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  1. #1
    Join Date
    Sep. 3, 2010
    Location
    Northeast
    Posts
    58

    Default Riding after spinal fusion?

    Hi,

    have a question. Has anyone on here had L5-S1 fused ???

    I hear thats the most common past to have fused when you have back issues. But, Im trying to find people who ride that have had it done.
    My b/f will be getting it done soon. We looked on the internet and found lots of people that said how great it was, no more pain, etc. Only the occasional person that said it was a nightmare and theyre always in pain now. Usually those people also had dozens of other issues and had other back surgeries.

    hes never had any other back surgery. I told him I would ask on some horse forums to see if any riders ever had that particular area fused and if they can ride again, which is what he is worried about. Of course.....if he cant ride a horse, then he probably wont be able to do his job either (military) and will be really screwed!!!!!

    thanks!



  2. #2
    Join Date
    Aug. 9, 2002
    Location
    USA
    Posts
    1,914

    Default

    Yes, I have. Here's my story:

    I had my first fusion in 2001 (I was 22 years old). L5-S1 was fused; had 4 pedicle screws placed with vertical rods connecting them. They did take a block of bone from my iliac crest (back of pelvic bone) as a bone graft - that was the worst part of the recovery. The back felt better long before the pelvis did.

    My second fusion was in 2004. This time they fused L4-L5. The S1 pedicle screws were removed as that fusion was solid and they weren't needed. They used the existing L5 pedicle screws, added screws to L4 and placed vertical rods and a horizontal crosspiece connecting the center of the rods. This time they removed the L4-L5 disc and placed a block of cadaver bone in it's place.

    Recovery from the second surgery was much quicker. I've had no problems since, I have excellent mobility (can still touch my toes while keeping my knees straight!), and I can ride without any problems. I do mostly dressage work with my OTTB who is prone to "Thoroughbred Moments" when he thinks something will jump out of the trees and eat him.

    I do not ride with a back brace. Both surgeons said it would not help and if anything, would hurt me in the long run as the muscles would become dependent on the brace. Strong core muscles (esp. abdominal muscles) will protect your discs above & below the fusion, not a brace.

    I do a lot of routine work around the house; gardening, bending over, waxing the cars, stacking firewood... I might be a little sore after waxing 2 cars in a day, but who wouldn't?

    I do have a patch of permanent numbness on the outside of my thigh; that's been there since the first surgery. And I do get goosebumps in odd patches on both legs....both were chalked up to nerve damage.

    One more thing: My first surgery was done by an orthopaedic surgeon who specialized in spines. My second was done by a neurosurgeon. If possible, use a neurosurgeon. My second surgery was 8.5 hours long compared to the first (3 hours) and I really feel like the neurosurgeon was very thorough and meticulous where the ortho was just concerned with finishing the surgery.

    Full recovery was about 6 months for me, but I am a very active person. If you have a desk job, I'd say 3-4 months, MAYBE two.

    Both my surgeries were done posterior (through the back), still have a nice long scar down my spine & likely always will. Only one incision, about 5-6" long.The surgery and recovery is TOUGH. I spent 5 days in the hospital each time. It was about 2 or 3 months before I was cleared to drive as I lost all the reflexes in my right leg.

    Best to you, please feel free to PM if you have any questions....

    Taryn

    ETA: Since you're in the northeast, I may be able to recommend docs to use and those to stay away from. If you like, PM me your general location and I'll see what I can dig up (used to work for an ortho surgeon & we had a spinal specialist on staff).



  3. #3
    Join Date
    Dec. 19, 2009
    Posts
    449

    Default

    I had 3 level fusion. I agree with taryn, a neurosurgeon is absolutely the better person to use. I was told riding was okay but he would prefer that I not sit trot, and use jumping position in the canter. No jumping. I was told if I followed h is suggestions, I would probably go about 10 years before I might need additional work on my back.



