First some background. I caused injury to the L5-S1 level of my spine a long time ago when I ruptured the disc. I had a difficult period straight after the injury but since then things have travelled on OK. In 1991 I lost sensation in the front of my right thigh and at the same time I developed an intermittent deep nagging pain in the centre of the front of my right thigh. Those are all things that you learn to live with.
Over about the last 5 years I've developed intermittent bouts of lower back and buttock pain which have become progressively worse. They took up two forms. The first was a nagging pain of varying intensity which at its worst left me flat out on the floor unable to do anything. The other, more troubling, was pain in my buttocks legs and feet which got worse on standing. Towards the end 5 minutes was too long to stand and I couldn't walk either for more than a few metres. That meant that it was time for action.
The symptoms were caused by stenosis of the neural foramina at L5-S1. That means that where the spinal nerves exited the spinal column through a gap, called the neural foramen, they were being crushed. This was happening because the facet joints at L5-S1 were slowly collapsing leaving an ever smaller gap for the spinal nerves to exit. Those are the nerves that control parts of your legs and that's why I had troubles.
My surgery was minimalist. I had a laminectomy, where the laminae - bits of bone behind the spinal column - were removed. The facet joints were also removed and four pedicle screws were inserted - one on each side of each vertebra through an area of tough bone called the pedicle. Then the nerve root on the right hand side was gently moved aside and a piece of plastic (PEEK in fact) called a fusion cage was slipped in between the two vertebrae. The idea was to re-establish the gap which used to be held open by the disc. Saying that the fusion cage was "slipped in" makes it sound easier than it was. Quite a bit of force was needed to re-establish the original gap and to get the cage where it was supposed to be. The cage was packed full of munched up bone that had been removed from my spine and the space behind the cage was also packed full of the same bone. This bone will grow and fuse the two vertebrae together.
Then a rod was placed vertically between the pedicle screws on each side of my spine and finally a cross piece was placed between the rods and the job was finished, but for closing the muscle and skin layers.
When I woke up I was totally pain free at the incision line and on the left side of my back and in my left leg. All the pain I'd been suffering on that left side had gone and has never returned. On the right hand side I had localised pain, muscle spasm and some intermittent leg pain. That has remained, though it's improving.
So to day 21. Here's the situation:
- Walk 5 km;
- Shower and dress myself;
- Sit for up to 10 minutes without too much discomfort and longer with significantly more discomfort;
- I can get in and out of bed and roll over with no external assistance;
- I've been able to manage flights of 20 stairs since day 3 - up and down - unaided;
- I can stand for long periods of time, basically pain free;
- I can lay for long periods so long as it's absolutely flat.
Not bad considering where I've come from. Now to the bad bits:
- I'm still on 2 long-acting opioid pain killers per day plus 1 anti-spasmodic for the spasm in my right buttock. Can't see when I'll be off those, but on the other hand I've weened myself off a bucket load of other stuff already;
- I don't drive because of the drugs I'm on - personal choice;
- I don't know whether my right side will ever get better than it is now and that's not great;
- I'm a bit depressed - people work and do their own thing and I'm left either walking (slowly) or lying down. Movies are all crap, I've read all the decent books I can find and I've listened to my whole music collection I think!
- I'm frustrated out of my brain! I can't sit so I can't work and I can't travel. I feel like I'm in limbo.
The bottom line is I'd probably do it again in a flash, even though the outcome is far from clear. Next week, I'm hoping one last little area on the suture line will be healed and I'll be able to hit the pool. That'll be a new distraction for all of 2.5 minutes, but a new distraction nevertheless!