective and is used to dynamically helping people and caring about them. So . . . here is this man who is used to "doing" for others and not being on the other end of things. Like Ed, he is very sharp and has always been able to do whatever, not easy for him to be dependent for a time. I do feel some concern re general anesthesia as his mother and grandmother both had Alzheimer's and as said, he is older.

I of course research till my eyes cross, BUT that is NOT the same as personal experience after such a procedure. Hearing from others regarding what was best helpful, what to avoid, and what brought most comfort is golden. And of course, support . . . . thank you; it is truly appreciated.

Thanks Ed for understanding where my heart and head are.

J.

Denise1847

I had a fusion and decompression of L2-S1 in 2021 and I am still walking around with pain during the daytime and neuropathy at night. I have tried everything except the PRP and stem cell and am researching those.

My recovery was rough with having to come home with a catheter because my bladder did not wake up. That was not expected. I had to go to a doctor for bladder testing and removal of the catheter a week later. He must learn how to turn without twisting in bed (log rolling). Lots of pain controlled by pain meds, constipation. He will need a walker, elevated toilet seat, shower must have grab bars and shower chair, grabbers (they give you these and a walker at the hospital). He may have drainage from the incision for a week or so requiring bandage changes. I was 70 at the time and the anesthesia and the pain meds really messes up your thinking. He will be able to go up and down stairs without difficulty. He will need a step to get in and out of an SUV, if that is your situation. He will not want to eat and probably be nauseated for a few days due to anesthesia and pain meds. Due to a loss of blood and everything else, he will be very tired for awhile. I finally resorted to Ensure or something like that because I wasn't getting enough nutrition.

I hope and pray this surgery is success for your DH. Living with pain is really terrible.

Ed1937

Jo, I wish the best outcome for both of you. When will the surgery take place?

M1

Hope it goes well jo. So many variables. My partner has had five spine surgeries related congenital scoliosis and dislocating her c2 vertebra by falling off a ladder. Biggest problems came from "adjacent segment disease" when she developed recurrent stenosis just below the original cervical fusion. Your dh will probably have to watch for that both below and above the fusion levels. Keep us posted how he does and wish him well from me....

Jo C.

Thank you. If I have not remembered to say how much I love the wonderfully kind folks here; I am saying it now. It is deeply touching to have such support and feedback. His surgery is on July 03. He is going to a pre-op instructional Spinal Class on Monday; the med center has an entire floor unit for spinal surgeries; all private rooms, and the floor has its own P.T. department which is good. He will also get OT. I researched his surgeon six ways from Sunday and he has an exemplary reputation, and stellar education. Turns out he is the Director of the Spinal Program and does teaching at UCLA and has done so at Harvard. He will be doing the surgery minimally invasive - Isaac Isimov style . . . robot! Got a three ring binder in the mail from doctors office today, chock-a-block filled with dividers and all sorts of information, instructions, and so much good stuff.

Denise, how long ago did you have your surgery? I am sorry for all that happened, it must have been awful for you.

We have a chair lift to the second floor of the house as we have a lot of steps and they rise mightily. I use it because of my knees; he always uses the stairs, but the surgeon wants him to use the lift for the first week or so. The master bedroom is huge, so I am planning it like his "apartment," until he advances in a week or two post-op. Been having deliveries to the house like a mad parade. He got his lift chair, a shower chair, a raised commode and oh my . . . a bidet . . . he will not be able to twist around, so bidet we went in the Master bath. Got grabbers for bathroom, bedroom, sitting areas, and leg lifter for car which is a sedan; luckily he will not have to climb up to get into a vehicle. Got soft easy-on clothes including elastic waist pants; slip on shoes, sock appliance for getting socks on, long handled shoe horn, small light plastic basket with handle for him to put beside himself in bed or in chair so he can place his items in it as he cannot turn his body for awhile, it will keep all next to him. He will get a walker at the hospital, so that will be coming. Has to walk every few hours. Frankly, I thought having a male nightshirt to wear for the first four days or so at home may do well as no pants to get on, but he will not even think of such an item. I thought being a pointer and not a setter, it would make the bathroom easier the first few days. Okay; I goofed on that one.

Got lots of extra pillows and little step-up platforms to use to elevate one foot when standing at a counter as instructed, or getting into bed or anything else. Other various items I am forgetting, but I was wanting to get everything into place prior to the surgery so Mr. Stubborn (love him) could get used to them being around. Got to get the bidet in so he gets used to that very soon. Still concerned just a bit about the anesthesia and dementia risk; will speak with the anesthesiologist about that. Well; we can see how J. is trying to control the uncontrollable - order more! Fix the room! Research till the eyeballs rebel! How funny it is; the RN is built for - "DO SOMETHING!!" If only I had two good knees.

Oh M; she fell of a ladder! What a force of nature she was and the dynamics were amazing in all she did and accomplished . Yes; I too feel concern about stenosis above and below fusion areas; that is a lot he is having done. What is surprising is that this week, the pain and disability has progressed severely and his legs are in horrible pain and compromised function; especially the right side. The upright man suddenly walking bent over and having to sit down every few steps. Talk about nerve compression! Celebrex helps very modestly, but even a little bit helps. However, it also makes him a bit whoopy-do cloudy. It is weirder than weird. He forgot the pill one day and though painfully paying for that, he was not at all cloudy. Some years back, I was prescribed Celebrex for my knees and it had a profound effect on my CNS. Whew, was I ever foggy, could not think clearly. I had to discontinue.

I will give DH your kind wishes, he will be appreciative. Thanks for listening and giving input. What awesome therapists you all are!

J.

Iris L.

Jo C, did you see my question about your DH using gabapentin for pain relief?

Denise1847

Hi Jo,

Your DH is one lucky man to have you. It looks like you have covered everything. You are impressive! My surgery was almost 2 years ago. Six months after the surgery when I still had pain, the surgeon said I had a "pinched nerve" and wanted to do more surgery. I went for a second opinion and the new surgeon said, "I wouldn't do surgery on you and please don't shop for a surgeon who will as there is one out there who will for the money." It sounds like you have a great surgeon and minimally invasive is the best (I didn't have that). Wish I had had you as my nurse😀. Good luck with the surgery. I feel for your DH and all of the pain he is in.

Ed1937

It sounds like you live in a round house, with no corners left uncovered. He is a lucky man. Not because he has problems, but because he has you. We'll all be waiting for the latest word on July 3. Just wondering - is this an AI surgery? I've heard pretty good things about that.