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Spinal Fusion "to have or not to have, that is the question?"

AnonymousUserAAnonymousUser Posts: 51,465
edited 06/11/2012 - 8:33 AM in Lower Back Pain
Hi, I'm interested to hear from anyboy who is either considering spinal fusion or has had spinal fusion. Also, i can't seem to find any figures with regard to the percentages of success.
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Comments

  • I had my two level fusion with the other stuff last December. At 7 months out I dont feel I am a good person to ask as I am not completely healed yet. But wanted to welcome you and say good luck. Also you need to put a little more info on what you are looking at.
  • thanks for replying. i was begining to think i hadn't registered properly. So your 7 months post op and i guess not feeling great as your comment. My team here in the UK seem to be leading me down spinal fusion of L5/S1 but it's my decision. I want to see actual results from people having it done. There must be some results somewhere. I'm only 39 and have 2 young children so i need to think very carefully about my options. Hope your better soon. One thing i always think of is that there is always someone worse off than you. Take care
  • to add to my original message. I'm 39 and 2 years post op of a discetcomy on L5/S1. i'm still in a lot of pain and unable to work as i have a white collar job. I take a vast amount of medication every day which is affecting my tummy. I have recently been on a Pain Management programme that i found very useful. I'm now at a crossroads and do i start to push 4 spinal fusion. There is some great information on here but i would like to hear peoples actual experiences both good and bad. Also, can anybody help me with finding out statistics on the success of spinal fusion. look forwarding to hearing from you.
  • im also from the uk, im waiting for discetomy app, had x-rays, 12 months pt, mri and nerve block injections under cat scan. just found out i also have osteoarthritis in facet joints.
    been on this merry go round of the wonderful NHS system for 18 months, dont feel i have gotten any further than when i began this journey, still in the diagnostic stage to find root cause of pain.
    tried just about every med u can name, still not totally pain free, looks like i will have to leave my job, worked so bloody hard to get where i was in it, but hey, im still walking.
    fusion is only option for me, just wish it was over and done with already.
    my quality of life sucks, thats why im ready to go under the knife, good luck with ur decision, only u can make that choice, keep us posted :H
  • flippin eck sounds bad. my quality of life sucks 2. Have u been on a Pain Management Programme? they are good espically with helping in the head department, dealing with pain, coping stratergies.

    i ended up having emergency surgery after the hospital left me for 3 weeks with clauda-equina syndrome and now have permanent bladder damage. Make useful a real pest to the team. I've lost everything including my wife of 11years. It's a real mess.

    take care

    I'm neil btw
  • sounds like u been through much more than me mate, cant get to c pain management, doc says hosp needs to refer me and hosp says doc needs to. makes me sick when i work in health profession, don't even start me on that subject lol.
    im very sorry that u have lost everything. life stinks sometimes but u sound like a fighter. u will make many friends here, what part of the uk are u from ? im from sunny Devon where it rains 6 days out of 7 and on the 7th it p....s down.
    take mate and keep on fighting :D
  • sorry youve had so much trouble.
    the question is how do you define success?
    if fusion is done to stabalize spine and not cure pain and spine is secure but pain increases is it a success?
    only the surgeon can give you a percentage pf success prediction on chances of success for reducing pain in your situation.
    after looking at peoples comments here on spine health i'd say only 50% got pain relief from fusion. i had 2 fusions and got no pain relief.
    for pure pain relief maybe spinal cord stimulator has better % of pain reduction....maybe 70%
    good luck
    pete









    ?
  • sorry youve had so much trouble.
    the question is how do you define success?
    if fusion is done to stabalize spine and not cure pain and spine is secure but pain increases is it a success?
    only the surgeon can give you a percentage pf success prediction on chances of success for reducing pain in your situation.
    after looking at peoples comments here on spine health i'd say only 50% got pain relief from fusion. i had 2 fusions and got no pain relief.
    for pure pain relief maybe spinal cord stimulator has better % of pain reduction....maybe 70%
    good luck
    pete









    ?
  • That is the real question you need to answer for yourself. I have just spent quite a bit of time trying to find some statistics for you. The various studies I found define success by fusion rates, which is not what I think you are looking for. I found passing remarks about fusion not solving 100% of a patient's pain.

