Spinal fusion 5 years later

 Last February I had my 4-year followup appointment. They told me I was doing well, and also that my neck (which has arthritis and signs of other problems) was not any worse than it looked the last few years. They say that I'm doing so well that I've "graduated" and no longer need a yearly followup.

I told them that with my neck situation, I would really prefer if I could continue seeing Dr. Chung or his PA, so they scheduled me for two years from then. So I do not have a 5-year followup this year.

I am doing quite well, a little back stiffness in the morning sometimes, but overall painless. I continue to walk a couple miles daily, weather permitting, and do a set of pushups at least daily.

I want to include an image from November 2019, about nine months after the surgery. It was from a CT scan. The scan was two "sessions", one thoracic and one lumbar. I just recently managed to stitch together a view of the thoracic spine with a matching view of the lumbar spine. I don't know why the hardware shows up purplish, but I just think it looks pretty cool.

CT scan November 2019

Spinal fusion 3 years later

I had my 3-year followup in February. Since the 1-year followup, I have been seen each year in February. Each year I see either my surgeon Dr. Chung or one of his Physician Assistants. They alternate each year.

My post-op progress has been great and I'm doing very well. I still have limitations and I will have them for the rest of my life. I can't lift more than about 40 pounds without serious stress to my lower back, so I don't try. It is a struggle to tie my shoes, but I manage pretty well. Anything that requires much bending is impossible. I have to squat or crouch to reach things down low or on the floor. I cannot run, but I walk a couple miles every day and do a set of pushups. I manage pretty well, all things considered. There is generally no pain in my back. I am really happy so far with the outcome of the surgery.

Spinal fusion

As some of you know, I had spinal fusion surgery last month. I am doing pretty well but it will be a long recovery.

Here is what my spine looked like before surgery:

MRI front view September 2018

Rear view December 2018

And here is what my spine looks like now:

Front view March 6, 2019

So I have 4 rods and (I think) 20 screws and some other hardware holding my lower spine together, and a 13 inch incision in my back that is still healing.

I am still much weaker than before the surgery, but getting stronger. I'm walking a couple of miles or more most days. I still facing a probable year-long or longer recovery. I'm not allowed to bend, twist, or lift more than a few pounds until everything is fused properly, and I'll have life-long limitations. And I have to wear a pretty uncomfortable brace for a few more weeks.

If you want to read more than you probably want to know about all this, read on.

In January 2018 I found that I could no longer do flip turns without back pain when swimming laps. I gave up flip turns. Later, in the summer, my back hurt when I got up from bed. It generally loosened up after a few minutes, and I had little or no pain most of the day.

Sometime during the summer, I was lying in bed one night when my right leg suddenly started tingling from a little above the knee down through the foot. When the tingling didn't stop after a few days, I saw my doctor. He also noted that I had no reflex in my knee. He sent me for a lumbar MRI, which showed I had a lot of problems with my lower spine. I had scoliosis, stenosis (narrowing of the spinal canal that holds the spinal cord), spondylolisthesis and retrolisthesis (some vertebrae shifted forward or backward relative to where they should be) and degenerative disc disease, as well as general arthritic degeneration of the spine.

The doctor referred me to a spine surgeon. The surgeon's nurse practitioner evaluated me and confirmed that I had problems that warranted surgery. In December, the surgeon told me he would fuse my spine from T11 down to the pelvis. So he was going to do a complete fusion of my lower vertebrae from a couple above the lumbar spine on down.

He advised that I could maybe wait a year or two before doing the surgery but that I would need it eventually. I wanted a second opinion, hoping I could get fixed with something less drastic. I got the name of another spine surgeon, Dr. Woosik Chung, from an acquaintance at the recreation center where I swim. He advised me that Dr. Chung was something special, and some research indicated that has a great reputation.

I was fortunate to be seen by Dr. Chung, and after his own evaluation he told me I needed fusion from T10 down to the pelvis. So his recommendation was even more extensive than the first surgeon's. He didn't think I should wait a year or two because he said my spine could degenerate suddenly and catastrophically if I waited. After some serious consideration, my wife Debbie and I decided I should go ahead as soon as we could get in. Fortunately we could get scheduled at the end of February.

My back took a turn for the worse, and after my pre-operative appointment with Dr. Chung's PA, his office moved up my scheduled surgery to Thursday, February 14.

So on Valentine's Day my daughter Kim drove Debbie and me to Presbyterian-St. Luke's Hospital (PSL) in Denver. That morning I met with Dr. Chung and his team, including the anesthesiologist and his IONM (intraoperative neurophysiological monitoring) guy, who said he would attach "about 50" electrodes (not sure if he was exaggerating or not) to me and monitor my system during surgery to make sure that no damage was being done with all the manipulation that would be happening to my nervous system.

They wheeled me into the OR about 11 am. The next thing I knew I woke up in the ICU with Debbie, Kim and her SO Adam by the bed. I barely remember that. I found out later that it was late in the evening. The operation lasted until after 6 pm, about 7 hours.

I was supposed to get out of bed and start trying to walk the day after surgery. When I got out of bed and stood up I nearly fainted. This was due to my blood pressure dropping precipitously (orthostatic hypotension). I was unable to stand up the next two days as well. I had lost about 2 and a half liters of blood during surgery and only some of that was replaced during the operation.They gave me additional fluid through my IV in the ICU and that seemed to help. On the fourth day I was finally able to stand up and move a little. It was slow going at first. I shuffled around a little with a walker.

I worked with physical and occupational therapists each day on the spine floor at PSL and continued to get stronger. On Friday the week after surgery they discharged me to an inpatient rehab facility, Encompass Health in Littleton, CO. That was a bit more convenient for Debbie, who visited me every day at PSL. The rehab facility was a much easier drive for her.

The nurses, doctors, and therapists at Encompass were excellent. I won't say I had a great time there but it was necessary and they were very helpful. By the middle of the next week I was given "green leaf" status, which meant I was allowed to leave my room and walk around and go to the dining hall on my own. This was great, since I could barely walk when I first arrived there.

On Thursday, February 28, I was discharged and went back home. I was also given a couple weeks of outpatient home care, with a few visits from therapists and a nurse. The nurse was there mainly to evaluate the home situation. She also screened me for dementia. Fortunately, I passed the tests.

The therapists were helpful, and I have been doing the exercises prescribed. Next week I will begin physical therapy at a nearby outpatient PT clinic.

It has been quite an experience. I am not out of the woods yet, as it will be months before we know that the vertebrae are actually fusing properly. I will meet with Dr. Chung or his PAs every couple of months for about a year, I think.