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Another Question

pepper09ppepper09 Posts: 138
edited 06/11/2012 - 8:30 AM in Back Surgery and Neck Surgery
I am almost 4 weeks PLIF L5, S1 fusion and have so many questions.

After my laminectomy surgery didn't provide any relief from my leg pain, my only choices were really another laminectomy or a fusion. So, I got a fusion. I'm happy with my choice because I'm feeling pretty good and not a lot of pain, but now I concerned about my other discs because I don't know why my L5 disc was severely degenerated and my other discs are normal. It doesn't make sense to me.

Also, what am I waiting to be fused in a L5, S1 fusion? How can there be a 1 level fusion? I'm confused.

I trust my doctor, but I didn't ask a whole lot of questions at my appointments other than "will this take care of my pain" and "how long is the recovery". I didn't ask specific questions about why and how I got this way.


  • L5-S1 are the vertebrae, with the disc inbetween them being what he fixed.

    L4-L5 would be the disc that your having issues with now I am guessing?
  • Was just reading through your post and glad to hear that so far the decision to have the fusion surgery has had some positive effects on relieving the pain in your legs.
    There is no way for any of us to tell you why your L5-S1 disc was degenerative, and the others were normal. Degeneration can be genetics to an injury to general wear and tear. The disc that was worked on between your L5 to S1 is a common disc to develop problems in the lumbar because it is the disc that gets the most abuse over the years. The discs are all like shock abosorbers for the back and this disc takes alot of that beating over the years. So its hard to say why that disc in particular although its a common one, a good question to ask your doctor.
    What the surgery essentially did was to take out the bad disc between your L5 and S1 vertebrae, pack the area with bone material and then stabalize that part of your spine with rods and screws while the fusion takes place. Basically the idea is that you will have one solid bone there connecting those vertebrae. This is a one level fusion because only one disc was removed. The fusion process takes a while, a year on average and something else to discuss with you doc.
    The S1 is the beginning of your sacrum, and the L5 is the end of the Lumbar section of your spine. This is where they operated.
    I would suggest writing down your ?s and taking them in with you to your next appt and ask these things that come to mind. Some have a notebook handy that if a ? comes up they can write it down so they dont forget by the time they get to there appt. Best of wishes
  • The disk between your last lumbar vertebra and the first sacral vertebra was removed during the surgery. You may have been given something to fill in the space where the disk was (like a spacer or a cage) to hold the space. Eventually these three things will join together to create one solid piece.

    Think of this segment as an oreo cookie, with the vertebrae (L-5 and S-1) being the chocolate wafers and the disk being the white creamy filling. The filling was removed and replaced by a "spacer." (and ground up pieces of bone, either yours or from an outside source). The idea is that this newly formed "cookie" will grow together and you will be left with one solid, stable chunk.
  • Thanks for the explanations everyone :) That really does help. I wonder if a 1 level fusion fuses faster than a multiple level? With a multiple level, two vertebrae actually have to fuse together, correct?
  • The idea is that one level (say L3 - L4) fuses together. Then the disk below that is removed, so L4-L5 fuses, etc...so when you end up there is very limited mobility. This is why artificial disks seem like such a good idea, and the flexible system of fusing...they provide more ability to move a segment of the spine.

    That being said, people with five level fusions report they can still bend over, etc.

    The success rate for a one level is greater than a multi-level fusion...with multi levels, there is bound to be one segment that heals at a different rate and thus, the whole thing ends up taking longer.
  • I wish the fusion was as sweet as the Oreo cookie! :)
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