Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

please explain me what is the best for my L5 spondy

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:28 AM in Back Surgery and Neck Surgery
Hi all, (sorry for my english)

I am new here :-)
My name is Paolo, I am 40 and I suffer of L5 spondy from 12 years. First 11 years was bad.
Luckyly all the last year I am asyntomatic/no pain ( thanks God!), no drugs/medicine (!).
I know this is temporaney only, so I want learn about what to do when pain will restart.

My L5 spondy ( front) is about 11 mm ( less than 30%).
No ernhia, no radicular compression, no sciatica ( legs are ok), discs are pretty good ( only a bit compressed of course).
My body form is good. I walk 3 hours for day every day.

Now my doubt: fusion or not-fusion ?
I have read about Dynesys ; is it a possible alternative to fusion?
This because in Italy, Doctors are not so in favour to this dynamic stabilization teqhnique ! :-(
They prefer old fusion. ( why I don't understand)
What is best technique for my case?

In case of fusion, do you think I need fusion of S1 with L5 only or S1+L5+L4 ? I am confused on this .....

Or maybe S1+L5 fusion plus L5+L4 Dynesys ( or other flexible "device" )? Sort of interesting hibrid, no? :-)
As you can see, I am pretty in doubts for now ....

thanks ,
Paolo- Italy


  • Hi Paulo

    I had fusion for spondy and I suffered pain for 10-15 years before it get to much to bare.

    I would say dont do surgery unless you are at the end of your tolerence with the pain and ongoing suffering.

    Fusion is not realy a cure just a last option and an attempt to break free from the pain.

    My fusion has been succesfull and im in a lot less pain than I was.
    I realize you have had pain but ask yourself is my condition getting worse so that fusion is the only option for me?

  • Hi Ironman :-),

    very thanks for sharing your experience!

    Yes I am in doubt but I believe my spondy can worse if I make nothing.....:-(
    Actually I am well ( all the last 12 months! A sort of miracle. Dr.s do not has a clear explanation for this phenomena.
    But I can't make a "normal" life. No possible I pick up 10kg... Yes only 10 kg! I have the brute force but I can't employ it ! :-(
    I am italian, this is a severe problem for me. No my fear but I do not considerate me a "real man" in this strange condition....:-) :-) :-)
    I can wait, no problem for now.
    But I would be totally informed about alternatives to old fusion that I "dislike".
    I am mechanical guy, semms to me very strange that is no possible something better for my specific case.
    My interest is for Dynesys......is it possible in your opinion?
    Perdone me, I know a lot of other forumers have much more pain /issues than me but I would be become "normal"...:-)

    Thanks Paolo
  • Sorry, forgot to say that now I must use orthopedic corset/bust ( all the day excerpt night).......not so bad , I am accustomed at it :-)
    Hovewar I can't go in bycicle, BUS, or walking in downhill :-(

  • but had it removed 12 months later because it never secured my spine. The flexibility was not good for me.
    Being informed of what is out there is one thing but your individual surgeon will have his own preferences as well as your personal health issues so please don't be too particular on your search for solutions.

    So glad to hear you are asympromatic at the moment. Fingers crossed you will stay this way!

    Curious you ask about the levels. I wonder this too.
    Do most spondy's have a one or two level??
  • I take it from your name you to are a cyclists? I have L5 pars defect, disc degeneration, slight bulg and it is causing me horrible hip pain. I have received spinal injections with some relief, but not fixing the problem. Because of this I have been off the bike for 5 months and have been contiplating a fusion of S1-L4. My biggest concern is being comfortable on the bike after the fusion.

    I was an avid cyclist clocking over 15 hours a week and racing every weekend so this new form of life is driving me crazy.
  • Welcome to Spine Health Paolo,

    This is a good place to get the type of information you are looking for. As you said it yourself, fusion is a major surgery, although personally I am very glad that I had it as for me it was very successful. But if you are at the beginning of your quest, take your time, look up the various sites in the internet, there is a lot of useful info out there. Do you live close to a Medical University? If you do, sometimes they let people use their library and there you may find some excellent books on the subject. What I am trying to advise here is that find out all you can about the various treatments, both pros and cons.

    And if you have any other questions, we are happy to tell you about our experiences, but remember, we are not doctors, just fellow back pain sufferers.

    By the way, your English is excellent, I wish I could say the same about my Italian.


  • Welcome to the forum. I hope you find answers to all your questions here and from your doctor. I had a one level fusion myself and the disk was removed and a BMP was used to replace the disk. My issue was Spondy, severe DDD and severe Spinal Stenosis. Take good care of yourself and good luck!