  4. #4
    Join Date
    Jul. 10, 2001
    Posts
    6,704

    Default

    Quote Originally Posted by tarynls View Post
    One more thing: My first surgery was done by an orthopaedic surgeon who specialized in spines. My second was done by a neurosurgeon. If possible, use a neurosurgeon. My second surgery was 8.5 hours long compared to the first (3 hours) and I really feel like the neurosurgeon was very thorough and meticulous where the ortho was just concerned with finishing the surgery.
    I will disagree with this. I am a researcher with an orthopaedic spine group at the medical school. I am not sure how you know if the orthopod was more concerned with finishing given that you were under anesthesia. Surgical times are not indicative of surgical capability. A L-S fusion is generally easier due to the stability of the sacral vertebra as compared to the L, T and C. I have been in 13+ hour surgeries for L and T and 6 hours for L-S (our patients tend to have massive deformities or trauma). It also depends if they go anterior/posterior/both etc. You definitely learn how to stand on not use a bathroom for exceedingly long times.

    A good surgeon is a good surgeon. Then the only difference between an orthopod and a neuro in spine is how dainty their hands are. My suggestion is to get a surgeon, regardless of who, who has done a significant number of fusions. Make sure they understand your EXPECTED outcomes, e.g. want to ride. A surgeon who is also up on the more recent orthobiologics and enhanced fusion techniques is good too. Yes, you do not want a person who will just rely on the instrumentation to obtain fusion.

    A friend of mine just had a revision on a 2 level fusion in the L and is back riding comfortably (reiner). I have her first set of hardware on my desk. Her revision was due to non-union (failed to fuse).



  5. #5
    Join Date
    Aug. 9, 2002
    Location
    USA
    Posts
    1,914

    Default

    Quote Originally Posted by RAyers View Post
    I will disagree with this. I am a researcher with an orthopaedic spine group at the medical school. I am not sure how you know if the orthopod was more concerned with finishing given that you were under anesthesia. Surgical times are not indicative of surgical capability. A L-S fusion is generally easier due to the stability of the sacral vertebra as compared to the L, T and C.
    I agree with the statement that surgical times are not indicative of surgical capability.

    However, going into the first surgery, the orthopod was aware that I had more than one sacral vertebra. Part of the reason I had the second fusion was that the L4-5 disc herniated. The other reason was the first surgery needed to be completely revised as there were many issues that were not addressed. That would certainly fall into the category of 'fully research your surgeon before letting him/her operate'.

    I was in constant pain between the first two surgeries. The last fusion was done in October of 2004 and I have been pain-free since. We've even started conditioning my TB for long-distance rides and I can handle a 12-mile ride with no issues.

    OP, best of luck!



  6. #6
    Join Date
    Oct. 29, 2000
    Location
    Southern Pines, N.C.
    Posts
    11,448

    Default

    I had my fusions (triple level cervical) done at Stanford Medical Center in Ca. -- I don't know if they are the norm or not, but there was an understanding there that Neurosurgeons operate above T6, while Orthopedists' territory begins at that vertebrae and goes on down.

    I was dating an Orthopedist at the time and he told me that this "line in the sand" (or in the spine) has settled a lot of inter-specialist warfare, and everyone was good about living with it.

    So, if you were at Stanford, there would be no question -- an Orthopedist would do your surgery. You could, of course, choose your ortho.
    "I used to have money, now I have horses."



  7. #7
    Join Date
    Feb. 10, 2006
    Location
    Middle of Nowhere, take a right, FL
    Posts
    4,438

    Default

    I had it done and I will say it was HORRIBLY painful for the first week. But it got better after that. It would have been better if the stupid Dr. had not come and taken the morphine pump away the NEXT DAY. Yes you could get a shot from the nurses when you needed it but they were always busy and besides not wanting to bother them (they always seemed so harried) you of course had to WAIT while they got to it. So be sure and talk to the Dr. about that, they should leave it in for 2-3 days unless he doesn't need it. (everybody's pain tolerance is different) I did not have a great result but it was because of damage done to the nerve before surgery by the disk and during surgery. I'm about ready to start riding now (fusion was end of April), I wish I had access to an old plodder to start though rather than 2 um ALERT TB mares.
    Every mighty oak was once a nut that stood its ground.

    Proud Closet Canterer! Member Riders with Fibromyalgia clique.



