My Latest Spinal Fusion Surgery of February, 2024, and Dealing With Psoriatic Arthritis (PsA)

This page is to share more details about my most recent spinal fusion surgery in February 2024 for those interested and for those who may have or be faced with a similar situation and/or for those dealing with Psoriatic Arthritis (PsA).

Another major spinal fusion surgery up to the T10 level to straighten out my spine in March 2023 was complicated by the treatments for my Psoriatic Arthritis (PsA) when the surgical incision was dehissed four weeks later in mid-April. More properly, “wound dehiscence” occurs when a surgical incision reopens. That required another rushed surgery to reopen, cleanse, and disinfect the entire surgical area once again to prevent infection (it was open and bleeding out for four days from Friday to Tuesday) and reclose the incision, this time with three different layers of various sutures to ensure it stayed closed. Another week in the hospital and round-the-clock antibiotics spared me from any serious infections after the incision in my back was open for days. God be praised!

In November, a follow-up x-ray revealed that my spine had pulled away from the fusion screws at the top two levels, T10 and T11. Both screws in T10 had loosened and pulled away, and one screw in T11. A CAT Scan, MRI, and another CAT Scan followed over the next few months, preparing for yet another surgery. And this would be a major and extensive surgery, it turned out.

The surgery that took place in mid-February of this year, 2024, had four goals.

The first was to remove and replace (with larger ones) the loose screws in T10 and T11.
Second, to deal with two new ruptured discs that were nearly pressing on my spinal cord, one above the existing fusions and one below.
Third then, fuse two more additional levels at T8 and T9 above all the rest to strengthen and support the repairs that had been done with the new larger screws at T10 and T11. Unfortunately, the screw holes at T10 were so stripped out that the surgeons, without enough bone left to secure any screws, were unable to place any larger screws in that vertebrae, so it remains unsecured in the middle of the others and hopefully will not present any new issues or problems going forward. Fingers crossed!
And four, the base of my spine was no longer supporting my upper spinal column, so they revisited and reworked the existing fusion of L5 to S1 from 2001 with additional hardware and then, finally, fastened and secured my sacroiliac to my pelvis with long screws so that nothing moves at the base at all any longer.

The surgery lasted over six hours, and the incision ended up being over 17″ (43 cm) in length. It was closed with a first layer of permanent nylon sutures, which will never be removed (until the next possible surgery, that is), and then 60 staples from top to bottom. By “bottom,” I mean just above where important bathroom business takes place if you get my drift.

Complicating recovery has been repeated bouts with my Psoriatic Arthritis (PsA). PsA is a chronic inflammatory condition that stems from an issue with an overactive immune system out of whack. I had been doing self-administered injections of Humira every other week to address the PsA to suppress my immune system, but I needed to get off the medication for several weeks before and after the surgery so that everything would heal properly and the incision not dehiss or split open again.

But, with PsA, one is subject to “flares” when the disease symptoms worsen. For me, a flare is like having the flu without a fever. Whatever hurts — hurts more. In addition, things that normally do not hurt suddenly begin hurting, like knees, hands, wrists, shoulders, etc. PsA also affects where tendons attach to the bones, and for me, specifically the Achilles tendons, feet, and left wrist, in addition to inflaming the cartilage where ribs attach to the breastbone, causing the chest to ache. Intestinal issues abound, including upset stomach, bloating, nausea, and diarrhea, together with extreme tiredness and lack of energy. Pretty much all I feel like doing is lying down and being left alone. And my face breaks out with adult acne, so there’s that neat little wrinkle, too.

Basically —

You feel like you are down with the flu . . . . but you’re not.
You feel like you may be having a heart attack from chest pain . . . . but you’re not.
Your face breaks out like you are still a teenager . . . . but you’re not.

Sometimes, I can tell when a flare-up may come a day or two in advance. My face breaks out, and my lower legs, ankles, and feet swell—a lot. The rest of it inevitably follows over the ensuing days. But at other times, I can go to bed feeling perfectly fine and awaken the next day with swollen legs and feet and feel like I was run over by a garbage truck.

Following my surgery and having been on a Humira “vacation” for several weeks, major flares came every seven to ten days and lasted progressively longer and longer, not two to three days anymore, but eight to ten days in duration. Then, a week of feeling somewhat better with only the normal after-surgery misery, only to be struck down by yet another extended PsA flare.

I have been back on Humira for two months, and my rheumatologist has upgraded my injections from every other week to weekly now, hopefully, to shorten the time period required to get back to the therapeutic dosage level more quickly, which is normally 24 to 26 weeks otherwise. I have too much to catch up on to wait for that, and so far, everything seems to be getting better, with the duration and severity of flares much decreased. And I am walking my little Chihuahua assistant again! So that is all a very good thing.

For the past sixteen months, I have been living in one full back brace or another. I am now also wearing a special bone growth stimulator for a half-hour every day. As I understand it, this device delivers a magnetic ultrasound signal through the skin to the surgery sites to stimulate bone tissue for growth and healing, developing solid new bone fusions of my vertebrae. It is a $5,000 piece of equipment and came with a hefty out-of-pocket co-pay, so truly hoping this works!

Following last year’s post-surgery piece, I was asked by a number of followers to please start posting more about my surgery preparation tips, along with the various tools and equipment I use to get thru the day and my feelings about them. Always reticent to share too much on the personal side, I held back from doing that, but following this last go around will go ahead and start sharing some of those things, dealing with PsA and other issues, etc. If for no other reason than simply to let others know they are not the only ones dealing with these things, and that especially with PsA, a lot of what one may be feeling or dealing with is not in the imagination. There is no one specific test for PsA, and in my case, it took several years for doctors to get diagnosed. So, for those interested, please watch for that.