    I think I recall my surgeon stating 80-85% of patients having lumbar fusion were better off than prior to surgery.

    Many people who have fusion do so believing that it will "fix" their situation and they will come out pain-free. They are the ones who are disappointed with the results. It is important to know that fusion will not restore you to the way you were prior to the onset of your injury or pain.

    You have to decide what options you have and whether you can go on the way you are. I resisted fusion for over three years because I kept thinking there must be a better way. But specialist after specialist kept telling me there was not, nor was there anything on the horizon that would replace fusion. When I could no longer stand for more than a minute or two and I was driving down my driveway to get the mail, I realized the time had come.

    Each person has to make this decision for him or herself but it must be done with eyes wide open, knowing what fusion can and cannot do for you.

    xx Gwennie
  • Hello I had L5/S1 fusion back in April. It is different for each person. I knew going in that it wasnt a cure. I cant tell you how much it has helped me yet to tell you the truth. I have good days but it seems right now I am having more bad ones. I had trouble with my recover. I have been dealing with alot of swelling. It is something that you have to choose for yourself.
  • Hi Glassback,

    Why are you having or needing fusion. What is the problem and where is it?

    I had spinal stenosis and I saw four or five surgeons before I chose who I was going to entrust my one and only spine to.

    The first four told me that I needed fusion and only one told me what I wanted to hear, which was, as far as he was concerned in my case, fusion was not the right way to go and he chose spinal decompression. I am now 5 months post surgery and after 5 years of chronic pain through the sciatic nerve down both legs I am now almost 100% pain free. I suggest that you get more opinions before you proceed. After all it is your body and your own responsibility.

    John B.








    Medical History

    Suffered almost five years of progressive spinal stenosis using pain management procedures with regular epidurals and subsequent Caudal Epidurals with contrast and 'C' arm guidance with increasing frequency.

    February 2009
    Preoperative Diagnosis- Chronic Multilevel Bilateral Lumbar Spinal Stenosis with Recurrent and Persistant Chronic Radiculopathy.

    Operative procedure
    L3-4 Bilateral Hemilaminotomies and Foraminotomies with nerve root decompression.
    L4-5 Bilateral hemilaminotomies with Foraminotomies and nerve root decompression.
    L5-S1 Bilateral Hemilaminotomies, Foraminotomies and nerve root decompression.
  • :) thanks for the responses. I have disc degenerative disease and 1 of my orthopedic consultants commented that my lumbar spine reflected that of a 75 year old ! I'm 39. I see 2 orthopedic consulatnts and a pain mangement consultant all of whom agree that fusion is the very last option. My issue is my quality of life. Ican only potter around a very empty house. I can stand to wash the dishes for more than 10 mins. All house hold chores are hard and take me twice as long. All of this with 8 Paracetamol & Tramadol. Pre-gablin 1000mg a day and lots more. The tablets are recking my stomach i have a hyetus hernia so have to take medication for that and drink gaviscon by the bottle ! I can't drive not at work since April 08. But the comments and help from you guys is great. I am a strong person and determined to pick my career back up again. Shirley, i live in a very sunny (today) Leicestershire. I accept that my life will not go back to how it was but surely i can be better than this ! it's like being an OAP but some 40 years to early. LOL
  • Although the relative success of any procedure many have statistical evidence to support that notion what you are interested in is how this will effect you and what level of improvement may be gained for this type of operation. We all come to this procedure with differing experience and historic symptoms and to that extent all individuals and although we all share commonalities that is where the similarity ends. You have to do what is best for you give your pre-existing condition and I understand that is a difficult leap of faith into the unknown. My failed fusion has no bearing on how this will help you and just reiterates my misfortune. The key may be what your option are can you last longer without the fusion and what is the implication is not having this procedure done at this time.

