What can I do after a laminectomy with spinal fusion?

[JohnOL]

I'm about 3 weeks away from back surgery. I've tried for years to overcome or train out/away my leg/back issues with no success. Believe me I just did not want to have to resort to surgery. My spinal stenosis in the L4-L5 area is severe. My buttox, hamstring and general leg pain is making life difficult. MRI and CT have very clear findings that I need to decompress my spinal cord and the vertebral misalignment is quite obvious.

Currently 210 Lbs 15 Lbs of which has been added due to inactivity, holidays and general sitting on my ass due to my condition. I used to be 5' 9" but they tell me I'm 5' 8.5" now.

My neurosurgeon says that I will be back in the gym again but will have to avoid heavy bending & twisting movements. I have slippage between L3 &L4 that my surgeon said should be corrected along with the laminectomy. He says I need a single level fusion and will use bone from the laminectomy in the fusion avoiding donor bone.

I want to get back to my active lifestyle. Training in the gym has been a regular activity since my teens and I'm 63 now. Up until a few months ago I was hiking in the hills with my 2 German Shepherd Dogs 4 to 6 days a week 5 to 7 miles per trip. The post hike leg pain became too severe and I had to stop hiking. I stopped squatting and deadlifting during the summer. Bench pressing I can not put my feet on the floor with out pain, forget about trying to arch my back. I will just hold my legs in the air with my ankles crossed. I stopped Pressing too. Pullups and bench press became my only exercises. Occasionally I would do some seated supported dumbbell presses.

I've also been told I will be out of work for at least 6 weeks and will need to wear a belt type back brace when up and around. I know doctors are overly conservative with their recovery guidelines but also I don't want to be stupid.

Any advice for what a guy like me can return to doing or what I must just avoid having fusion hardware in my spine?

**P.S. My son received his own copies of Starting Strength and Practical Programing for Christmas. He is currently serving as an Airborne Infantryman and is working on earning his way to SF.

[Mark Rippetoe]

John, I hate to tell you this, but this is just your first back surgery. I've had two guys in my gym start this process, and it's never finished. Back surgery is the shittiest of all options, because 1/3 of the time it works, 1/3 of the time it doesn't improve anything, and 1/3 of the time it makes things worse. Your odds are never good. If there is any way to avoid this and get back to squatting and rack pulling, you should. It sounds like things got worse when you stopped loading your back. You have 3 weeks to see.

[JohnOL]

John, I hate to tell you this, but this is just your first back surgery. I've had two guys in my gym start this process, and it's never finished. Back surgery is the shittiest of all options, because 1/3 of the time it works, 1/3 of the time it doesn't improve anything, and 1/3 of the time it makes things worse. Your odds are never good. If there is any way to avoid this and get back to squatting and rack pulling, you should. It sounds like things got worse when you stopped loading your back. You have 3 weeks to see.

Ripp,

I hear you 100% and a year ago I said those percentages to a neuromuscular specialist MD and he agreed.
However my problems have only worsened even while training squats & deadlifts. My Spinal Stenosis is significant and is severely impinging on my cord in the L4 L5 area. My symptoms vary from feeling good in the morning to wondering last night if I could make the 1500 foot trip to the corner and back with the dogs. My leg pain is always there it’s the severity that changes.

My neurosurgeon said he can’t predict who will need follow on surgeries. However he said they are a very small fraction of his back surgeries. I’m in the medical field as an engineer working with CT scan, MRI and PET scan. I’ve seen thousands or scans while I’m not trained to diagnose I can easily see my problems. And it appears only miraculous training would solve my problems.

I’m at the stage where I want to feel just plain good enough to stand for any length of time without pain. Even going to bed at night is an ordeal. I need to adopt a fetal position to stretch and open the impinged area before I can lay out flat and it is not unusual for me to need to take 600 mg of ibuprofen just to calm the throbbing leg pain so I can fall asleep.

PS I greatly enjoy SS Radio!

[Mark Rippetoe]

Have you tried spinal decompression with a chiropractor? Exhaust all your options before surgery.

