Heavenly Endeavors While Stuck on Earth: Back Surgery Update

I had back surgery 10 days ago and can finally sit down long enough to update everyone. I thought it would be interesting to show an explain what I had done, so I'll be mixing in some clinical type information that I found on a website to help explain it...

I have a condition called spondylolisthesis. - Spondylolisthesis is the term used to describe when one vertebra slips forward on the one below it. This usually occurs because there is a spondylolysis (defect) in the vertebra on top. There are two main parts of the spine that keep each vertebra aligned-the disc and the facet joints. When a spondylolisthesis occurs, the facet joint can no longer hold the vertebra back. The intervertebral disc may slowly stretch under the increased stress and allow the upper vertebra to slide forward. A fusion may be used for both conditions to stop motion in the problem vertebrae. - This is what was happening between sacrum and the L-5 vertabrae directly above it.

Because of this slippage between vertebrae, and the resulting disc degeneration , I have severely pinched sciatic nerves on my right side. I had surgery back in 2001 for the same sciatic symptoms. Then they only scraped away some of the existing bone that was pinching the nerve, but didn't do anything to stabilize it. I was working on that through physical therapy. However, I was blessed with finally getting pregnant, unfortunately my back was in such a weakened state that it caused my spine to slip even further. Before this surgery my slippage was at 30% off, after my pregnancy, the slippage was at 60%.

I managed with this up until last summer when the sciatic pain kicked back up with a vengence. I went to a different doctore ( I wasn't all that impressed witht the first surgeon anyway) and he was very clear that surgery was my only option because the slippage and nerve damage was so severe.

So fast forward to surgery and this is pretty much what he did. -

A fusion is an operation where two bones, usually separated by a joint, are allowed to grow together into one bone. Spinal fusion has been used for many years to treat painful conditions in the lumbar spine.
During a spinal fusion, a bone graft is used to join two or more vertebrae. The vertebrae grow together during the healing process, creating a solid piece of bone. The bone graft helps the vertebrae heal together, or fuse. The bone graft is usually taken from the pelvis at the time of surgery.
Your surgeon can use an anterior (from the front) approach, a posterior (from the back) approach, or a combined approach to lumbar fusion surgery. (Mine went in from the back).

Posterior Approach
The posterior approach is done from the back of the patient. This approach can be just a fusion of the vertebral bones or it can include removal of the problem disc. If the disc is removed, it is replaced with a bone graft. The surgeon moves the spinal nerves to one side and inserts the bone graft between the vertebral bodies. (They were not able to insert this bone on me because the slippage is too forward and the nerve was so delicate as it was.)

With a posterior approach, an incision is made in the middle of the lower back over the area of the spine that is going to be fused. (About an 8 inch incision going from my middle back downward.) The muscles are moved to the side so that the surgeon can see the back surface of the vertebrae. Once the spine is visible, the lamina of the vertebra is removed to take pressure off the dura and nerve roots. This allows the surgeon to see areas of pressure on the nerve roots caused by bone spurs, a bulging disc, or thickening of the ligaments. The surgeon can remove or trim these structures to relieve the pressure on the nerves. Once the surgeon is satisfied that all pressure has been removed from the nerves, a fusion is performed. When operating from the backside of the spine, the most common method of performing a spinal fusion is to place strips of bone graft over the back surface of the vertebrae.

Pedicle Screws
My surgeon used pedicle screws to hold the vertebrae in place while the spine fusion heals. Designed to stabilize and hold the bones together while the fusion heals, these devices have greatly improved the success rate of fusion in the lower back.

So that's basically what happened. I only had to stay in the hospital for 3 days and now I'm in the rehabiliation phase. It will take at least 3 months for the bone to fuse then it will continue to solidify for one to two years. Although I can walk around fairly well, I'm forbidden to bend, twist, lift or sit at right angles for more than 15-20 minutes. This may go on for upto six weeks depending on how I'm improving. It really sucks having to ask everyone to help me when I drop things (and it sure feels like I'm doing that a lot more lately:-)

Here are my actual x-rays from two weeks after surgery.