MASpinept

Ok thank you, I will work on getting something set up.

I think the specific, stabbing back pain is more noticeable, the leg pain in consistent to what it has been in L5 and S1 but it’s more distinct through the front of the leg and knee. I thought it was a screw, especially on the left side of the back, which was causing pain over the past several months. But when I pointed to where it hurt the spot is above the screw in L5.

Looking forward to getting your interpretation of the images. Thanks again.

Well it’s variable; I would say the leg pain and back pain can exist together or apart and aggravation and pattern is not consistent between the two. The right leg I have frequent nerve pain from buttocks to toes, mostly L5 and S1 (and this is chronic damage from the multiple injuries and surgery, I never expected that this pain would go away even after the fusion). When I am active I get symptoms more on the front of my leg and into my big toe, sometimes this happens on my right toe as well but does not follow such a specific pattern on the left leg.

For the back pain, it’s always best in the mornings and by about 2-3 pm it starts getting worse, evening and night time are very uncomfortable. I try to walk 1-2 miles daily even now, despite having had to peel back most of my activities. At first I feel fine during exercise and then I start getting pain that feels directly in my spine, sometimes it will spread out like a cross but not always. Lately I get very specific sharp pain that feels very close to the top left screw, this is definitely bone pain and it doesn’t radiate too far from that spot. Immediately after being active my back feels locked up. Once I stop moving and then as the day or evening go on my back just aches and aches, it feels like the area around the screws, sometimes it feels hot and inflamed. I can feel the screw heads very easily when feeling my back, it hurts to lay on hard surfaces so that is how I am able to tell where they are, if that makes sense.

The night when the pain is very bad it feels like a combo of pain in my entire lower half of my body. It feels like throbbing pain in my spine that goes down to my tailbone, then it will involve my hips and radiate down to my legs as well, but the leg pain associated with this isn’t the specific nerve pain, but sometimes that specific nerve pain is there at this time, as well. Additionally I get a lot of muscle twitching and restless leg feelings (also something I am not expecting to ever go away).

The worst activity is running, which I have stopped doing since the summer. Although now horse back riding, specifically posting at the trot, has become very painful and almost not worth it, I have basically stopped that as well. Peloton is the only exercise that doesn’t cause a lot of discomfort after.

Sorry this is so long winded, just trying to specific with the pattern of pain!

In your experience is it likely that fusion growth continues beyond 12 months? My neurologist performed the EMG today, he said there is not continued acute compression but there is some chronic nerve damage to L5 S1. He feels that i have continued spinal instability and that my sx are related to irritation caused by this instability. He said his interpretation of the fusion is that there is “some bone growth there but not enough.”

There are conflicting opinions on my exercise/activity amount-neurologist says stop doing everything for the next couple of months to see if that will help the fusion growth (although he admits this may not make much of a difference), neurosurgery says no restrictions as there should be a stable joint.

I don’t have the follow up with neurosurgery until the end of October- roughly 14-15 months post TLIF-is it reasonable to expect a decision on if a revision surgery is needed?