[JohnOL]

Have you tried spinal decompression with a chiropractor? Exhaust all your options before surgery.

Yup!

Physical Therapy -> Joke! But he was better at diagnosing my condition than all the previous M.D.s (pre-imaging). 1st time I ever heard Spinal Stenosis & Laminectomy. He said my symptoms indicated stenosis.
Chiropractor for months no improvement.
Pain management M.D. for spinal injections. Lidocaine to see if I was a candidate for a nerve ablation. Injections did nothing.

Thanks Rip for responding. At this stage I'm hoping for a good result, my overall physical condition, positive attitude, commitment to get back to training and a very active lifestyle will carry me through. I'm 100% medication free. At 63 I take nothing and want nothing in my system. Prior to this back issue I could keep up with guys half my age. (Now I know what kills people!)

P.S. I really appreciate your political philosophy. I'm trapped in the Commie controlled NorthEast. Trying to get my wife to move to a free state but she tells me not while her mom is alive. She is 91 and carries a pharmacy in her pocketbook and has more Dr's that Old Senile Joe. But she is sharp as a tack and still driving.

[VNV]

54 y.o. here. I have some milder lower back pain. An Xray indicated minor pathology around L4/5 and L5/S. *No stenosis observed* (at least, that word was not in the radiology report). My issues are niggling compared to yours. With the disclaimer that this is way above me, I'll add a comment.

I am currently decompressing my spine by hanging from a squat rack with wrist hooks and am noticing positive changes. An intense pain moved from my right hamstring, to an attenuated one in my left lower back. There's some technique to a dead hang. Sucking in the gut seems to let the pelvis hang looser; it produces the feeling of additional tension in the lower back.

It's not clear that a physical therapist would be as aggressive - even if they have you on an inversion table.

I'm following some old advice on Rip's board: 3 sets of 30 seconds, 2x a day (or more, as time permits).

Obviously, this is not medical advice. A dead hang might be totally contra-indicated for your back issues; it's beyond me to determine.

[ML67]

I can't talk to training after fusion, but had 2-level laminectomy/facetectomy (L3-5) ~ 20 mos. ago due to severe stenosis with neurogenic claudication. I'm 64 and recently set new squat (415) and bench (307.5) PRs. Deadlifts are stuck at 425, so I've started a halting/rack pull split to get unstuck. For me, surgery was not an option - I simply couldn't be on my feet for more than 10 to 15 minutes w/o severe numbness and pain in lower extremities. I trained right up to surgery - did a set of deadlifts day before surgery.

Here is more detailed information on my experience. 2-Level Laminectomy

Unfortunately, surgery cannot always be avoided. Hopefully you've found some magic in these last few weeks. Did you end up having the surgery?

[JRT6]

I'm not going to go into my health history but I've had 13 surgeries and counting at age 54. I'm a life long strength athlete but I also have a strong genetic predisposition for arthritis, plus I made a lot of training mistakes when I was younger.

I knew I had a touchy back for years but as long as i didn't box squat or suddenly stand for 8 hrs straight it wasn't an issue.

A couple months ago I went for a leisurely incline treadmill walk and that has been the last time I've ever been allowed to hold more than 10lbs.

I had back pain so bad I understand why people in pain self select. In patient meds barely dented the pain. I swear to God I can't do that again.

MRI showed advanced stenosis L2-5. To the point I was barely in control of my bladder. Had the surgery and it turns out my ridiculous pain was from undiagnosed chronic spinal myelytis. So my back giving out may have saved life.

I got a laminectomy but didn't get anything done to my disks because Ripp is 100% correct about segment disease. And four fused disks will never stop. My surgeon bought me some time. I'm not a candidate for disk replacement because of the laminectomy. At least at this point.

My surgeon said I had the strongest spinal musculature he has seen at any age.

My goal now isn't to be the strongest ever; my goal is to be strong as long as possible.

I am still on 24/7 IV antibiotics. I went for a walk today but I live in Pittsburgh so everything is a hill which I actually like a lot. I did three miles and my quads and back were smoked.

I will have 100% clearance at the gym soon. BJJ, I'm a long time brown belt, may not happen anymore.