More Search Tools: Doctors Videos
Back Surgery and Neck Surgery
Welcome to Spine-health’s Back Surgery and Neck Surgery patient community. You can also read doctor approved Back Surgery and Neck Surgery Articles and watch Back Surgery and Neck Surgery Videos.
2 replies [Last post]
jenfab's picture
User offline. Last seen 2 weeks 4 days ago. Offline
Joined: 01/10/2009
Posts: 54
Points: 108
Double level fusion L4-5 LS1

I just came back from an appt. w/ my surgeon and am going to be having a fusion at the levels listed in my subject line. He said I will have two different incision sites...One in the front and one in the back. Is this normal? I am scared to death...I went in there hoping for a double disc replacement...but see now that is so not feasable due to insurance coverage etc.
Any info or experiences would be great. I pray to god I am doing the right thing...but am in so much everyday pain, I cant see it getting much worse.
My recent discogram really showed my discs are severly degenerated and have grade 5 tears in both.
Thanks for any info.

_____________

Bad back since early 1990's. Had a disectomy feb 07 at the L5 S1 level...LARGE rupture!!!!,DDD, disc buldges at levels L4 L5 L5S1 & T-11-12-- current massive sciatic pain. 38/female 2 duaghters 17 & 19. happily married for 20 years this aug.! Had 2ND Microdisectomy on Jan 15 2009...If possible...an EXTREMELY LARGER rupture at same level... Fentanyl 100mcgs and Norco for BT pain. Hope to wean down the patch soon. But not expecting miracles. Went to Post op appt.on March 10th and dr said that he had to not only remove the ruptured disc pieces, but go inside the disc space itself to retrieve broken up disc. Said I am NOT a good candidate for a fusion because I would need a double level, and he doesn't want to put me through that at my age (38)...but said I would be a great candidate for ADR (artificial disc replacement) and to wait about 3 mos after surgery to see where to go next.

Nov 2009
Had a Discogram done because the pain will not subside. It was very sucessful and showed two badly Degenerated discs and 4-5 grade tears in both (L4-5, L5-S1)
Have an appt. Dec 15th to see my surgeon and hopefully put in for the ADR... Am now told a fusion is likely..maybe its cuz I am older (39)? not sure.*crosses fingers and toes that its approved by my ins) But was told not to hold my breath and that we will prolly have to appeal it. I just dont want to live in this pain anymore Sad
Had my Appt and was told my insurance will not cover ADR..so I opted for the fusion. I will be having it done on Jan 15th 2010. It will be a 360 double level (L4-5 L5-S1) w/ hardware and BMP. SCARED!!!!!

User offline. Last seen 16 weeks 6 days ago. Offline
Joined: 08/25/2009
Posts: 7
Points: 14
Options

Maybe you could have fusion at L5-S1 and adr at L4-5.

lsteller's picture
User is online Online
Joined: 09/19/2008
Posts: 845
Points: 1714
Jen

I'm so sorry to hear you're still in pain after two discectomies. Dang! Fusion is not for the faint of heart, but they do tell me that you eventually recover from it. I had three levels done last November and am still very stiff and sore, but I'd have to say that the intense pain I suffered pre-surgery is largely gone. I was hardy and active before my surgery, but now I must weigh everything by, "will doing this hurt my back?" You must be prepared to avoid lifting, reaching, twisting, bending, etc., as folks with a fusion (especially a multi-level) are constantly at risk for damaging the discs above or below their fusion site (yours would be all above).

So, yes, the fusion will probably help to stop the majority of your extreme pain, but you must be prepared for a long recovery and you must be prepared for being careful with your spine for the rest of your life. I wish you the very best.

Linda

_____________

Ruptured discs L3/4, L4/5, L5/S1 May 2007
One ESI in 2007 with lots of PT
Microdiscectomy and foraminotomy L5/S1 December 2007
Worsening of symptoms (back pain, sciatica, right leg weakness) June 2008
New MRI and Discogram show all three discs torn through the annulus, left to right, all three levels
2 ESIs unsuccessful in managing pain
PT, Duragesic pain patch and percocet for break-through
Was told nothing could be done for me because I had three levels and DDD
Given option of three-level fusion after being told nothing could be done
Surgery was November 19, 2008 fusing L3/4 to S1
Attempted PLIF (from both sides) on November 19th.
Rods and pins were placed, but scar tissues prohibited removal of the old discs.
On November 24th, I had ALIF (opened from top of pubic bone to the bottom of my left ribcage) and removed the torn discs, placed dowels with cadaver bone, and some of my own bone marrow mixed with BMP. I left the hospital on the 26th of November.
Currently suffering temporary (hopefully) nerve damage of both legs and total numbness of right foot. Strange tingling in both feet at 4.5 months out of surgery. Numbness still exists in right foot at almost 9 months out.
Weaned off Fentanyl patches and only take occasional percocet for pain.

Jump to: