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Level 4 lumbar fusion surgery

AnonymousUserAAnonymousUser Posts: 49,731
edited 06/11/2012 - 8:37 AM in Back Surgery and Neck Surgery
I am about to undergo in 2 months a level 4 lumbar fusion surgery. S1-L5; L5-L4 disks collapsed; S1-L5 are slipping; L4-L3 and L3 - L2 are bulging and pinching nerves. I am really scared about undergoing this surgery and was wondering if anyone had any words of wisdom...maybe what to expect afterwards....how to prepare?

Thanks,
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Comments

  • Hi and welcome to SH. I am a little confused about what you are having done. Are you having 4 levels fused? Do you know what kind of surgery it will be? There are several different options and folks here will be able to give you advice based on similar surgeries. The stick post at the top of this forum that list post-op must haves is very helpful to get you thinking about what you will need to help you with your recovery. Recovery times vary based on the type of surgery. This is major surgery and you will need to give yourself time to heal. Let us know more details. The folks here can relate to your situation and will be more than happy to give you words of wisdom and support.
  • Hi Igilmore, and welcome to Spine Health! Hope you will hang around and get some info from these postings, just keep in mind that everybody is different, and your experiences may not mirror those of others. A four-level fusion is pretty big, but even that does not mean that you'll have more problems than some with a one or two level fusion. You see, I had a three-level lumbar fusion, and compared to some who only had a single level fused I came through quite well. The best advise I can give you is that use the two months prior your surgery to build up your strength, eat well, try to walk as much as you can, if you are able to do core muscle exercises do them, take vitamins and go through the the Pre-surgery list (you can find it under the first "Sticky") and prepare your home for the recovery period by getting things in order per the list. Once you have everything under control try to relax (believe me, although it may not be easy, it can be done!) and hopefully everything will go well. Even the postoperative unpleasantness will be forgotten once you realize that you are much better off than prior to the surgery.

    Good luck to you, and keep us posted.

    Kin
  • Quick question: how much change in mobility do you feel now that you are fused? How aware are you of the fusion?
  • Well I am not that verse in all the technical, but the NS said that he will be putting in rods and screws in S1 - L2 and said it was a level 4.
  • I haven't had surgery yet...Dec. 16
  • Thank you for the advice. I am going to try to keep myself going and healthy and try to be the best shape I can be in by surgery time. I have only had surgery once on my knee many many years ago and a little scared to undergo such an extensive surgery(so people tell me). I guess just hearing from those that have had it, makes me feel hope is there.
  • I just got the surgery procedures from my surgeon...L5 Gill(I have no idea what that is exactly); L3-S1 Decompession Instrumentation & fusion; L3-4 Discetomy.
  • Yes, I realize that. I was hoping Kin could say more about her fusion. You will have the same segments fused as Kin had. You will have four vertebra worked on, resulting in a three level fusion.

    I see you surgery is scheduled for right before the holidays. You might want to think about postponing it a couple weeks into January. Things get so backed up over the holidays. I was just thinking if you needed to contact your surgeon post-surgery, it would be more difficult at this time of year...to say nothing of being laid up over the holidays. Just a thought....
    (I had both my surgeries the second week of January so I have thought about this a lot!!)

    Have you looked through this information?

    http://www.spine-health.com/treatment/spinal-fusion/modern-lumbar-spine-fusion-surgery
  • I know this is a scarey time for you. Kin was right on, exercise, take you vitamins, lose weight, relax, and pray. Get you mind right, Think thru the surgery to recovery. There will be some hard times but you can do it.

    I had back and leg pains for about 4 years.I went thru PT, the back root nerve injections x2 ,back exercises, I walked 5 miles twice a day until I couldn't walk across the room. I found the right surgeon. I looked up everything about this surgery , ask questions and was fully aware of everything that was going to happen. I was ready.

    I had a level 4 fusion , PLIF L3-4-5 and S1 on 6/4/09. I have 8 new rods and screws with a new disk between my L5 and S1.My spine was strighten and I gain an 1" in height. I ask for 5"s.ha The first month was ruff.I have not had and back, hip, or leg pain sense surgery.I do have some numbness were the pain was. And I've not had to take any pain medication once I was home.
    I'm 65, diabetic, I have 3 grandkids and 2 greats and I'm walking 5 miles twice a day . I know my limits and I've never felt better.

    Good luck on your surgery. we are all praying for you.
    Nanaclark 10/10/09
  • If it makes you feel any better, from what you described, you will be having a 3 level fusion. The L3-4 segment will be joined to the L4-5 segment, which will be joined to the L5-S1. It is a minor point, but, quite frankly, it would make a difference to me if I were facing fusion...which I am in a couple months.

    I had a variety of opinions a couple years ago when contemplating surgery. The opinions varied from fusing 3-5 levels down to fusing 1. I saw 8 different specialists (I was a tad excessive @) ) and 6 each said he recommended fusing L4-5 only...so I went with that opinion. My pain has remained the same as post surgery....so after two years of a whole variety of testing, visits to a bunch of different types of specialists, etc. I am waiting to hear if we are now going to do L5-S1 only or L5-S1 and L3-4.

    If I'd had three levels done to begin with, I probably could have saved a lot of time, pain and money...but, who knows!!

    You might want to ask your doctor to tell you a few more details about your surgery. Will you have a bone graft, if so, what kind? Are you having cages or what will support the vertebrae, etc. Is he going in from the front, the back or perhaps, both? These are all things you might want to know about ahead of time as it might make a difference in your recovery.

    If you have other concerns, just ask. Many of us on the board have had fusion.

    Cheers-
    Gwennie
  • Lgilmore - You have certainly found the right place for support from knowledgable and expereinced spineys. This site really helped me prepare for and survive my husband's revision (do-over back surgery). We were not at all prepared for the recovery before surgery #1 but we were for surgery #2 and it made a big difference. Even so, we were not totally prepared for just how long recovery can take. My husband Chris is now 18 months out from his L2-5 fusion. It has been a long road with many twists and turns. He is still improving. Prepare yourself, find some good support, work steadily at your recovery and be patient. Best of luck.

    Terri

    p.s. one of the best things I did before surgery was read a thread titled "Fusion" by Dave. He was about my husband's age and posted regularly troughout his entire fusion...it gave me a great real-life story.
  • There is some great advice here (above) - there's not much I can add...

    Is this surgery bad - yes - my nurses told me that spinal fusion is the second most painful surgery - second only to open heart.


    But, I found that by preparing for the worst was kind of good. Nothing could be as bad as I imagined. The actual pain was a challenge and not something I am anxious to repeat, but mentally I felt prepared and found that I was able to handle it fairly well.

    You should make a list of questions to ask your dr,:
    Are they using BMP, where, how much? Are they harvesting bone from your hip, using cadaver bone or what. How much mobility will you lose. How long do they expect you will be laid up - tip - double or even triple what they tell you, it always take SO much longer than anyone expects!

    You should also research your dr. You should ask what his M&M rates are. (Morbity and Mortality) My physiotherapist coached me on this before my first NS appt. and deliberately sent me to an NS that was slow to cut and the most up-to-date on procedures.

    FYI -

    My NS put in BMP filled 'bullets' around the spine - The plastic bullets were used to preserve some of my flexibility. If you are having a 4 level fusion, it places a lot of strain on the next levels up. Like a tree in the wind, it's better to bend a little so you don't break.

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