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Conditions and Diseases > Back Pain Forum > Chronic pain related to T10 -L1 fusion
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Q: Chronic pain related to T10 -L1 fusion
asked by: pilothawk on January 25th, 2009
New User
I crushed my T-12 vertebrae 6 years ago in an ATV accident. I underwent vertebral fusion from T10 to L1 with bone grafts to T12. I have been on percocet 10/650 for the last 5 years, and unfortunately they are no longer as effective as they used to be. The majority of the pain I have is either proximal to the fusion, or distal (low back), and I am tired of hurting. So far I have tried acupuncture, TENS, steroid injections (caudal and facette), physical therapy, massage, chiropractic therapy, NSAIDS, neurontin, and lyrica. Right now I am using a combination of 225mg of lyrica at night and 150mg in the morning, with 800mg of ibuprofen 4 times a day, and the percocet 10/650 q4 hours PRN. More times than not I find myself needing the percocet to take care of the pain. Unfortunately I am an RN and its very difficult for me to take the narcotics when I'm at work. I am at my wits end! my pain level rarely drops below a 3 on a 1-10 scale, and most of the time I live at a pain level of 5-8 on that scale. I don't know what else I can do. I just know that I want to quit hurting all the time. I am waiting on a referral to a neurosurgeon right now to see if there is anything he can do to help.

My back is "healed" the fusion is stable and there isn't much I can't do because of it if I can deal with the pain. I am 39 years old, and can't afford not to work. I just don't know what to do. I already feel like I'm a junkie, but the percocet is the only thing that gives me relief even if it only is for a couple of hours.

If anyone has suggestions, or words of encouragement it sure would be nice to hear them because I am starting to get really frustrated with this.

Thanks for your time,
Chris
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littleonefb
replied on January 25th, 2009
Extremely eHealthy
Did you have instrumentation used with your fusion?

When was the last time you had a CT scan?

Are you/have you been seeing the same spine surgeon that did your original cervical fusion?

Have you gotten any other opinions from any other spine specialists? Either an orthopedic surgeon that specializes in spines or a neurosurgeon that specializes in spines only?

Where the discs removed when your fusion was done?

Fran
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pilothawk
replied on January 26th, 2009
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Did you have instrumentation used with your fusion?

I'm not sure I fully understand the question. There are six screws with holes in the heads that line up in order for a titanium rod to pass through.

When was the last time you had a CT scan?
I haven't had a CT scan since the fusion was done.

Are you/have you been seeing the same spine surgeon that did your original cervical fusion?

Unfortunately I was not in my home state when this happened, so I haven't seen the surgeon since he did the fusion.

Have you gotten any other opinions from any other spine specialists? Either an orthopedic surgeon that specializes in spines or a neurosurgeon that specializes in spines only?

Not yet, I am waiting on an appointment for a local neurosurgeon.

Where the discs removed when your fusion was done?

I'm not sure if they were removed or not.
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littleonefb
replied on January 26th, 2009
Extremely eHealthy
instrumentation is hardware used for fusions, though sometimes a fusion is done in situ, that is without any hardware.

Did you have CT scans done after your fusion to be sure that you did fuse or is it just assumed that the bones fused?

Since you are waiting on seeing a local neurosurgeon, it would be good for you to contact the office of the spine surgeon that did your fusion and get all your records sent to you. All the office visits, surgical notes, OR notes, MRI, CT reports, and all the films. Also get office visit notes, follow up post op reports as well.

All of this is very important for a new doctor to have and see what was done, what your condition was when you had your accident and what has gone on since the surgery.

You no doubt will need a new CT scan so that the new doctor can see what is going on now and compare it to the films before and after surgery.

Depending on whether the discs where removed or not, it could be disc compression on nerves if they are still in place.

It could be the hardware that is pressing on nerves and will need to be removed.

In the mean time, you could try using moist heat or ice to see if it relieves any of your pain.

Good luck and keep us posted on what the new doctor says.
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pilothawk
replied on January 27th, 2009
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I have a copy of the records here at home somewhere (I just need to find them), and I had planned on taking them with me when I went to see him. I had a few X/R's done last year before I had the steroid injections.

I was talking to one of the neurologists at work last night and he was fairly concerned that I get this looked at, especially from a mechanical perspective.

I really appreciate the input, because now I know the kind of questions I need to be asking.

Thanks,
Chris
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littleonefb
replied on January 27th, 2009
Extremely eHealthy
Chris,

Another important thing to find out from the operative report is whether the surgeon used BMP during your surgery.

BMP is FDA approved for lumbar surgery only and can be an affective tool in aiding the fusion process.

On the other hand, it can cause bone to over grow and trap around nerves.

If it was used in your surgery, that would have been used in what is caused "off label" and may have created excess bone growth.

And of course there could be a problem with scar tissue.

It is fairly common that the hardware used in a fusion can also cause continued pain. Many times surgery is done to remove the hardware.

Once fusion has taken place, there is no reason for the hardware to be left in place. There are doctors that automatically remove the hardware once there is a solid fusion.

One other thing, don't be afraid to get a second, third or even a 4th opinion on what is going on, especially if surgery is suggested.

It is always good to get more than one opinion whenever possible.

Fran
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bev219
replied on March 19th, 2009
New User
low back pain
i had decompress lam on l5 S! on 2-19-08. I been dealing with back pain for 16 yrs. I'm hairdresser. i went today for mri,and i don't know how to read it,on a disk it has mri lumbar UID 102 thru105 neut/sit t1 t2. can anyone explain why the pain is in low back hips,and down left leg and foot,and my knee and ankle swell? i have nerves burn in low back and eprdural,nothing help,i thought i might have blood clot in my leg, so when i went for follow up on 2-19 i told my neuro about the pain and swelling i don't see him until may,and i want find out nothing about mri or droppler test! i really upset and i appreciate any advise,i new to this forum.
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