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L4L5 Artificial Disc Replacement

Hello everyone,

You can search my name for more information about my pre-op situation. Basically for 11 months I had relentless bilateral nerve pain down the front and back of both legs and crippling lower back pain. I could not do anything to escape pain and I was lying flat for most of the 11 months. I truly mean that, I was house and mostly bed bound. I couldn't walk for much longer than 20 minutes without my back getting very heavy and I could not sit at all as it was immediately uncomfortable in the lumbar spine. 

I had an MRI that showed a disc at L4L5 that was degenerative with an annular fissure. Notably there was no nerve root compression. With nothing else to go on I had an artificial disc replacement at L4L5 on Jan 23rd 2019. It's been 10 weeks now since the op. 

Immediately since the op I could sit again, basically all day. That lumbar spine pain was more or less gone. I can in theory walk as much as I want as well without my back getting badly fatigued. It is still sore to push the back into extension or flexion. But it's more muscular in nature. It really hurt to do so pre-op.

My problem is that I continue to have severe relentless nerve pain and this is now coupled with a lot of strong stinging sensations in my lower back. I know they say wait a million years for nerve pain to resolve but I am simply baffled. My surgeon wrote on my surgery report that "there was an inflammatory reaction in the nerve roots, they were red looking and the vessels were inflamed". 

I'm just distraught. The nerve pain is still really bad and continues to limit my activity. I can still only go for a 20 min walk a day due to it irritating my nerves a lot.

Everything goes so slow in my country. I have an x-ray on Monday to see how well the bone has grown into the prosthesis. On the 20th I meet a rheumatologist and I am begging him to refer me for some steroid injections. I'm also asking if they can include hypertonic saline to break up any adhesions.

The worst part about this, is that I seem to be the only person with any sort of grasp on the situation. All of the docs seem to be completely clueless. Since my case was not standard (no compression, no massive disc height collapse yet so much nerve pain) they are just shrugging and offering gabapentin and amitriptyline etc. which don't help me and not really taking the situation serious ebcause physically it is not life threatening.

I've extensively researched arrachnoiditis and while I have the symptoms I have no clumping or adhesions on my MRI.

It not as simple as me just going and asking for second opinions. I have legitimately seen nothing but gross incompetence across the board. If you don't fit into the textbook situations it's chronic pain management which is basically useless.

I basically feel like I'm at the end of the road. The only thing that was diseased is now gone and you can't replace the central nervous system.

Anyone have a prolonged recovery where the nerves just transmitted lots of pain post op even though they were no longer compressed?

Thanks for reading!

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1

Comments

  • timsdeecettimsdeece Posts: 42
    edited 04/06/2019 - 9:20 AM

    Here's a long list of things I'm asking this rheumatologist about:

    • A medrol pack
    • Low dose naltrexone
    • Ketorolac injections
    • Steroid injection / adhesiolysis
    • A copy of recent blood tests (they were inflammatory markers like ESR and urate etc.)
    • Facet injections
    • An MRI or a CT with contrast or both
    • Complete blood work for any possible thing ever
    • 1. Vitamin levels
    • 2. Hormone levels
    • 3. Allergens like soy and gluten
    • Do an oral glucose intolerance tests
    • Spinal cord stim
    • Pain pump

    I have tried the following with no success:

    • b12, b6, magnesium, calcium, iron, turmeric supplements
    • CBD oil
    • Cannabis
    • Many forms of physical therapy / rehabilitation
    • 1. More walking
    • 2. Less walking
    • 3. Many types of stretches
    • 4. Core strengthening - My core was very, very strong before the pain broke out 
    • 5. Yoga, various types
    • 6. TENS machines
    • 7. Heat / Ice
    • 8. Various levels of activity from absolutely nothing bed bound to trying to walk a lot more and do some core work
    • Epsom salt baths and baths in general
    • A chiropractic adjustment pre-op made pain so much worse and I'm not getting them ever again
    • Meditation of many kinds
    • Several medications of anti convulsant and anti depressant classes
    • 1. Gabapentin and Pregablin
    • 2. Amitriptyline, Cymbalta and Venlafaxine
    • 3. Tramadol and Tapentadol (opioids) at low dosages for very small times
    • 4. NSAIDS - unfortunately trying a lot of these decreased my tolerance, I can now only take diclofenac suppositories which don't even help
    • 5. Paracetamol and metamizole
    • A consistent anti inflammatory diet and in general eating very healthily (I am slim despite all the inactivity)

    I'm almost sure that if you have a 'have you tried' and it's something one can do themselves without a prescription then the answer is probably yes. As I said, the nerve pain is relentless, it only worsens the more I do and I've had many stretches of a time trying various activity levels to test that out. 

