Sunday, June 21, 2020

Spinal Fusion Surgery

Two weeks ago today, I was released from the hospital following spinal fusion surgery, and I couldn't be happier with the outcome.  It seems to have been completely successful (so far), and I am recovering nicely.

I have experienced lower back pain since I was 29 years old, and have been in almost continuous chiropractic care since that time.  Even though I had fairly significant subluxation in my spine, the combination of exercise, stretching, and chiropractic care enabled me to function normally and to minimize pain most of the time.  I was even able to re-join the Army Reserve and complete several overseas deployments without chiropractic care, due to my intensive routine of yoga-like stretching and exercise, including a number of exercises from Matt Furey's books "Combat Conditioning" and "Combat Abs".  I very highly recommend these books to anyone wishing to maintain extreme functional fitness:

Matt Furey's Website

As I got older, however, the underlying physical condition of my spine worsened - in particular, several of my disks degenerated to the point where no matter how much I stretched myself back to where I could function, I continued to experience pain.  The replacement of my right hip last year relieved a significant amount of the pain I had been experiencing, but also isolated and brought into focus the remaining problems in my spine. Due to reduced space between my vertebrae and the consequent pressure on various nerves, I was beginning to experience sciatica and to lose strength in my right leg, among other physical problems.

I consulted my physician, and after x-ray and MRI analysis, he strongly recommended that I consult with a neurosurgeon about spinal fusion surgery.

Anterior X-ray of my spine before surgery.

Lateral x-ray of my spine before surgery.

I was referred to the Axis Spine Center in Coeur d'Alene, Idaho, and consulted with Dr. Daniel Blizzard.   His background, demeanor, and the information he discussed were tremendously reassuring. Dr. Blizzard recommended that in order to stabilize my back, I should have five vertebrae fused - L2 through S1.  

The idea behind spinal fusion is to a) restore the normal orientation and spacing between the vertebrae (to the extent possible), b) stabilize the bones in this position, and c) cause the bones to grow together (fuse) into one solid bone.   Depending on how extensive the fusion, you lose some flexibility but preserve nerve function and reduce or eliminate pain.

L2 through S1 is a very extensive fusion (five bones), and would require what amounted to three separate operations over a 2-day period.

For the lower two fusions, he would perform an ALIF surgery:


For the other fusions, he would perform an XLIF surgery:


These surgeries would both be performed on the first day.  Then, after examination to ensure that the pressure on the nerves was sufficiently relieved and the spine was as straight as it could be, he would go in from the back on a second day of surgery to insert rods and screws to stabilize the spine in its new orientation.

I decided to take his advice and schedule the surgery.  Axis Spine Center performs their surgeries at Northwest Specialty Hospital in Post Falls, Idaho.  We originally scheduled the surgery for April 9th and 10th, but as the dates approached, the uncertainty surrounding the COVID-19 pandemic and its effect on the medical system required that my surgery be cancelled.  Even though this is a specialty hospital, for this extensive a surgery they require that an ICU be available just in case of complications.  ICUs were being reserved for acute cases, and were not available for elective surgeries.  So we had to wait.  Finally the surgery was scheduled for 4-5 June, and went ahead at that time.

I had to stop all medications as well as alcohol consumption for the week before surgery. That was an interesting week, as I found out how I *really* felt without the effects of pain-deadening medications.  By the end of the week I was very ready for the operation!

After two days of surgery, I went for x-rays at the hospital.  I was able to snap photos of the screen with my phone:

Anterior x-ray of my spine after surgery.


Lateral x-ray of my spine after surgery.

Dr. Blizzard was extremely happy with the outcome.  He was able to accomplish even more straightening of my spine than he had anticipated.  He warned me, however, that "every muscle in my back will hurt for weeks", because of the extensive re-orientation of the vertebrae and the consequent need for the muscles to adjust.  The incisions (seven in all) also caused some pain, particularly the abdominal one.

I stayed in the hospital Friday and Saturday, and was released Sunday afternoon.  The first few days (both in the hospital and at home) were excruciating, and I was grateful for the potent pain medications.  By the beginning of the second week, I was in less pain and was better able to get up and walk around with the aid of a walker and and a very stiff back brace.

In addition to the back brace, very careful movement (no "BLT", or bending, lifting, and twisting), and lots of rest, they prescribed a bone growth stimulator, which is a very cool device that I wear around my waist, either in bed or while sitting or  walking around. It creates a pulsed electromagnetic field around my back which affects the bone cells in a way that encourages them to grow and fuse together.

Orthofix SpinalStim   (click on "how it works" for an explanatory video)

I am supposed to use it at least 2 hours a day for the next year or so. I am anxious to heal, so I've been 100% compliant, and using it for 4-6 hours per day.

By the middle of this past week I was ready to go outside.  With approval from the doctor, I took my first short walk on Tuesday, about .24 miles to the bottom of our cul-de-sac.  The next day I went for another walk, intending to try a little further (perhaps about 1/2 mile or so).  But I didn't want to stop, and just went all the way to the bottom of the hill.  I have taken that walk each day since then, and it feels great!

My daily walk on Strava.

I am still experiencing pain when I stay up too long, and especially when I sit longer than about 20-30 minutes.  I have to rest on my back and sleep a lot.  But I am very encouraged by my progress.  I have follow-up visits with xrays at 6 weeks as well as 3, 6, and 12 months, so I'll be able to track my bone growth progress.  I am looking forward to being out in the wilderness again next year, with a pack on my back and no pain! (Well, only the normal amount of pain from that activity, lol).

Mood: Happy
Music: Mein Vater ist ein Wandersmann

0 Comments:

Post a Comment

<< Home