    With the knowledge and experience I have it places more pressure on the extremities of the rods themselves which may cause problems in the future and I could not walk at he time so that decision was made easier in what was the alternative. I saw a professor at Manchester, he said I would have to live with this pain period, that took some guts to tell me, whatever evidence you research that is not you, we are all looking for some reassurance or guarantee and with hand on my heart, none is available.

    I was 33 had two children and lost my job eventually and I understand your plight and the waiting does not make it any better, I am pleased you gleaned some help from PM and Sternbach has written much on this subject. It is hard to know what to do for the best, Walton have information and a pain centre.

    Take care and keep in touch

    John Lancs
  • I can tell you that I had a 2 level fusion (L2-L4) in 2003 when I was 38. Recovery was rough, as they went in through the back; if you do get a fusion see if they will do it from the front, as this supposedly is a much "easier" recovery. I also have DDD, now it is in my neck and under the fusion. You need to be aware that above and below the fusion takes a lot of abuse and those discs can deteriorate, as mine did.
    Now I am looking at another fusion possibly for L4-S1.
    Once I healed from the fusion and felt better I was not as careful as I should have been. I had another child which put a lot of strain on me,too. Now I am back to where I was before, on pain meds every day.
    I "feel your pain", household chores are tough and having 2 girls ages 4 and 7 I wish could do more with them.
    Do as much research as you can (this site is great, good luck, and don't be foolish like I was that once you have a fusion everything is OK. You still have to be careful what you do and how you move.
    To end on a positive note, my husband had a low back fusion long ago and he has never had any problems!
  • I have been told by 3 doctors that I need a fusion. Scary- a large pills to swallow- so much to consider- I am piggy backing on your post- so THANKS for your post!~ LOL

    Shannon
  • There have been some great comments here and it gives me pause to consider my own level of success! I am just 3 weeks out from fusion of L5/S1. I admit I was hoping for the 100% pain free stories that you hear. I don't think I will be one of them :( But, on the other hand - I do think the surgery has fixed some of problems (obviously those relating to that disk area) but I have OA throughout my spine and facets and this will still cause me pain and stiffness. So, I will continue to wait and see where I end up as I still have a lot of healing to do - but I think I will still have pain in the long run even though I feel that the surgery was successful in some aspects.

    My advice if you do consider a fusion is to look at Minimally Invasive surgery. I am a firm believer in MI surgery and how much easier recovery time is!
  • This is a tad off-topic but I just wanted to say that I think people on this board become too focused on what type of procedure they are going to have.... It gives the impression that we, as laymen, are going to march into the specialist's office and tell him or her what surgery we want done. We tell others what type of fusion to have or which test to demand and I think it gives people new to all this the idea that we actually have control over telling the specialist how to handle our case.

    This is, of course, nonsense because the surgeon will do what he is most comfortable with and what he considers "best" for the particular person with his/her unique set of issues. I might really want an ADR and have my heart set on it, but it is not going to happen because there are physical findings that would rule me out as a candidate for that surgery.

    The same goes for minimally invasive surgery. It sounds great but many times there are valid reasons why a surgeon does not elect to do it on a particular patient. I just hope new people on this board realize that it is important to learn as much as you can so that you can have a conversation with your surgeon and partake in the treatment plan, but realize that it is the surgeon who will call all the shots. As a patient, if we don't like what the surgeon has planned, we can leave and select a different specialist...but we cannot walk in and expect a particular doctor to perform a specific procedure just because we want it.
  • :H

    thanks for even more comments, it's reassuring to hear peoples plight and a feeling that i'm not alone !

    gwen, i agree totally and i'm using this board to gather information to discuss my plan and for me to be more equipped at making a difficult decision. I'm of the view that perhaps i will stick where i'm at at the moment. Build myself up to be both physically and mentally more prepared, this i will pose at my next meeting with my orthopeadic surgeon. Knowing what our UK NHS is like it may take time for things to go through.

