Question
Hi Margot, I found you by goggling this post-op problem. I am a 52 yo female (healthy and active), who had suffered with low back pain for 3x years. I had my first fusion (L4-5) in March 2009 with a bone graft taken from my right iliac crest. At @ 6 weeks post-op, I bent over to load the dishwasher and felt/heard a pop in the graft area; I continued to have pain here and in October 2009, the Orthopedic surgeon went in to explore and reattached the fascia and pulled up the ligaments and muscle and sewed them to the ilium. I continued to have pain over the right SI joint, right hip and graft site. Then, I needed a second fusion ( L-3) in December 2009. This time, he took a bone marrow aspiration from the left ilium and it doesn't bother me. To date, my grafts have taken and he says the spine looks good. My concern is the "severe" throbbing and ache I continue to have over the right iliac crest which radiates around to my right groin and into the perineum and sacrum.I also have a sight limp and some right leg pain. I saw the surgeon today, 5/18/2010 and he suggested PT, continue the Hydrocodone and try an anti-inflammatory. Do you think I need a second opinion, ie., see a Neurosurgeon?   Donna, RN

Answer
Hello Donna and thanks for writing

It sounds like both your surgeries worked out quite well with the obvious exception of the lingering iliac discomfort, but at least your back is okay because as I抦 sure you抣l well aware, many people are not so lucky with resolving the severe back pain after fusions.

The throbbing sounds more like inflammation by the way you describe it than nerve involvement so I抦 not sure a neurologist would be your beds bet for a second opinion.  I am curious about your alignment and care strength, perhaps you抳e been favouring one side for quite a while and your body has accommodated so long it抯 permanently off center now.  

I抦 not a big believer in chiropractors, mostly because there are so many dangerous ones out there, but I certainly do believe in the science.  I抦 thinking maybe a good sports medicine physician might be a sensible next step as they have a great deal of knowledge in the area of joint inflammation and alignment issues ?if you could find one who works at or with a rehab center you could do rehab physio under their guidance.  If I was you, that would be my next step along with doing core strengthening exercises on my own in between appointments.  

Wishing you all the best, I hope you抮e better soon!
Margot