    I genuinely feel like the management for chronic pain is pretty useless when the pain is severe and most docs aren't willing to help aggressively anymore

  • memerainboltmemerainbolt IndianaPosts: 6,443

    timsdeece

    All of your replies and new discussions need to stay in this thread. Members are not going to look elsewhere, it's happened too many times.

    Your question at the bottom stated "Anyone have a prolonged recovery where the nerves just transmitted lots of pain post op even though they were no longer compressed?
     The nerves have to wake up. Some take longer than others. Read different post on spinal surgery and you will hear about this happening to almost everyone. When you see your doctor with your list, also take the list "that does not work" too. I think that's a great idea.

    Take care and keep us posted.

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  • Thank you for replying, Sandra and for that tip, I agree, that's a good idea.

    I hope you are well. I have read before you have a pain pump installed, have you felt any benefit from?

  • I will keep everything here. I posted my first post in back pain as I had had no procedures at that point, second post in injections (since I had injections) and now this is recovery since I'm recovering from surgery. I didn't intend to make it confusing  :s

  • memerainboltmemerainbolt IndianaPosts: 6,443

    I know you didn't. You will have less replies that way. 
    Yes, I have gotten a lot of relief from my pump. I have other painful issues that it does not cover but I am so glad I decided to do the pump. The one thing it will not cover for anyone is nerve pain.
    Are you considering one? I also had a SCS so if you have questions about either one just let me know.

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  • Ok, so a pain pump is a bad idea for nerve pain?

    Have you felt any benefit from the spinal cord stim? (for nerve pain if you have any?)

    I'm considering anything that stands a chance of helping to be honest  :(

    I have read your medical history which is hyperlinked under your name. I do mean it when I say I'm sorry you have been dealt all those hands. I don't know how things really are on your end, but you've at least dealt with it in a productive way, it's admirable. I'm a mod in an artificial disc replacement facebook support group and helping people there is also one of the things that has gotten me through the days the past while. 

  • memerainboltmemerainbolt IndianaPosts: 6,443

    I spend most of my days in my wheelchair, which reclines, as I can't do much else. But I'm comfortable, happy and have a wonderful, very caring husband. I still look at other members on the forum that are worse off than me.

    Thank you for what you do, helping others on your forum. It feels great, doesn't it? 

    I had a SCS for about a month and had it removed. They never could get it adjusted right and I was in more pain than before. Plus, I had too much permanent nerve damage. If you are considering one, please do your research on different manufacturers as they are all different. Besides, I could never get my rep to call me back. I know you will find a lot of information here and on your forum, so good luck. We have a vast library, go to the search box and key in "scs". Or, let me know what you need, I'll send it to you.

    The pain pump will not cover nerve pain. I wish it did or I would be mostly pain free. Since this is nerve pain, have you see a neurologist? Please don't give up in trying. Maybe there is a procedure out there would give you some relief.

    Take care and keep us posted.


  • challengercchallenger Posts: 1,209
    edited 07/16/2019 - 4:50 PM

    timsdeece

    a little story about myself, in Nov. 2018 I had a discetomy  on T12-L1 because of severe burning sensation in my back, I was not having any leg pain associated with it, when I woke up after surgery, both legs and feet were hurting, right foot was extremly cold, like it was in a bucket of ice, not to the touch, just felt cold to me, it continued to get worse for about 3 weeks, the leg pain finally started to calm down after the 3 month mark and is mostly gone now, my right foot is not as bad now, but if I walk very much it still hurts and gets cold, not as bad but still there, the main thing is I am still seeing improvement, not as fast as I would like but I still haven't given up on it.

    I guess the main thing I am trying to say is, don't give up on it, as frustrating as it can be

    Take care and I hope you feel better soon

    Chip  

  • That you very much Chip for sharing that. I hope you continue to see improvements also.

    Thank you Sandra as well for sharing your information about the scs. I will use the search function to find out more from other members as well.

    Thanks again to both for your replies!

  • I forgot to mention that I did have a scs for several years, I had pretty good success with it at first, my back kept getting worse and I ended up having fusion surgery in 2015, the surgeon did not want me using it right after surgery, when I got the o.k. to start using it again it would not work, not sure if it was because of the surgery or something with the unit itself, it was about 6 years old at the time, anyway I had it removed during my second fusion in 2016.

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