    Evelyn :H
    Had PLIF in 2008 and a Laminectomy. One level fusion, L4-L5.
  • Hi itsalongwalk :-)

    thanks for your suggestions.
    Yes asymptomatic for 12 months after 11 years of pain is a good news for me! :-)
    Incredible, guys!!

    Excuse but i do not understand 100% your question : I have only L5 flipped 29% . The thing make me wonder is that some surgeons suggest to make fusion S1-L5 only, others will ADD L5-L4 too!
    I do not understand Why...... Am I stupid? :-)
    My disks are good, nerves are perfect, why a so definitive procedure without a chance with a "lighter approch"( Dynesis or other, I am not an expert).

  • Man if you have to wear a corset to pick up ten kilos then you are in trouble.
    I know how that feels, I had to roll to get out of bed before the surgery.
    Spondy at thirty percent is pretty advanced.
    Remember that the pain comes from your spinal cord.
    When you get the pain is it totally excrutiating or is it an ache from the muscle or both?
    Mine was both and I bcame terrified of the condition it can lead to. Cauda equina syndrome. NOT TO SCARE YOU BUT TOU LOSE CONTROL OF YOUR BLADDER AND BOWEL AND suffer SEXUAL DISFUNCTION.
    If your job is manual it is something to take seriously.
    Dont be alarmed these are the facts.

    When I got home from work {Trade] I could not get up the stairs, it became totaly unbearable. Im not saying wait that long but be sure in your own mind that you have no other option.
    For me its been a total success. L5 S1 fused and im about to return to work.[had six months off]
    I cant comment on Dynesis.
    I had Isthmic Spondy and DDD and for me it was the best option.
    All the best my friend


  • Hi ironman! ( nice nick) :-)

    Uh, mine 29% is only 11 mm , just over level 1 ( 25%) , no?

    Pain was ..difficult to describe now: sort of "pression" plus
    hot internally , very concentrate in the L5 zone.

    It was my fear about disfunction you are talking, but I was luck ! No issue.

    Yes you are right, I am in trouble : corset is a protection
    only to avoid spondy advancement ! :-(

    I am glad your fusion was a total succes :-)
    How much brute force can you apply on your back ? to say 1/4, 1/2, or what? This is a crucial point for me.
    No one surgeon was clear on this point..... :-(

    So you are fused S1to L5 only....make sense to me.
    I sure have to considerate it .

  • Hi joesusco :-)

    No, I am not a biker.
    I am sorry you have big pain.....I understand very well what means to be inable to make what you love! :-(
    First year after spondy , my pain was so acute I was never sit down .
    BTW, 3 vertebra fused is a lot IMO, is it no possible make something of more "delicate" ?
    Are you sure you will can go in bike after the fusion?
    Does the surgeon be clear with you about this point?

  • Hi Kinpain :-)

    Thanks for support, I need new friends with similar problems to exchange infos. No importance if you are not a Doctor, I think real life storys are precious at this point. And we know our back as nobody else can, Doctors or not! :-)

    I am happy for your positive fusion, how much % are you now respect when your spine was "perfect"? 50%, 80%, etc??
    This is much important point to understand for me. I need datas to make a little statistic... :-)

    Yes, technical literature can be precious ; I have just start to inform myself. Not sure if italians Med University are so kind/permissive as yours but! (?)

    Thanks for kind words about my english , audio-forums are responsable for this, not my merit!! :-) :-)

  • Hi Evelyn :-)

    Thanks for kind words and wishes ! :-)
    Good luck you too!

  • Paolo,

    To go back to your original question, if L5 is misaligned, than probably both L4 and S1 are affected. But how many levels would need to be fused is only a question your Dr. can answer, as he is the one who sees your MRI. Once he tells you what he wants to do, is there a way you could see another surgeon for a second opinion? It is always a good idea to have more than one opinions before such an important decision.

    Take care,

  • thanks Kin,

    If I understand your statament, my L5 is flipped towards front but perfectly axial, no asymmetry.
    I have read that If L5 is flipped LESS than 50% ( mine is 29%) normally it is sufficent one level fusion.
    Sometimes surgeon add something between next upper vertebra to prevent issue at level disc ( sort of shock absorber ? :-)..)
    Aniway you are right, I'm serching one very good surgeon that perform both stabilization systems : fusion and Dynesys also.
    He will tell me if Dynesys is possible for me.

    The problem here in Italy is that 95% of surgeons are "old"
    and do not look well this controversial technique!
    I am not capable to find one only to talk of my case!! :-(

Sign In or Register to comment.