    best of british everyone, here's to enjoying a wet weekend !! LOL
  • Hi im 36 with 3 young children after years of fighting to have MRI and work done I had my first unsuccessful op in Feb 2007 to be followed by a private op in August 2008 (the NHS offered me a wheelchair or full spinal fusion due to state of my spine) all I can say is do not give up hope I had Fuser to L5/S1 and corflex stabilisation to l3/4 and l4/5 not pain free but has improved my life no end can give you name of guy I saw as hes brilliant as he said I will never be fixed but it has imporved my life. I still have pain but not for 6 weeks or longer at a time, I still have permenant nerve damage and my left leg does what it wants but im better.
  • OK, check this out:

    http://www.spine-health.com/treatment/spinal-fusion/tlif-back-surgery-success-rates-and-risks

    This if for a TLIF:

    Studies indicate that the patient’s pain is improved 60% to 70% after TLIF spinal fusion surgery and approximately 80% of patients undergoing TLIF spinal fusion surgery are satisfied with the surgical result.

    But again, what does "satisfied" mean to them, as opposed to what it would mean to you??

    Does it mean 40% are the same or WORSE??
  • There can be increased danger in waiting "too long" to have surgery. I believe I did, even though all through the three years I was trying to make up my mind, I kept inquiring if I could be causing permanent nerve damage by waiting, and the answer was NO....

    I went ahead and had fusion which was medically successful. But 19 months later, I have the very same symptoms as though I had never had surgery. At least I am no worse. I guess I should be grateful for that!

    On another note, for those of us that do not speak British, what is "OAP?"

    xx Gwennie
  • :H

    Hi Gweenie - OAP - Old Age Pensioner
  • With some emphasis we are understandably looking for any opportunity of success and 100% recovery, once you have decided to have the fusion you are left with the remnants good or bad. Waiting only extends your research time and although this procedure may be seen as a last resort when nothing else may have been effective is no guarantee that the hope we all place in it is realistic.

    All those with ongoing chronic pain come to this specific crossroads and it is suggested that recovery itself may take up to two years in total, so although initially we may feel concerned time may assist and we need to be patient.

    Gwennie makes a good point, that in reality our underlying condition and medical evidence would determine when the time is right and what is the most effective surgery, would we expect other people to tell us how to do our jobs. My best question was to look the consultant in the eye and say, well what would you do ! even though at times I may have not liked the reply, you could not fault that integrity or compassion.

    We all have to enter this type of surgery with conviction and a realistic evaluation of its success and be in the most optimum shape possible, having predominantly lived with chronic pain for a long time before this procedure is feasible, and having survived that journey nuances of change will get us all through the worse days.

    John
  • Hi John,

    Just read your post as I was searching for some answers. It has been 5 days since I had L5 Hemilaminotomy and a Foraminotomy. From your message it appears that you are doing real well and that gives me courage. I have a labor intesive job and am worried when I go back whether I will be able to function without the pain reoccurring again.

    Right now I seem to be doing fine - though I am bored to death. I have hard time sleeping at nite because I am constantly worried about turning without hurting myself. Also, I am never sure if I am sleeping in a correct position. If it is not too much bother, you could please shed some light as to how I can prevent any mistakes. My doctor advised about the lifting, bending and twisting which I have been self-concious about except for the twisting part when sleeping. How often were you up and about?

    Also, are you working? If you went back, how long did you wait to go back and what are some of the precautions you are taking right now.

    Sorry for all the questions. Can't help being concerned and idle mind makes it worse.

    Any advice you can offer is greatly appreciated. Look forward to hearing from you.

    Thank you.
    Shamu
  • Six weeks ago I underwent an ALIF (through the abdomen instead of the back). It was at L5/S1. I am having an easy recovery, and my fusion is healing nicely. I will always have aching joints from osteoarthritis, but my back no longer bothers me.
    Good luck with your decision.