  8. #8
    Join Date
    Nov. 1, 2005
    Location
    Bonsall, CA- with my horses finally home again!
    Posts
    2,165

    Default

    I had my whole back fused and two Harrington rods installed when I was 16 due to rapidly-progressing scoliosis. From about the middle of my shoulder blades to my lower back (T2 to L1 maybe?). My x-rays are impressive... whole lotta hardware in there. I was in the hospital for a week, off the pain meds in 2 weeks, home from school for a month, I started running 3 months to the day after the surgery (I interpreted "you can start light exercise in 3 months as "I can run 5 miles my first day back ), and have never looked back. I ride, fall off, lift really heavy things, and almost never think about my fused back until I see threads like these pop up. Good luck to you- I would hate to think how deformed my body would be now if it hadn't been for that surgery almost 20 years ago

    (a caveat, i did start seeing an excellent chiropractor about 2 years ago. I always joke with him that he keeps me on the straight-and-narrow (some one has to! ) He does always comment that my range of motion and the types of activities I participate in are extremely impressive for someone with my kind of hardware. Maybe BECAUSE I started pushing the limits right away? YMMV of course)
    ~Living the life I imagined~



  9. #9
    Join Date
    Mar. 13, 2006
    Posts
    637

    Default

    Good responses! I, too am interested to hear the stories of other riders who have had the spinal fusion done on L-S.

    I have had 2 discectomy surgeries done on L5-S1 and I am now considering either a fusion or a trip to Europe to get a total disc replacement. I cannot decide which will be better in the long run.

    The disc replacement would be more costly (out of pocket/travel to Europe) but seems like a better option to me. I just don't know how long it will hold up. The spinal fusion sounds painful with a long recovery time and limited mobility. I am worried I might need to get it redone in 10 years also. Any opinions?

    Has anyone ever had a disc replacement surgery in Europe?



  10. #10
    Join Date
    Jun. 17, 2011
    Posts
    81

    Default

    Having gone through three spinal fusions with my mom, there are two critical things that you need to be concerned about. First off is get the best surgeon you can. Ortho (my mom's first surgeon) or Neuro (2nd and 3rd surgeons) isn't as big of a deal as how much surgery do they do, how long have they done it and do they generally do athletes or older people. LHU, never heard about the line for ortho and neuro in the spine but my mom's are low (S1, L5, L4, L3) and she had both types of surgeons. Lived in different cities for the surgeries, hence the different surgeons.

    A person in their 60's or 70's is a whole different ball game than one in their 20s or 30s.

    Secondly, make sure your surgeon is concerned about your rehab. It is essential that you have an incredibly strong core. Your back will be less flexible and therefore there will be more stress directly above and below the fusion. Your core needs to help compensate for that lack of mobility.

    You need to be stronger than the normal person to compensate for your back being less flexible.



  11. #11

    Default

    Quote Originally Posted by hey101 View Post
    I had my whole back fused and two Harrington rods installed when I was 16 due to rapidly-progressing scoliosis. From about the middle of my shoulder blades to my lower back (T2 to L1 maybe?). My x-rays are impressive... whole lotta hardware in there. I was in the hospital for a week, off the pain meds in 2 weeks, home from school for a month, I started running 3 months to the day after the surgery (I interpreted "you can start light exercise in 3 months as "I can run 5 miles my first day back ), and have never looked back. I ride, fall off, lift really heavy things, and almost never think about my fused back until I see threads like these pop up. Good luck to you- I would hate to think how deformed my body would be now if it hadn't been for that surgery almost 20 years ago

    This is me too. My surgery was 13 years ago, but otherwise the same, except the running--I don't run. Too boring and hard! LOL. I started riding again about a year after surgery, although I felt ready within a couple of months. My surgeon and my mom made me wait a full year. I have no issues resulting from the surgery.

    ETA: One thing I do consider is, when horse-shopping I specifically look for horses with an easy-to-sit trot. I want to minimize jarring as much as possible since I have no shock absorption in my spine. I'm a little concerned that, down the road, I may be prone to arthritis in the few vertebrae that are left unfused. But that hasn't been an issue yet, and your BF may not even worry about this at all since he's only having 1 joint fused.



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