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***TLIF (Fusion) Patients - Please Help***

signavyssignavy Posts: 63
edited 06/11/2012 - 8:31 AM in Back Surgery and Neck Surgery
Greetings All,

Please take a glance at my history below. I really need some perspective – I met with the same Ortho Spine Surgeon from Feb 09 again on 21 May as I felt tingling/numbness in both legs for about a month. My PT ordered the #2 MRI and they were able to fit me in before my appointment. The OS told me once before that he doesn’t treat MRI’s he treats patients – so the fact that my #2 MRI looks better is not necessarily an indication that I would feel better. He said the spondylolesthesis looked about the same which I interpreted as good, but since I was continuing to experience symptoms likely from the herniated disc and the grade 2 spondy that I needed to make a decision. Surgery or no Surgery.

This time he explained that if I went the surgery route he would do a TLIF to ensure he was able to get all of the posterior herniation out of there and a TLIF offered a 360 fusion with cages/rods/screws - more secure in his words and better fusion rate. As for Meds – I am still taking Mobic (7.5mgs now), Neurontin 600mgs, Valium (only when needed – maybe 5mgs twice a week), and Tramadol (only when needed – maybe 50mgs (three times a week). I have read some many posts with many requiring much more pain medication and many enduring the pain and discomfort for so much longer before taking the surgery route that I am questioning myself as to if I am jumping into surgery way too soon – yes I scheduled the TLIF for 3 August 09.

All this said – sorry it is so long. I would love to hear from any and all TLIF post surgery folks out there and hear about the recovery and what your pain levels pre-surgery were like. I would call my pain level a constant 2 or 3 – and maybe classify it as more of a discomfort. I am in very good shape (exercised 6 days a week before Sep 08 to include 3 to 5 mile runs). Now I walk about 3 miles x 4 days a week. I stretch three times a day to maintain flexibility. Sitting for prolonged periods of time (1-2 hours) is hard and painful and I swear I feel my L5 slipping during certain movements. Flexion and Extension Xrays do show movement. The Sponylolesthesis thing really freaks me out - to think there is a fracture in my spine scares me to death. The pain definitely keeps me from doing most of the enjoyable activity type things that I like, but all in all I am not in horrible shape. I do however want to feel better than I do, but maybe I am asking for too much. The Surgeon says 50/50 on improvement of back pain and 75 to 80% on improving leg/buttocks pain. And then the real scary stuff that you all already know about – more nerve pain – chance of damage to the nerve – just the retracting it may aggravate it and cause more pain. Okay enough from me – love to hear your thoughts and stories. Best wishes to everyone enduring the pain that only we truly understand.

All the best, Mike

-Sep 08 LBP/leg pain/spasms after doing low weight squats and lunges
-Jan 09 Ortho PA loaded me up with Meds - Mobic (15mg), Valium (5 Mg x 3 perday), Neurontin (600mg a day) and Tramadol only when needed).
- Jan 09 scheduled for ESI, but canx due to adverse reaction to oral steroid
- Feb 09 Met with Neuro Surgeon who said PLIF with PEEK cages would make sense due to symptoms not resolving 6 mos post injury
- Feb 09 Met with Ortho Surgeon who offered diskectomy or ALIF with PEEK Cages - said the Fusion made more sense as he thought with the diskectomy I would reherniate. Also said I should avoid surgery as long as I could.
- Started PT in Jan 09 which has helped a little - continue to do PT at home - walk and core exercises.
- MRI #1 Dec 08: DDD at L5/S1 w/bilateral pars lysis. In addition to annular buldge, there is a right posterolateral disc herniation which has free fragment or extrusion component severely narrowing the right S1 lateral recess. The L5 foramen is severely narrowed due to accompanying bulge. After meeting with an Ortho Surgeon he classed my Spondylolesthesis as grade 2 due to 33% forward slippage of L5 onto S1.
- MRI #2 May 09: DDD at L5/S1. Persistent severe narrowing of the right L5 foramen secondary to lateral extension of an annular bulge/small prolapse. The larger disc herniation seen on previous study with free fragment is no longer identified. The large disc herniation seen on prior study was more prominent and also affected the right S1 nerve root sleeve and had a free fragment – these findings are no longer identified.



  • Well, I had my 2 level TLIF about a year ago because I suffered a reherniation on L4-5, 1 month after a microdiscectomy. I also had retrolisthesis at that level, severe DDD L4-S1, and continuing nerve compression.

    My pain averaged around 4 with strong medications (Fentanyl patches, Norco, Zanaflex). At times it would flare up badly and I'd be given steroids to calm the pain and inflammation. After seeing a neurosurgeon I decided to have surgery in the hopes of feeling better and getting my life back. I was told however that I would feel better, stay the same, or get worse. My last surgeon told me that I would always have back pain, and back surgery is to relieve leg pain only. At the time my back pain to leg pain ratio was 50/50.

    I spent 4 days in ICU and when I went home, I still had a lot of pain. 6 months later I felt the same and didn't do well with PT either. A few months after, I got worse and was sent in for another MRI which showed scar tissue was compressing the nerve root at L5-S1, and the thecal sac at L4-5. I also found out that I had permanent nerve damage in one leg.

    Well, I know this isn't a good outcome and I had complicating factors. I wasn't fit when my back troubles began and I'm sure this may have played against me. I already had a history of widespread arthritis too. I hope that your surgery is a success and I'm happy to answer any question you may have. Take care
  • edited 10/23/2012 - 10:09 AM
    Someone tell me if I should have returned to my surgeon when they told me I had a large amount of compression from scar tissue on my thecal sac?
  • Roseannmazzone@verizon.net said:
    Someone tell me if I should have returned to my surgeon when they told me I had a large amount of compression from scar tissue on my thecal sac?
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