    Rusty
  • <<<<The same goes for minimally invasive surgery. It sounds great but many times there are valid reasons why a surgeon does not elect to do it on a particular patient. I just hope new people on this board realize that it is important to learn as much as you can so that you can have a conversation with your surgeon and partake in the treatment plan, but realize that it is the surgeon who will call all the shots. As a patient, if we don't like what the surgeon has planned, we can leave and select a different specialist...but we cannot walk in and expect a particular doctor to perform a specific procedure just because we want it.>>>

    Just to add to this - if you search for a MINIMALLY INVASIVE trained surgeon, you most likely will be able to get MI surgery as those doctors can do MOST (but not all) back surgeries using an MI approach. However, the poster above is right, that if your doctor is not an MI doctor and has no experience doing it, you cannot very well tell him or her to perform the surgery that way.

    This is why, I found an MI doctor to go get a surgical opinion from (he does all his surgeries using MI) when my OS said he would do an open fusion and I knew that I didn't want that.

    However, as the person said above, especially with ADR, you can go see a doctor who does ADR surgery but you can still not be a candidate (I wasn't because of my facet disease) and they won't do an ADR surgery.

    So, if you want MI surgery, research and find a doctor who is a member of the MI association and who performs all of his surgeries that way and see if your type of surgery can be done with an MI approach.

    I have had 2 surgeries done that could have been open - my fusion and a hysterectomy - and did them both MI - and I can't say enough of the difference in my recovery from talking with those who did an open surgery - many of whom went that route because that was the way their doctor does surgery instead of getting another opinion.

    Just my two cents on this.
  • I had my spinal fusion L5 S1 about 4 weeks ago. I am doing well as far as the pain in my back. However I am now suffering with severe depression and anxiety issues. :-(

    Hugs
  • I sent you a PM so that we can e-mail. However for the benefit of anyone who needs the same infornation I will briefly outline my answer to your questions.

    Firstly, 5 days is a very short time with respect to the surgery that you had. I was in hospital for a whopping eight days!

    Next ,don't be bored, be thankful that you are even able to think about being bored instead of worrying about pain. Relax and use the down time to heal.

    Sleeping is a real nuisance. I found that I was walking around during the night and sitting at my computer on Spine Health. My doctor wanted me to take Ambien which I was taking in the hospital. I did not feel comfortable taking it and I wanted to sleep naturally. The sleep thing will come back with time and as you begin to heal. You have to remember that your muscles have been disturbed and healing takes quite a long time.

    As far as how you are sleeping is concerned, I use extra pillows to stop myself from turning over too much and I sleep with a pillow between my legs too. That does help.

    The lifting, bending and twisting thing is really about you and how you feel. Your body is the best guide, just don't overdo it. You know when that is and I do not have to tell you. Basically you must not lift more than 5lbs for 90 days. That is a general rule only, but you do not want to go out there and conquer the world even though you might like to. Just remember Rome was not built in a day and you are not superman and nor should you try to be. You have just had a serious piece of surgery and it is up to you not to screw it up.

    Finally, I am retired, but I still do lots of active things and I am still doing stuff slowly and carefully. Yes I ache sometimes but that is getting better ache and not strain from doing too much. I just listen to my body.

    Anyway, look at your PM and e-mail me for some more details.

    John B
  • on the advice of my doctor and physiotherapist and pain consultant .the reason is for this is my back is full of scar tissue and i have facet joint hypertrophy ,from what i have heard a fusion equals more pain
    STRAKER
  • Hello - I did 6 years of non-invasive therapy (facet blocks, rhyzotomy, narcotics, etc.) and finally had my fusion (L5S1) three years ago. I had anterior/posterior...although the surgery and 4-5 days in the hospital were difficult, it is by far the best thing I ever did....I can walk for miles, stand, sit, ride bike, etc., with little or no pain..something I had not experienced since my teens (I was 47 at time of surgery). I wish you good luck, and as long as you feel you've exhausted all other options, and are still in pain, go for it!!
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