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What are all of the conservative routes b'for opting for a fusion?

hope4leohhope4leo Posts: 200
edited 06/11/2012 - 8:32 AM in Back Surgery and Neck Surgery
I have been in PT for over 3 weeks 3xs a week. I am still experience pain in my lower back, both right and left legs and hips. The pain isn't so bad while I am doing my PT but about 30 minutes after I am done, my back fires back up again. I have had months of pain meds, cortizone shots and a nerve block along with PT. I have DDD and two herniated discs at L4-L5 and L5-S1 both of which are on nerve roots. I have had 3 different doctors opinions, all of which say Level 2 fusion is needed. Are my options of conservative measures running out? As nothing has elevated the pain. Looking forward to so advise from those of you with experience.!!


  • I've had 5 epidurals and trigger point shots and PT accupuncture and facet joint injections. I hear water therapy with physio is supposed to be helpful for some people though I haven't tried it. If your discs are in bad shape meaning really degenerative sometimes surgery may be inevitable. Ask your Dr. Why fusion instead of a laminectomy or will time heal the herniated discs? If the herniations are large they may not heal on their own. But if the discs are in rough shape they need to do fusion. I'm not a Dr so it's best to ask the Dr everything so you'll know that surgery would be best for you. Take care and we're here to support you whatever happens. I found this other site very helpful. www.chirogeek.com Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • most of your conservative measures have been exhausted. There really isn't much besides PT and the epidural shots. I did have a microdiscectomy to get the disc material off my nerves, but the relief only lasted about six months. After that, I knew I needed the fusion. I was in such agony. I still occasionally have problems now, but nothing like before surgery. Investigate the different types of surgery and your surgeon well and then go about getting your life back. The recovery from surgery was not easy, but I'm glad I did it.


    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Leo,

    Sounds like you have tied most of it. Don't feel bad I have as well. I gave the PT and meds all of about a year to work. I must admit the PT did help and so did the meds (mobic, neurontin, valium (sometimes) and tramadol (sometimes). They helped getting me close to a comfortable state (sometimes), but nothing close to normal. After stopping the mobic for about a month I quickly realized that pain meds would always have to be a part of life unless I tried something. That something is a L5 S1 TLIF Fusion which is scheduled for 24 Aug. The TLIF procedure was recommended as the procedure of choice by both an OS and NS as my problem is two-fold: 1. Severe herniation 70% and 2. Spondylolisthesis (stability issue).

    For the longest time I truly believed I would be able to work through the pain and discomfort and avoid surgery - I still have days when I believe I can still get through this, but they only last at most a day. I was a very active and athletic 39 year old and my goal is to get something back - another turning point for me was comparing my my Xrays and MRIs from Jan to May 09 where I could see the difference in loss of disc space - meaning the disc is degenerating. That said, I am still scared to death of Fusion Surgery, but after much research on spine-health, spineuniverse, and chating with the the many SH friends out there I've concluded it is worth trying for what I want out of life.

    I know it must be hard trying to decide whether to pursue surgery or not - I was wishy washy for a long time and finally got fed up with it. As Charry has asked - why does your doc recommend Fusion and no other surgical procedures like a micro-d or lami? All the best, Mike
  • Hi, I would try the aqua therapy first before surgery. a good pt could show you exercises to do in a pool. The pain will ease up in the pool. If you go to a health center where they have a heated pool they also have a hot tub to relax in after the pool. It helped me recover from my diskectomy. I still am in my pool as much as possible. do you take anti inflammatories? that would help reduce inflammation some also reducing some pain.
    2005-ACDF with Corpectomy at C3-C-5.
    2006-L4-L5 diskectomy.
    2009-Cervical laminectomy at C3.
    Steroid injections series x 4.
  • You sound just like me, but I am 49. I have tried everything and have finally decided on the PLIF that my NS suggested. The decision is not an easy one. I have NO issues with sitting or sleeping, but I can't stand up straight while walking and always have some pain while walking. I have a spondy grade2 and the disk has finally given up so I am faced with L5-S1 fusion. Good luck to you.
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