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March 9, 2010 - 6:52pm
Possible fusion, L4-L5 Any Advice? Anyone ever had a disc replacement?
After a year and a half of being in pain. After my second discectomy on l4-5 I have just been to my new neuro. This morning I fell to the ground from shooting stabbing pain in my low back. The pain felt like it did when i had the herniation. However after visiting with doc today he said there is no herniation at l5 s1 like i thought there might have been. Disc bulge there but nothing surgical. He thinks that since I have had two surgeries on same level L4-L5 both sides that there is not much left there. There is edema, and bone on bone,which is causing all my pain. He has ordered a bone scan with dye. He will look over that and decide if I need a discogram? I guess where they stick a needle in your disc and inject dye and u tell them when it hurts, he said it is very painful procedure but will determine if a fusion is appropriate. Has anyone had a fusion, and please tell me about your experience. I have been in constant pain and cannot do much of anything. Pain clinic shots have done nothing. On MS Contin 15 mg, Ultram, and Topomax. Doesn't do a whole lot for pain either. Has anyone had a disc replacement which I understand allows you more mobility than a fusion. A fusion scares me that I won't have any mobility. The doc said even if I get the fusion that he couldn't guarantee it would relieve my pain. I was hoping he would say yes I found the problem and I can fix it. Of course it's never that easy. Any advice about fusions or disc replacement would be appreciated! Thanks All
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If you go to the section of the board under Treatments called "Back surgery and neck surgery" you will find many threads pertaining to fusion surgeries. Or you can type "fusion" into the search box and see what all pops up...same for discogram if you are curious about that test.
Is most of your pain in your back or in your leg? Results tend to be somewhat better if the majority of pain is in the leg.
Discograms are a somewhat controversial procedure. Some surgeons are uncomfortable operating if the patient has not had one, but others feel they are an unnecessary, risky procedure. Depending on the problem, they are not always necessary.
Before you make any decisions, do your homework so you know what a fusion entails, the resulting recovery, etc. There are many articles on this website as well as others on the internet. You might also want to get a "second" opinion from a specialist in a different practice.
You can start your education here:
http://www.spine-health.com/treatment/spinal-fusion/lumbar-spinal-fusion...
You will note that the article states that in a one level fusion, movement is not restricted. I have found that to be true with my fusion at L4-5.
There are some people on the board who have had ADR. Again run a search and read their experiences.
Take your time making your decision. There is no need to rush into it unless you were to develop bowel or bladder problems. You want to be sure that there are no other alternatives before proceeding with fusion. It is the end of the line as far as back surgeries go...and once you have it, there is no reversing the process.
Good luck.
Gwennie
I have no medical training. Comments are based on personal experience and lots of research and reading.
PLIF @ L4-5 with Peek cage, rods and screws Jan 2008
Lami-foraminotomy L5-S1 Jan 2009
Fusion L3-S1 coming up -- 1 June
1. The merits of a discogram is questionable.
2. You did not suggest that the surgeon identified and reported instability at L4/L5, so why perform a fusion?
3. There are numerous artificial disc options, so get a second opinion if the real problem is excessive dessication of the L4/L5 remnant with significant loss of residual disc height.
I went through 2 surgeries, failed bone graphs, before they put the rods and screws in. If they would have told me about all the nerve, scar tissue and stenosis that would occur I would not have had this done until there was no other choice! My father has what you have, bone on bone same spot. He does stretching, sees the chiropractor, ices the area and does epsom salt bathes and has finally through all this got the pain under control, but I will say if he skips any of his ritual he is back to the pain and bedbound. He chose not to have the surgery after watching what I have been going through. Oh, he also gets medical massage and does excercises that strengthen his stomach muscles as those muscles support 80% of your back. I would talk to several doctors, get the facts about the long term effects that can or will probably happen before you make a decision. Good luck!