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Suggest Treatment For Unsuccessful PLIF Surgery And Laminectomy
Question: I had a PLIF L4-5 and laminectomy almost 16 months ago for spondiolethesis and severe stenosis. Very minimal bone growth. LBP and bilateral sciatica continue. CT shows minimal bone growth with no addl growth since last July. Flexion extension x-rays shows contniued instabilty. Emg - chronic nerve involement L5 and S1. Since surgery have had #10 lifting restriction, wear spinak brace while awake and on my 2nd bone stimulator. Surgeon scheduled another fusion for July. I went back to work the last time at 2 months. Im thinking going back too early may have contributed to the non-union. Im a hospital exec- so very stressful, long day, lots of sitting although walk around 7500 steps on a typical day around the hospital. My main question is recommended time off work after a fusion as i deparately want this next one to fuse? What would you recommend?
Brief Answer:
Six months of strict regimen needed after PLIF.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns.
I have read your previous conversations on HCM too.
In my opinion, PLIF was unsuccessful, since there's still listhesis and persistent schiatica symptoms.
Causes of unsuccessful PLIF may be returning too soon in physical activity, hardware miss placements, bone failure to fuse.
I think your case should be reconsidered for another stabilization surgery, maybe including one or two more levels in spondylodesis.
The minimal period of not returning to work and avoiding physical activities that may interfere with PLIF malfunction is six months.
Lumbar frame if used for too long (more than two months) causes weakness of lumbar musculature and predisposes to stabilization surgery failure.
To recapitulate, in my opinion, reconsider stabilization surgery, six months of strict regimen, physical therapy with the scope of strengthening lumbosacral musculature.
Hope this helps. If you have further questions or clarifications feel free to ask, if not, you can close the conversation and rate the answer.
Wishing you good health.
Six months of strict regimen needed after PLIF.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns.
I have read your previous conversations on HCM too.
In my opinion, PLIF was unsuccessful, since there's still listhesis and persistent schiatica symptoms.
Causes of unsuccessful PLIF may be returning too soon in physical activity, hardware miss placements, bone failure to fuse.
I think your case should be reconsidered for another stabilization surgery, maybe including one or two more levels in spondylodesis.
The minimal period of not returning to work and avoiding physical activities that may interfere with PLIF malfunction is six months.
Lumbar frame if used for too long (more than two months) causes weakness of lumbar musculature and predisposes to stabilization surgery failure.
To recapitulate, in my opinion, reconsider stabilization surgery, six months of strict regimen, physical therapy with the scope of strengthening lumbosacral musculature.
Hope this helps. If you have further questions or clarifications feel free to ask, if not, you can close the conversation and rate the answer.
Wishing you good health.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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