[Renee123]

#24514

Thank you! and of course, I understand that this is your protocol, however I have found that you protocol is usually in line with the surgeons who have the best success!

Are you referring to a medrol dose pack for 5 days or oral steroid with a lower dose? Also, can oral steroids inhibit fusion growth early on ? I just want to be able to rehab/walk without pain.

Last, if hamstrings get tight, how do you suggest keeping them loose ? Is sitting in a chair and raising leg to stretch an acceptable method?

Thank you again!!!!

[Donald Corenman, MD, DC]

#24519

I use Decadron 4mg twice a day for five days. It is a powerful steroid but with a short course. Theoretically, steroids should inhibit bone growth but with such a short exposure, it does not seem to affect the fusion. I would not raise the leg unless you are sitting and you can use a towel under the leg to bring it up with your arms. Just don’t bend forward as you do that as that would flex the lumbar spine too much.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[biofreeze]

#24521

Thank you !

Can you please tell me how I could get back and leg pain pain on contralateral TLIF side without having these symptoms prior to surgery ?

How common is this ?

[biofreeze]

#24522

Also. Please note. The pain worsens with walking and siting on hard surface. The pain is not continuous.

[Donald Corenman, MD, DC]

#24523

First, the TLIF is generally performed on one side and that side typically is the nerve root compression side. I will assume your initial painful buttocks/leg side is the side of the TLIF. Was the opposite side addressed with a decompression? If so, nerve manipulation can take 6 weeks to “calm down” You can find that out by asking your surgeon or from the operative report which every surgeon has to dictate and complete within 24 hours. I always send this report to the patient but if you don’t have it, call the hospital as they have to release all your records to you.

If the opposite side was not addressed surgically, there are three possibilities. One is that there is canal seroma (fluid collection) which happens to some patients post-op and takes 3-6 weeks to clear. The second is that the nerve was stretched by the size of the implant and most of these calm down in 3-6 weeks. The last possibility is that the screws placed on that side could be somewhat proud and causing some irritation to that nerve root.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[Renee123]

#24525

Please forgive all of my questions; the surgery itself went very well, however I just need to get past this hiccup.

You are correct, the decompression and nerve retraction was done through the right side (symptomatic) side and for right now, that side feels fine.

If you are a referring to a decompression of bone on the left side, that was not done. I was told cage was put in through the right thereby opening up the foramina on the left as well. Surgeon did not want to remove bone on left because I have had no leg symptoms on either side; I would have expected a problem on the right so this now seems like a mystery.

So now that we have established that the opposite side was not “addressed surgically” how can I diagnose and determine the best treatment for the below?

1.) How could a nerve become stretched by the size of the implant? Left side nerve was not retracted.

2.) Is there a way to diagnose and treat canal seroma? They told me n hospital there was none, but just looked at back and felt around.

2.) What do you mean that the screw is “proud?”

Sounds like all of the above would be treated by oral steriod or perhaps lyrica ? This is very nerve racking because once again, everything else was going smooth. I noticed this problems started in the hospital after taking a longer stride from walking with the walker after surgery then progressively became worse after coming home and sitting on a hard bar stool that I have in my kitchen.

Thank you so much; this is obviously something that I do not want to turn into a chronic problem or effect my rehab!!

The more detail you can provide would be most appreciated !!! I will be following up with surgeons office in the AM, but usually just get to speak to the nurse!

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