--- In piriformissyndrome@yahoogroups.com, "Joyce Zannoni"
<jaymzed@n...> wrote:
>
> Dear Mary
>
> Thanks for your support and detailed notes ref L5/S1 fusion and
outcomes. You have absolutely hit the nail on the head here.
Surgeons are not always aware of body mechanics whereas Chiros are.
>
> I had my metalwork removed 1 year post fusion - the surgeon
thought the titanium might be contributing to the pain but 2 weeks
after removal the pain got consistently worse, especially through
loading. I.e. sitting, standing in a static pose and so on.
>
> My Chiropractic told me exactly what you have reported. The load
at the sacrum is increased by the welding etc. and other muscles are
put under considerble strain including sacroiliac slip.
>
> Although Chiropractic manipulations, traction, exercises have
helped considerably (my sacroiliac joint was pretty much non-
functioning a year ago) there's not much more he can do for me.
>
> Have been offered piriformis release by another specialist in the
UK but declined the op as my Chiropractic warned me of the possible
consequences on muscle and pelvic stability.
>
> I am due to have root nerve injections at L5 S1 and S2 level but
the question of the fusion being absolutely solid is now also under
scrutiny. I'm like a dog chasing my own tail!! I never want to
undergo that surgery again!
>
> Jo
> ----- Original Message -----
> From: Mary Smith
> To: piriformissyndrome@yahoogroups.com
> Sent: Saturday, September 10, 2005 9:44 PM
> Subject: [Piriformis syndrome] fusion, SI dysfunction,
Piriformis Syndrome
>
>
> Joyce & Jamie- here are some thoughts that I wrote on
> a previous back pain group. I'm posting it here in
> case it might be relevant to your situations.
>
> " According to my Physical Therapist, 95%
> of of L5-S1 fusions fail. This means that at some
> point the hardware comes loose. Once that happens you
> will have pain just from the hardware & possible
> disk/nerve pain again. So they have to go back in
> tighten the screws again. It probably won't happen for
> years, but with a 95% failure rate, you can bet it
> will eventually happen to you.
>
> The reason for the failure is the location. L5-S1 is
> THE major point of motion transferring from the lower
> to upper body & vice versa. Although, they use
> Titanium parts, you can not rewrite the laws of
> physics, and that motion has to be transferred. So the
> sheer force of the movement will eventually loosen the
> hardware.
>
> I was thinking about the after effects of an L5-S1
> fusion on the pelvis. Once the fusion is done, the
> sacrum cannot be moved relative to the L5 vertebrae.
> (in effect, you "welded" the sacrum in a certain
> position)
>
> If the pelvis was not in the correct neutral position
> at the time of surgery, this will create &/or
> perpetuate problems in pelvis mechanics, which will
> result in pain elsewhere.
>
> Once fused, manual techniques will be limited in their
> ability to re-balance the pelvis. The therapist will
> only be able to adjust the other pelvic bones in
> relation to the sacrum, but not the sacrum itself.
>
> While the surgery may stop pain at the disk level, it
> will perpetuate problems in the pelvis.
>
> For example, this may explain why one person said the
> fusion worked but he has pain from sitting.
>
> Therefore, it is extremely important the pelvis be in
> the correct position during surgery. But the odds of
> that happening are reduced by two factors. 1- the
> muscle compensations resulting from pain, pull the
> pelvic bones out of position long before surgery
> happens & 2- Surgeons, in particular, are
> underinformed about the dynamics of pelvic
> biomechanics.
>
> Unfortunately, I suspect most of your doctors
> have no idea what I'm talking about. A chiropractor
> would understand though."
>
> In other words, one of many possible long term effects
> of having an L5/S1 fusion could be Piriformis Syndrome
> or other low back problems because the surgery has
> created a permanent pelvic imbalance that can not be
> completely created manually.
>
> Thinking out loud - if one then has surgery to relieve
> the Piriformis Syndrome - I wonder what other back
> pain problems will be created down the road.
>
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>
I heard Mary say this in another group also, but my friend has had
11-12 surgeys on her lower back,now her upper back is giving out
cause it has been carring the full load, she really has spent mons.
in rehap,I mean living at the place. So I saw her about a month ago,
I was so suprised by how much weight she has gained,cause of all the
surgeyes,she is practially bed-ridden, & she is only 43yr.old, so
now with all the screws & rods,shes really against the wall,she has
done it all & still in so much pain. 'As most surgens
say/think...you shouldn't be in pain,I just fixed your pain' Now
another friend had a fushion with the rods only to come back with
more pain also,so 4-5 mons. later he rolles his car on the Freeway,
& what a suprise,90% of his pain is gone,the Dr. can't explaine it
either?? Now another person I talk to had his neck fused,he had some
pain there & headaches that went on for wks. but he was O.K. for
3yrs,not pain free, I don't know if all of us in pain now except to
ever be painfree,I don't,I know I'll be in some kind of pain the
rest of my life,as someone said in one of the posts...I also was
told by the first M.D. I saw..'LEARN HOW TO LIVE WITH IT' so I have,
but I'am so sick of living in pain,saying no I can't go there or No
I can't do this with you,all cause of pain. Good Luck,hope you get
this message. Hugs, Pegi