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Laminectomy vs. Fusion

darbymai59ddarbymai59 Posts: 55
edited 06/11/2012 - 8:25 AM in Back Surgery and Neck Surgery
I seen a surgeon for the 1st time yesterday (ortho). I also plan to get an opinion from a neurosurgeon. I have already exhausted PM options. I was not too happy about what he told me. He said I have central spinal stenosis at L4/5 that is almost completely closed. He also said I have spondylolisthesis. I have numbness in lower leg and very bad back & sciatica pain. He gave me a choice to have a laminectomy or a L4/5 fusion. Both surgeries really scare me. He said the laminectomy will help but the fusion will help quite a bit more. I don't know if I should try the laminectomy first or just go ahead with the fusion. The recovery times are a lot different.

Can anyone give me their thoughts on this. Help!

Darby

__________________________________________
PM Procedures:
1 ESI, 2 Transforaminal Injections
Lumbar Medial Nerve Block
Radiofrequency Nerve Ablation
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Comments

  • See the NS before making your decision. I had both the lami and fusion done at the same time.

    Keith
    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Darby,

    If possible get a second opinion. Now as far as your question, it does not have to be either or. I had a fusion, but the OS also did several laminectomies and foramenctomies during that surgery. Part of the package. I just talked to somebody today who had a laminectomy at first, but a few months later had to have the fusion anyways. That is why I think it would be good to talk to more than one surgeon, see what the consensus is.

    Good luck!

    Kin
  • your already right in already having a appt with a neuro to.
    i know with the spondylolithesis which i had depending on the degree, i was told a fusion was the only way to fix that, as spondy is "a unstable spine" meaning if you put one fist ontop of the other and tilt them that is what your spine is doing.
    i was very pleased with my fusion for that. i mean i still get the same deep burning here and there. its not constant anymore.but otherwise i am very pleased.
    so get your two opinions as you are the only one that can make the decsion.
    and yes your right a fusion is a longer recovery..

    good luck in your decision!!!
    terri O:)
  • that you really need to get another opinion before you make a decision. Terri explained the spondy well and it makes sense that if that is an issue then a fusion will fix that but a laminectomy wont.
    i also had laminectomies with each level of fusion.

    Blessings Sara O:)
  • Darby, I had bil laminectomies with my fusion as well. I had an unstable spondy. Sometimes spondylolisthesis is stable meaning it is fixated in that position and doesn't move. Or it can be like mine and be unstable. I had flexion and extension xrays to check for the instability. They can't tell it on an MRI or reg Xray. I guess a stable spondy would be at risk for becoming an unstable spondy over time. Something like 8% of the population in general are walking around with a spondy, and most have no symptoms and don't even know about it.

    Do get that second opinion. See what the NS has to say and who you feel most comfortable with. Only you can make this decision and perhaps with another set of eyes on the situation the answer will become clear. >:D< Cali-Sue
  • Some people swear that if you have a complete laminectomy at any level that you should have it fused. I'm missing the complete back off of L4 and L5 and have no fusion. The NS and I decided that if there's a chance that I can either completely avoid a fusion or put it off, then it's worth the risk. The big difference though is my lower spine is very stable. I'm certain if there were any instability present, then the decision may have been different.

    "C"
  • Darby, get as much information as you can before making the final decision. I have grade 1 spondy and stenosis as well and had decompression surgery without fusion last December. Before the surgery I had sciatic pain for about 4 years. It has taken me 11 months but I can now say my pain levels are totally manageable. There are no quick fixes - but if you ask me if the surgery was worth it I would say yes. Recovery is different for everyone but I have found the key is get the pain levels down so that you can continue exercising and keep moving.

    Take care and keep us updated. This site is great for support through the whole process. Jaycey
  • Thanks for your reply. I have an appt. with a neurosurgeon at the spine center for a 3rd opinion on Dec. 18th. My PM doc said a decompression, my ortho doc said laminectomy and/or fusion. I was glad to hear from someone who only had decompression and is doing well. I first want to ask what grade my spondy is and if it is really bad I might consider the fusion.

    I'll keep posting and let everyone know my decision.

    Thanks to all of you for your help.

    Darby
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