HealthCasts – David Chang, MD – Post-Operative Pain after Spinal Fusion Q&A


The Marina Del Rey
Hospital HealthCast, featuring the doctors of
Marina Del Rey Hospital. Alright Dr. Chang, let’s go
back out to the calls. A lot of people want
to ask you questions about their individual back
and spine problems. Let’s go out to Eleanor, who is
next up with Dr. David Chang. Hi, Eleanor! Hello. Hello, how are you? Doctor, I had pretty extensive spinal
surgery last, a year ago, February. I had rods, a cage, cement
between the vertebrae. And it’s postoperative a year
and a couple of months. I’m having residual pain from
my buttocks down my back thigh, A little on the, a lot on the right side,
a little on the left side. It’s been pretty overwhelming. I can walk, but I can’t
stand for very long. And a little bit better, but
still have the major problem. I’ve been told it’s a nerve
that need to regenerate. But I’m a little concerned and,
of course, it’s debilitating. Can you give me any more information, if there’s anything out there that
can help me get over this sooner? So, Eleanor, it sounds like
you’ve had a fusion surgery, probably coupled with a laminectomy
to help decompress those nerves. So, couple of issues: One: in doing the fusion surgery, I think we’ve got to make sure that
we have test the document that, that fusion has taken, so to speak, that, one bone has fused to the other. If that bone has not, or that disc space, or that joint has not fused, potentially
there’s still some micro-motion there, that could potentiate
irritability, and instability, and irritate the nerves
around that joint, and therefore persist and cause
you that radiating leg pain. It’s also possible, that,
that fusion area is fused, and maybe an adjacent level, a level above or the level below, that fusion area is now
beginning to degenerate and develop maybe
some nerve compression, otherwise known as stenosis. And to evaluate that, generally,
you’re talking about getting an MRI or a CT myelogram to help evaluate
the nerves at the adjacent levels. Yes, that actually has been done, and it doesn’t appear
to be any further damage. The doctor seems
quite happy with everything. But I’m not. So, I’m still having
this ongoing problem. And Eleanor, your surgery
was how long ago? A year ago, February. So, 1 year and 3 months. And, so, there’re times
when sometimes those nerves do take a long time to rehabilitate. I think, earlier we had a call about, sometimes patients have pain, and
they don’t want to do anything about it, and they just put it off for a long time. Maybe 6 months, maybe a year,
maybe severals years. If we don’t get to the nerve soon, sometimes what we’re left with
is some permanent nerve injury, that we won’t know about until after
the surgery has been carried out and we give you the
requisite time to heal. Now, most of my patients,
I tell them after a year, whatever deficits they have,
they’re usually left with. But having said that, I’ve had
patients come back and tell me, maybe 2 or 3 years later,
that it took that much more time, for those nerves to
really heal and rehabilitate. Sometimes that’s it, with the use of
other medications like Nuronten or Lyrica. And these medicines are nerve
stabilizing type medicines, that really help mitigate the sensitivity or
the nerve pain, or those nerves endings. Have you tried anything like that? I’ve been on Lyrica for 2 months, and I
have not actually seen any benefit from it. Let me just answer a real
quick question on the Lyrica, sometimes it’s a dose depend response. And sometimes you need
to titrate that medication up, to get a level in your body, so that
the nerves can respond appropriately. So, I would just give it
a little more time. Yes, I’ve waited a long time. Dr. David Chang from
The Marina Spine Center, thank you so much for joining us on The Marina Del Rey
Hospital HealthCast. It’s been an absolute pleasure, I know
the listeners have learned a lot. And we look forward
to doing this again. Thank you for having me,
and it’s been a pleasure as well. The Marina Del Rey
Hospital HealthCast, featuring the doctors of
Marina Del Rey Hospital. For more information on
any of the topics discussed, please call The Marina Del Rey
Hospital Helpline at 855-51-SPINE, or go to www.marinahospital.com

1 thought on “HealthCasts – David Chang, MD – Post-Operative Pain after Spinal Fusion Q&A

  1. I am 3 weeks out from having ALIF/PLIF and I KNOW THAT PAIN shes talking about!! It it DEBILITATING!! I cant walk without crying…on top of that my pain management Dr is weaning me down from the meds.

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