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  • THR
    Participant
    Post count: 5

    I had a TLIF performed on L5-S1 on October 2, 2020. After most of the surgical pain and different feelings created by the surgery and incision healing had subsided, I have the original pain I started with. The muscles on the right side of my back stiffen and I still have the sharp pain I had pre op. I still avoid BLT and wear my brace when I am out of bed to help avoid BLT. I was told the results of the discogram I had indicated disc L5-S1 was my pain generator but I do not remember anything from the procedure. I do not know any information on how my L4-L5 reacted during the discogram. I do understand my muscles will have quite a bit of changing to do when I get to the physical therapy phase of recovery, but do not understand why the pain has returned in my right lumbar. It occurs when lying and sitting as it did before. What could be occurring? I have read how some surgeons do not remove the entire disk when placing the spacer with BMP, could some of the disc that was causing pain still be within the L5-S1 cavity and be irritated by the bone growth of the fusion? I am currently upset with myself for even having this performed as I have had no success with any treatment we have tried throughout the years. Thank you for your time.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    I will assume that you had an appropriate work-up and that L5-S1 was the discographic pain generator and L4-5 did not cause any pain.

    You are only 6 weeks out from your TLIF. It takes at least 3 months for the bone graft to “get sticky” and start to adhere the two vertebra together. Especially if you pain was endplate generated, the cage sitting on your endplate is only going to create discomfort. Give it six weeks to start to bond and please report back here.

    Dr. Corenman

    THR
    Participant
    Post count: 5

    Dr. Corenman thank you for your reply. I do understand what you explained, I wouldn’t have worried so much if this would have been mentioned post op. I will follow up with my progress. Again, thanks for your time and explanation.

    THR
    Participant
    Post count: 5

    Dr. Corenman,

    I wanted to follow up with you on how I have been feeling. I am working on scheduling my 12 week visit, I have to send in my imaging this week. The pain that I have had hasn’t changed, it has become more sharp. The last appointment I had in office with your PA he sent me home with a physical therapy script. I started physical therapy the same week and have been going 1-2 times a week (December 18 I started). My right leg thigh muscle has been going numb since December 28th, it was off and on the whole week up until New Years. Starting 01.06.2021 it has been numb continuously, it isn’t bad enough I can’t walk but I do feel like I have a phantom leg because of it. I will see if the office will schedule me to have an appointment with you, but I haven’t had any luck and only get the PA’s.

    Thanks for your time.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    PAs are OK as I discuss everything with them and during Covid, I have to wait until my vaccine catches up to see patients.

    Based upon your symptoms, a new MRI is warranted.

    Dr. Corenman

    THR
    Participant
    Post count: 5

    DR. Corenman,
    I’m not sure if it is appropriate to continue on this or create a new thread. October 2 will be my one year anniversary for my TLIF L5-S1. I am continuing to have pain. When I lay down it is still prominent on my right side. Sitting and working it will vary on which side. Currently sitting in my recliner with my right leg crossed over my left I feel the pain in my left side. (Lumbar where my original pain has been). I still avoid sitting as it triggers the pain, in my vehicle I use a purple brand seat cushion to raise my tailbone to be more level with my knees. With or without using it the pain is still the same.
    At work I will take my lunch break in my service truck and after 30min when I get out of my truck my lower back muscles are on fire and I am very stiff. I don’t let it slow me down, moving is still the best thing to keep the pain at bay or minimize it. I still struggle to fall asleep at night due to the pain. I do not know if my muscles are the cause of this pain. After surgery one of my prescriptions was Diazepam 5mg. This seamed to settle my muscles. I used it very sparingly because my body has a tendency to somehow block the effects of medication over a short period of time. I did have my family doctor to refill my prescription and use it when I’m about ready to loose my mind at work because of the pain or when I absolutely can not fall asleep at night. (We have tried prescription sleep medications up to higher doses and the effectiveness wears off after a week).
    I do remember the term “tennis elbow of the buttocks”, the pain has never radiated that low. If I am standing in a control room waiting for instructions from an engineer I will sometimes have episodes where I either get a sharp pinch where I slightly “bob” down due to the pain. I had this issue pre-surgery as well. I will tense up my back muscles and twist or bend side to side and normally get a pop and some relief.
    I do feel sturdy and not weak in my fusion area, but my muscles or something is still not working correctly. I am very active (not as in sports) walking up ladders silo/tank stairs +/-100′ climbing piping, equipment and walking around facilities all day with an average round trip commute of 2 hours pavement and dirt roads. Since being released back to work on May 11 my work days are a minimum of 10 hours with longer days being 16 hours.

    Thank you for taking the time to help all of us who have been struggling with chronic pain.

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