[vtpw1972]

SURGERY DATE: 11/4/2013

AGE AT SURGERY DATE: 62

SURGEON: Dhruv Pateder

SURGERY LOCATION/CLINIC: Reston Hospital, Reston, VA

DEVICE(s), LEVEL(s): Diagnosis - Spondylotisthesis at L4, degenerative disk disease at L3-5; Surgery - XLIF lumbar fusion of L3-5 thru left side using Mazor Robotics (disc material removed and spacers with stem cell growth material inserted), and posterior insertion of screws/rods on both left and right side of spine at L3-5

COST =
AMOUNT BILLED: $160,976
INSURANCE ALLOWED: $64,948
OUT OF POCKET: $1,931
TRAVEL: 7 miles from home
EXPLANATIONS?


ONSET OF LUMBAR PROBLEMS, DATE OF INJURY, CAUSE, ETC...: Onset of sciatica pain in buttocks and thigh, starting on right side and moving to left side, in September 2011.

PRIOR SPINE SURGERIES AND PROCEDURES (IDET, ESI, etc...): none

PRE-OP MEDICATIONS: Over the counter NSAIDs

PRE-OP DIAGNOSTICS (discogram, nerve root blocks, etc...): X-ray, MRI, PT

PRE-OP NEUROPATHIES (what, where, & degree of pain, numbness, tingling, sexual/bladder/bowel symptoms, etc.): Shooting sciatica pains thru buttocks and thighs on both left and right sides. Gradually also began experiencing aching and stiffness in both knees and calf muscles. Shooting pains could be very intense, but sporatic. Aching and stiffness was more constant.

PRE-OP CONDITION (Please include %leg pain/% back pain, pain levels, type of pain, ability to work and function, disability status, etc.... be direct, but be as verbose as you need to): I have been able to be fairly active through out pre-op condition. I stretched for 20 - 30 minutes upon getting out of bed each morning, walked at least 1 1/2 miles day, and played fairly energetic tennis at least 3 times/week. I was able to do the tennis with NSAID meds, stretching, wearing compression clothing, applying heat, etc.

TIME POST-OP AT ORIGINAL POST HERE: Original post is 19 days post-op

DESCRIBE YOUR SURGICAL EXPERIENCE: Surgery approx 5 hours. Hospital stay 4 days. First 4 - 5 days back home used walker to support movement. Prescribed oxycontin, vicodin, and a back spasm medicine for pain. Stopped oxycontin approx day 8 and vicodin and back spasm medicine approx day 10. Have been taking Tylenol 500 mcg only since. Still am quite sore in several places but improving evey day.

RATE FUNCTIONALITY / SATISFACTION AT INTERVALS BELOW:

FUNCTIONALITY:
1. Very poor: much worse... disabled after surgery.
2. Poor: worse after surgery.
3. Neutral: No improvement, or improvements offset by new problems.
4. Fair, some improvement, limitations are still serious.
5. Good, substantial improvement, some limitations.
6. Excellent: no limitations.

SATISFACTION:
1. Very sorry I had the surgery.
2. Somewhat sorry I had the surgery.
3. Too soon to tell, or I'm ambivalent about the surgery.
4. I'm somewhat glad I did my surgery.
5. I'm very glad I did my surgery.

Don't forget the detail update section below!

DATE UPDATED: _____11/23/2013____ FUNCTIONALITY: _5__ SATISFACTION: _5__ [2 1/2 WEEKS POST-OP]

DATE UPDATED: _____12/18/2013____ FUNCTIONALITY: _5__ SATISFACTION: _5__ [6 WEEKS POST-OP]

DATE UPDATED: _____1/27/2014_____ FUNCTIONALITY: _5__ SATISFACTION: _5__ [3 MONTHS POST-OP]

DATE UPDATED: _____2/23/2014____ FUNCTIONALITY: _5__ SATISFACTION: __5_ [4 MONTHS POST-OP]

DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [1 YEAR POST-OP]

DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [2 YEARS POST-OP]

DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [3 YEARS POST-OP]

DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [4 YEARS POST-OP]

DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [5 YEARS POST-OP]

DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [6 YEARS POST-OP]

DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [7 YEARS POST-OP]

6 WEEKS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ECT... (discuss surgery induced symptoms [leg pain?]):
I am in 3rd week of post-op physical therapy. The pre-op buttock and thigh shooting pains are gone. I have some pain in my left groin area and sensitivity to touch on my inner left thigh area that my surgeon says is due to disturbing the psoasis muscle and nerves during the surgical procedure. Also have some weakness and loss of control of my left leg; again, surgeon says is normal temporary result from the surgery. At my first PT session I was unable to lift my left leg while laying prone on the table; on Monday this week I was able to do 3 sets of 15 reps with some minor hand assistance. Therapist said she was designing my program to "re-awaken" the muscles/nerves that the surgery disturbed - seems to be working. I am sore mainly in the areas disturbed by the surgery, but have no real pain like pre-surgery. I take a standard dose of Tylenol right before I exercise at home or go to PT. In addition I walk approx 1 1/2 miles/day with no problem. I am able to sleep both on my back (which I couldn't do pre-surgery) and on either side. Am still under doctor's orders to not bend at my back, not to lift heavy objects, not to twist my spine. Go back to surgeon in approx 2 months for x-rays to see how the bone fusion is progressing.

Frankly, I feel like I could begin to get back to a more active routine of running 3 - 4 miles several times/week and playing tennis 3 - 4 times week. Will not do either until I see my surgeon in February. In retrospect am very glad I chose the XLIF procedure. For the problems I was having and their root causes it made a lot of sense versus the other types of surgery available. While I am still dealing with some post-op issues, mainly weakness of my left leg and some soreness, I am pretty confident these will prove to be temporary.

My surgeon's office took x-rays when I went for my initial post-op exam. I was a bit surprised with the amount of metal put into my back. I have a brace on each side of my spine screwed in at L3,4,5. Each brace looks to be approx 5 inches long with 3 screws each that are several inches in length. I also saw the 2 implants (spacers) inserted between L3 - 4 and L4 - 5. They clearly lifted the bone off my nerves. The x-ray also confirmed that my vertebrae at L3, 4, 5 are now in perfect alignment, relieving the pressure on my spinal cord.

Keeping my fingers crossed that my x-ray in February shows indications of bone fusion.

3 MONTHS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):-ray
Today marks 12 weeks post-op. I have continued 2x/week PT sessions focused on core and specific muscle strength rebuilding, as well as daily stretching exercises at home. Walk approx 1 1/2 miles/day. Still am weaker on my left side (XLIF procedure went thru my left side) but have steadily increased strength. Feel real good except for some soreness in my upper buttocks, which I think is the result of my daily exercises. Go back to the surgeon on 2/13 to have an x-ray to gauge how my bone fusion is progressing. I feel good enough to return to running and playing tennis, but need to get the green light from the surgeon.

4MONTHS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):
Went to surgeon on 2/19/2014 for 2nd post-op visit. Have been going to PT 2x/week for 2.5 months and supplementing with exercises at home daily. Sore most days from exercises but definitely my core and specific muscles affected by surgery are stronger. Surgeon took X-rays, which showed good bone growth for both levels of my surgery and fusion. He gave me the go ahead to begin light jogging and to return to playing tennis, being careful not go for difficult shots. He believes my fusion will be nearly completed in 3 more months. I played 2 sets of doubles on 2/21 and ran approx 2 miles today. I am sore but overall feel great. Am playing tennis again tommorrow; expect to play 3x/week ongoing. Pre-surgery pain is gone and soreness I feel is mostly from strength-building exercises and using muscles for first time in 4 months. Feeling on top of world as I type this, and very cognizant of how blessed and fortunate I am to have my surgical outcome.

1 YEAR POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):

2 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):

3 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):

4 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):

5 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):

6 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):

7 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):