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Had A Lumbar Spinal Fusion, Back Pain, Numbness. Has Spondylolisthesis. Why Are Bowels Sluggish? Take Nerve Block Injections?

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Posted on Fri, 6 Jul 2012
Question: Hi i am a 35 year old female i had lumbar spinal fusion in Sep 2011 for ongoing back pain and numbness to leg bilaterally i had spondylolisthesis of l4, l5 and s1. In 2006 i had a microdisectomy and from then i had conservate management of facet joint injections and physiotherapy and analegisa but my smyptoms became more debilating and i opted for surgery. Anyway my problems got worse in ways since i had the fusion. I had to return to hospital after the fusion and have further surgery to remove l5 screw as it was too close to nerves and had been causing extreme pain, but i also developed infections and had to be treated for 6 weeks with intravenous antibotics. I was unable to urinate post surgery and as a result i still have to continue to self catherise. My bowels are also very sluggish and unless i take laxitives they will not work, even when i go i never feel like i've completely emptied. I have spoke with the urology consultant and in his opinion it is unlikely that my bladder function will improve - i have a neurogenic bladder.
I continue to have pain and will be having nerve block injections at the end of April, I'm just wondering in your opinion is there anything else i can do to possible improve my experience
doctor
Answered by Dr. Shivakumar S. Kupanur (12 hours later)
Hello.

Thanks for posting your query.

I have gone through your history and I feel sorry for the suffering you are going through.

There are some adverse events happened during management. Neurogenic bladder is developed due to nerve injury, might be due to pedicle screws. I have seen patients improving from neurogenic bladder, though it takes longer time. You need not to lose your hopes. Continue intermittent catheterization. You can lead a quality life with little back discomfort over a period of time.

Regarding your back pain, your updated MRI will help me to suggest you better. If there is no nerve compression and spine is aligned, conservative management is sufficient. If there is never compression or bone infection, we may need to treat it aggressively. Local injection can be tried whenever pain is severe. Continue good physiotherapy.

If you provide me pre-op and post-op MRI images, I can suggest you better on that.

I hope I have answered your query. I wish you pain-free comfortable life soon. I will be available for follow up queries if any.

Regards.

Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Shivakumar S. Kupanur

Neurologist, Surgical

Practicing since :1997

Answered : 65 Questions

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Had A Lumbar Spinal Fusion, Back Pain, Numbness. Has Spondylolisthesis. Why Are Bowels Sluggish? Take Nerve Block Injections?

Hello.

Thanks for posting your query.

I have gone through your history and I feel sorry for the suffering you are going through.

There are some adverse events happened during management. Neurogenic bladder is developed due to nerve injury, might be due to pedicle screws. I have seen patients improving from neurogenic bladder, though it takes longer time. You need not to lose your hopes. Continue intermittent catheterization. You can lead a quality life with little back discomfort over a period of time.

Regarding your back pain, your updated MRI will help me to suggest you better. If there is no nerve compression and spine is aligned, conservative management is sufficient. If there is never compression or bone infection, we may need to treat it aggressively. Local injection can be tried whenever pain is severe. Continue good physiotherapy.

If you provide me pre-op and post-op MRI images, I can suggest you better on that.

I hope I have answered your query. I wish you pain-free comfortable life soon. I will be available for follow up queries if any.

Regards.