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To fuse or not to fuse?

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:35 AM in Lower Back Pain
I have a spondylisothesis Grade 2 at L4/5.

Although I am not in great pain now I have been advised to have a fusion while I am relatively young (51). I have very little of my disc left and the gap between the vertabrae is getting narrower. I had hoped it would fuse naturally but this hasn`t happened.

The lisothesis was diagnosed in 2002.

Would other members agree with this proposal?


  • I would advise you to make your decision based on the level of pain you are having. If you are in otherwise good condition, I don't think age is going to make that much difference...maybe if you were 25, but by the time you reach 50 I really question whether it makes that much difference.

    My 88-year old MIL and I both had spondylolisthesis at L4-5 and had similar surgeries within one month of each other. She healed as quickly as I did and she refused all pain medications because she didn't like the way they made her feel. I took them for the first eight weeks!

    More important than the age issue is how much this condition is affecting your life. It is important to understand that back surgery is not like any other surgery. In almost all cases, surgery will NOT restore you to the way you were prior to injury or onset of pain. In other words, having surgery will not give you the back of a twenty-something. In most cases, it will relieve some or most of the pain, and in the case of spondy, it will provide stability.

    If your pain is bearable, I would think long and hard before agreeing to fusion. Once you have it, there is no turning back.

    Good luck with your decision.

  • I had this condition last year. I had horrible spasms that kept me awake for a few days, would go away, and then come back. I then ended up with embarassing incontinence that became severe. After much conservative therapy, only thing to do was a fusion. Only you can make the decision as to whether or not you need the surgery. I would get a couple of surgical opinions.

    Best to you,

  • I had an L5, S1 fusion and almost 6 months later I am doing fine and out of pain. My L5 disc was degenerated. I'm 41.
  • I had a 2 level PLIF in 11/08 and while most of my low back pain has dwindled I do have permanent nerve damage (from retracting the nerve root to get to the spine) and I still have twitching and spasms in my legs just about every day. Do I think I made the right decision for me? Yes. I was so bad before that I couldn't stand or drive or walk more than a minute or two. I say listen to your body, really listen. If you feel as if you *cannot* thrive with the pain you are under then do what you feel is appropriate. I hope that my input helps even a little. We all are here to support you no matter your decision.

    One Love,

  • Pete,
    It was very important for me to have two opinions.Have had lots of surgeries-and a spinal fusion is a big one.I had pain into my foot-so it was something I needed to do for myself.I also had a very good neurosurgeon.No one but you and your doctor can make that decision.My back will require continual maintenance,if I want to remain healthy.Pain was my motivation for surgery and if your not having much now-I would sure get SEVERAL opinions from qualified neurosurgeons-even if you have to go to another state.My fusion turned out well,but has changed my life in a lot of ways.Age has very little to do with it-as I have seen older people who have a good result-and younger ones that have not.Your lumbar spine supports your whole body and a lot of activities have to be modified after a lumbar fusion.It made my cervical fusion look easy.Just some food for thought.
  • Personally I would wait...If your pain is tolerable I really don't see the need for a fusion..Fusions almost always limit your range of motion afterword, some more than others..I had a 2 level 5yrs ago and being a golfer i can sure tell that there has been an extreme limitation on my range of motion in my back. Also scar tissue can be a problem in the future...Just my 2 cents worth..Good-Luck in whatever you decide.
  • I'm in the process of scheduling my PLIF for the same condition. Doctor is waiting until I can pass a nicotine drug test to schedule the surgery. Although with mine it is progressively getting worse and it hurts like all get out. Mine was a grade 1 9yrs ago and it is now quickly moving. I'm just about a grade 3 and they don't know if it will stop on its own or not. So I'm going to get it stopped, and hopefully relieve some of the pain. If yours isn't causing pain or unstable I wouldn't mess with it.
  • Do they really test you for nicotine?? I know it can slow they progress of healing but never heard of the nicotine test..
  • Explain the nicotine test please?
    C3-4-5 fusion 2005
    C-5-T-1 disk bulged
    L-4-5 bulge to the right, with Microdiscectomy, failed
    L5- Bi-Lateral bulge
    Pain in right foot -loss of feeling
    Left butt, hip and front thigh pain with bad shooting pain into inside ankle sometimes
  • Nicotine tests are taken for a few reasons. The most obvious reason is for health insurance. They use it to classify smokers and adjust premiums. Since smokers tend to have more health issues, it's simple economics.

    The test itself is done to detect continine. When your body metabolizes nicotine, it turns it into continine which can be detected in the hair, blood, urine and saliva. Nicotine leaves the body in about 3 days, it can take up to two weeks to get rid of the continine.

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