Back Augmentation

After a recent visit with the back doctors, I am struck by the marked contrast between how great I feel on the outside and how thrashed I look on the inside!

After nearly three months of convalescence, last week was the first follow-on visit with the back doctors since surgery.  We compared "after the fall" x-ray film with film they took on the day of this recent visit.  The before surgery film showed a lower-down vertebra completely exploded and a higher-up vertebra pretty-well cracked.  The doctors explained that had the upper vertebra experienced damage similar to the lower one it would have been game over for my spinal cord.   Toward the base of the spinal column our spinal cords divide into several smaller nerve bundles that continue down to the lower extremities, and the exploded vertebra they replaced was below this critical junction.  Yet again, a very lucky dude.

The x-rays from the recent visit showed significant scaffolding they had installed on either side of my backbone like a ladder but with screws attached and extending into either side of each of four vertebra.  I'll save you the doctors' blow-by-blow of the surgery, but given that this blog is all about being a "cautionary tale" (please skip the rest of this paragraph if you're sensitive to graphic surgery descriptions) I will leave your imagination with the doctors being far from gentle with me while peeling back muscle and scouring bone prior to drilling screw placements to prevent infection.  

Because it hasn't felt like there's much of anything new back there, I was expecting to see not much more than a series of screws holding the vertebral together. Surprise! I wasn't aware they had installed that much hardware and that it will remain in place for the duration.

The doctors were pleased with what they saw and indicated I should gradually test the boundaries of BLT (bending, lifting, and twisting) restrictions established at the outset of the first three months after surgery.  Initially while still bed-ridden I was cautioned countless times to treat my legs & torso like a solid log and roll en-masse from one side of the bed to the other for position shifts to avoid pressure sores, linen changes, sponge baths, and other vital functions.  After gaining the freedom of my power wheel chair I was allowed to sit up throughout the day and carefully reach out with the slightest bit of back twist & bend.

Eventually, and within the limits of the range of motion resulting from the hardware, I should be able to do just about everything I was doing before the fall.  It's not that I might yank something loose by trying to do too much, but rather it will probably be a little bit more difficult to reach down and tie my shoes. The doctors suggested looking into shoes with Velcro straps, . . . but you still have to get down there to strap them, and I haven't seen Mountaineering boots with Velcro straps in any case.

Other good news is that I shouldn't be overly concerned about the numbness I feel in my lower left side where they went in to replace that one lower vertebra.  They explained that in moving a lot of stuff around during surgery the nerves in the area tend to shut down but that eventually they would likely settle down and start reporting feeling again.  OK, so I'll suspend disbelief on this aspect of recovery until the next visit with them three months hence.

Potential bad news is that because I'll be bending/twisting with only a subset of vertebra those that remain in action will get much more wear and tear then they would have otherwise, and there's a chance---even a likelihood---that within a decade or so they will be done and will need to be fused as well.  The doctors said that everyone is different and there's really no single protocol for long-term recovery from this type of surgery, so I'll just move forward with the assumption that my body will adapt and build muscle to support the weakened areas and everything will be just fine.