Neurosurgeon Questions

“Increased pain and swelling after spinal fusion”

I had a fusion of L3/L4 on Nov 13th. After the surgery I had increased nerve pain down my right leg and a numb right calf I hadn't had prior. I have spondolthesis there. Anyhow pain seems to be increasing to the point today I felt like I did immediately post op. They won't prescribe narcotics after 14 days I guess. All I got was 1 hydrocodone. The pain was never really controlled. Biggest concern is the swelling at the top of the incision. It's fairly hard. No noted drainage. I finally get a F/U in person on Wed. Adding photos from post op and today. Should I be concerned? Should I call on call # ?? Will I be ok to wait til Wed. It's 250 miles to appt.

Female | 55 years old
Complaint duration: 18 days
Medications: Levothyroxine .25 mcg qd. Nuerontin 300mg tid, xanax .5mg tid prn , Cymbalta 60mg qd, calvoum. Vit d , recently added flexiril 10mg tid pro, amoxicillin 875mg bid x 7 days, a few hydrocodone 7.5/325 MG q6hours prn
Conditions: Spondolythesis. Hypothyroid, anxiety, depression, tmj

4 Answers

You should have post operative imaging and have your surgeon address this.
The hard portion at the top of your incision is usually muscle. That will subside with time. As long as there is no drainage or redness that is spreading chances are it is normal. As always, this is something you can discuss with your surgeon's office since it would depend on the type of surgery you had
Im sorry that you have these issues after a fusion procedure.  While I cannot answer definitively, I will try to serve as a guide for you. The incision site looks like it is healing properly.  The swelling you are noting appears to be the way you are seeing how the incision was stitched together.  Without any drainage or redness, I would continue to watch and ice it if necessary. The pain is the biggest concern here.  Although pain after a spodylolisthesis fusion procedure is expected, you should have a plan in place by your team to help manage the pain, particularly given how far you are from your center.  The pain and numbness down the leg can be considered normal, but you should talk to your providers so they are aware and can manage it in their own way. Good luck.
Hello, If you are having any fevers, redness around the incision or worried that you have worsened since surgery you should head to your nearest emergency room/urgent care center. If its just pain then toughing it out until your appointment is reasonable, but since I am unable to examine you or feel your incision myself I can not fully provide you accurate medical care. Hope this helps. Be well, Aleka Scoco, MD