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To cancel...or not to cancel surgery?

signavyssignavy Posts: 63
edited 06/11/2012 - 8:32 AM in Back Surgery and Neck Surgery
I really wish the results of spinal fusions could be more predictible. I have a TLIF scheduled for 3 Aug due to 1) badly herniated L5 and 2) grade 2 spondy L5 over S1. I was seriously thinking about canceling and just dealing with the pain and discomfort as well as being a long-term pill popper to manage day-to-day. Then I read an interesting article regarding the treatment of spondylolesthesis on Spine Universe. a OS from Isreal wrote that his research confirmed conservitive treatment of spondylolesthesis (drugs and exercise) was not as successful in long-term pain relief as surgery (fusion) - especially in patients with DDD - he further explains and shows xray evidence of a patient whose slip gets worse as the disc degenerates more. Have any of the Spondy paitients out there heard this from their surgeon?

My OS basically said that the only procedure he could perform on a Spondy patient is a Fusion and that is not likely to change anytime soon. That said - my thoughts are more towards the surgery now for a few reasons 1) 39 yrs young 2) no other health probs and 3) in good physical shape. Why wait it out? I have waited and been working through PT for almost a year now - if my condition was going to get better on its own I think it would have by now - correct? One last question for my spondy friends - overtime did your back pain get worse? When I injured my back my leg/buttock to back pain ratio was 90/10 it is now about 70/30. Thanks in advance for any comments.


  • spondy but I am 9 weeks post op 2 level TLIF and feeling good and glad I had the surgery. Of course, everyone is different and so there can be different outcomes. I went to my 9 week checkup yesterday and surgeon is pleased with my progress. You have to decide if the quality of your current life is what you can live with or not. It's a hard decision so I hope whatever you decide is best for you.

  • Hi Mike,

    I had spondylolisthesis of L4 over L5, tried the conservative route for months, but, as you have found in your research, spondy can only be corrected with fusion. Before fusion, which was a year ago, I had bouts of 3 to 4 days of horrible spasms that prevented me from doing anything, no sleep, not able to get out of bed. The last incident I also had out-of-control urinary incontinence. Very embarassing to say the least. I also was unable to walk 2 feet, sometimes not at all. Post fusion recovery has taken me a while, but as you say, you are young and in good shape. I am 52 and also have rheumatoid and osteoarthritis. My horrible pre-fusion symptoms are gone, still have chronic low back pain and difficulty walking. I think, though, from what I have read on here and from chatting with people here online, that you will have a good chance of recovering well.

    Good luck with your upcoming surgery. Please post and let us know how you are doing.

  • Mike - I read a lot on here (both people's posts and the articles) before I had my surgery. I could see there was nothing that would make be comfortable in going without the surgery. My doctors wanted to implant an electronic nerve stimulator to help me deal with the pain. I just couldn't take that -- one more thing for which I would lose the remote! Surgery probably won't be a breeze and you'll question why you did it, but by the time you're about six months out, I think you'll be happy you did. There's nothing quite like having your spine stabilized. With the three levels I had, it does make me a bit stiff, but that agonizing pain is gone. It's worth all the money in the world.


    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Popping pills is never an answer. Narcs are overprescribed vs. finding a solution/fix to the problem at hand.

    Of course surgery is scary. Good luck toya.
  • I'm glad you found an article that made sense to you. There are two things to think about when you have spondylolisthesis. One, you can have all the conservative treatments in the world and it is not going to make your spondy any better, nor do anything to stabilize the back, and, two, fusion for spondylolisthesis has the highest rate of success.

    It sounds like you have given conservative treatments a fair shot. Just be sure you have the best surgeon you can find and that you are comfortable with. Do plenty of reading on your condition and the procedure you will be having so you know what you are getting into and so you understand that it is a long recovery. If possible, set aside a block of time that you can devote to recovery without feeling the pressures of deadlines.

    I waited over three years before finally deciding to have fusion. I kept them that in an age where lung transplants were routine, surely there must be a more modern procedure than fusion....I consulted with eight different specialists, both ortho spinal surgeons and neurosurgeons, hoping to find someone who would tell me he would recommend something other than fusion, but no, that didn't happen. I consulted with one doctor who conducts trials on the latest technologies and he assured me there was nothing in the pipeline to replace fusion. So I finally decided I needed to go ahead and bite the bullet.

