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Heading into lumbar fusion.: Which one?

JohnnyOJJohnnyO Posts: 118
edited 06/11/2012 - 8:37 AM in Back Surgery and Neck Surgery
Hi everybody. After having horrible lower back disc problems since I was 14 years old and 6 lumbar operations now at 30 years old I am heading into fusion.

Ive had two failed operations since my last serious herniation injury at the beginning of 2008. Ive had two opinions on fusion at the same major hospital Ive always gone too. Both said they would do the fusion, the first doctor was very conservative and really scared me from getting t done so I had another opinion. The second opinion is from a very known and respected surgeon who made me do another EMG and a discography. After the EMG he said he thought some of the nerves in my leg and foot were trying to heal themselves but were probably unable too, and that some he believed would be chronic. He wanted a discography which was positive at L5/S1(just a slight increase in burn intensity) and nothing at L4/L5 in which the dye actually shot out of the disc through a herniation. About eight hours after the discography my pain had increased and over a larger area of my leg and foot. I see this Surgeon for his suggestions in a couple weeks.

The first surgeon I saw was going to do a two-level (L4/L5/S1) interbody fusion in which both discs are removed. I like the idea of the surgery because I am desperate to get both those discs out of there they have caused me trouble for so long. I however know there are fusions where the disc is not removed and I worry my current surgeon first will only want to removie L5/S1 because of the discography and second will not do an interbody fusion. Both discs are in bad shape with severe DDD.

I am unsure what fusion options I have for my situation. I know there a few different ones but Im hoping that the ones where the disc is left alone are not an option for me. After two failed laminectomy/discectomy's for this injury I am worried of disc pressing on nerves that will be missed during fusion.

Anybody who has any info on what is likely or my best option, I would be grateful for responses.

I have unbearable nerve pain in my leg and foot and have been hospitalized at least 5 times for pain control since this happened. I am only now able to control my pain after working on my medication for a long time, and I have to take a ton of medication which is not realistic to live with.


  • I would be inclined to get at least another opinion, preferably from a spinal specialist from a different hospital association. Also, I am a bit surprised that you have had five operations. When an area is operated on repeatedly, the problems with epidural fibrosis increase. I would be concerned that some of your nerve pain may be coming from scar tissue that is possibly compressing one or more of the spinal nerves.

    Just be sure to bring up your concerns to whichever doctor you decide to go with. Have him explain what he has planned and ask specifically about removing the disc and doing an interbody fusion. I'm afraid after this many back surgeries, the nerve itself may be causing the chronic pain.

    Good luck in your search.

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