    You gain nothing by waiting as you will have surgery one day. It is just a matter of when.

    If you have questions about the procedure or recovery, I would be happy to try to answer them for you.

    xx Gwennie
  • Definitely there isn't any conservative treatment to "fix" a spondy, and it makes sense that the more your discs degenerate...the worse your spondy gets. I waited 4 yrs to have my surgery. I thought I could get away with doing conservative stuff. Unfortunately my L5 disc degenerated and desicated (dried out) to the point that there was no disc left. By the time I broke down and had my (1st)surgery I had been bone on bone at L5 for a while, and had rubbed myself a nice synovial cyst full of disc and bone material. I also had a bone fragment stck against my nerve root that had broken off. Also, my stenosis had gotten so bad that it had completely flattened my nerve root. When I scheduled my surgery I couldn't move my little toes on my left foot and I was having occasional urinary incontinence. Now, because I waited so long, I have permanent nerve damage in my left leg/foot and saddle area, and when I had my second surgery (they couldn't do all that I needed at the 1st surgery b/c the nerve damage was so great), there was another chunk of bone in there.

    Sorry for the long post, but the message is....don't put it off! Spondys only become more unstable over time (typically). The longer you wait (although you should always exhaust conservative measures first), the more you risk permanent damage or more "junk" for the surgeon to have to clean out or work around. I'm coming up on 39 myself, and I think age is on your side with such a big surgery. I had nurses on my neuro floor say that the younger patients really do much better.

    Best of luck! If it were me...I wouldn't cancel.
  • Mike,

    If you found a surgeon whom you trust, go with his recommendation, after all, he is the one who has all your information available. I suffered from sciatica on and off for years, and my OS tried different things before, but last year he told me that the MRI shows that the spondy and DDDs are at the stage where surgery is the only viable option. So I had a three-level fusion over a year ago, and I have not regretted it for a moment. I am doing really well, and other than avoiding doing something stupid, I don't really have any restrictions. Best of all, the sciatic pain and leg numbness are completely gone!. What a relief! So, ask your doc what kind of outcome does he expect out of the surgery, and if the odds are in your favor, go with the surgery. With spondy and DDD, there is not a chance that it gets better without intervention.

    Good luck,

  • I had a 2 level TLIF/laminectomy a year ago because of retrolisthesis (inward slippage) and recurrent disc herniation 1 month post op. I did go through PT, ESI's, and taking medicines but eventually I went ahead with the surgery. What made me decide was the fact that I was in constant severe pain with no let up. The problem area is L4-S1 and I do have severe DDD going on as well.

    This is a hard decision to make. Fusions are major surgery which do not come with full guarantees of relieving all your pain. You do not want to risk further complications by putting off surgery such as permanent nerve damage, or the injury to the spinal cord.

    Only your doctor can determine if you are at risk, and knows which treatment is best. Of course, spinal surgery comes with risks too, and you should research and ask your doctor any questions you may have. Take care
  • To all my SH friends - I very much appreciate all the advice and the sanity check. I picked up copies of my MRIs from Dec 08 and May 09 as well as Xrays from Jan 09 and May 09. WOW - on the Xrays I could clearly see a difference in disc height btwn L5 and S1 - so the disc is definitely degenerating faster than I thought it would. I know I am not a doctor, but from the looks of it, another 4 to 5 months or sooner I could be bone on bone. I can't imagine that feeling good. To my un-trained eye the Spondy looks fairly stable just a little more forward movement over the last 5 months.

    My new take on this is that waiting can only make matters worse in the long run. Yes - my pain is managable now, but for how much longer? I really can't believe how much closer L5 and S1 are to coming in contact with each other. I will be emailing my OS just to make sure my read on this is close to being correct. I am very comfortable with this OS surgeon - only have a couple choices as I am active duty military. He just seems so symptom focused and that is what keeps me wondering if I should endure this crap until the symptoms get really bad. Has anyone else had a surgeon like this? All the best to everyone, Mike

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