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Need support and information about 4 level spinal fusion.

AnonymousUserAAnonymousUser Posts: 49,622
edited 06/11/2012 - 7:38 AM in Back Surgery and Neck Surgery
It has been recommended that I have surgery. Four levels. Anterior interbody fusion L2-3 L3-4 L4-5 and L5-S1. Then a Posterior spinal fusion with instrumentation from L2-S1. I have moderate stenosis with narrowing of L5-S1, DDD of L2-3 L3-4, L4-5 and L5-S1. MRI also showed 3 or 4 of these discs herniated.

I am having trouble understanding all of this and it's overwelming. I could use all the information I can get. I have searched and see a lot of 2 level fusions but not any 4 level. I have tried Chiropractor, Physical Thearpy, epidural steroid injections with only short term temporary relief if any. The Chiropractor wanted to start the SpineMED disc decompression treatment but it was expensive and insurance won't cover it. I don't really know how successful that treatment is. The spine center I'm going to does not believe decompression treatment will help and the Chiropractor and SpineMed (company that makes the machine) claims a high success rate. Why would insurance pay for a $150,000 surgery but not cover a non-invasive non-surgical treatment?

Right now I'm on short term disability waiting on a surgery date which won't be some time in January. I hate the thought of going through this surgery and a 4 level fusion sounds like it will take away a lot of flexability. I understand that disc replacement is not very viable and the FDA has only approved a one disc replacement. I know other countries are doing more. My favorite hobbies are Tennis and jogging which sounds like are over for me. I also understand that after having a fusion it puts more pressure on the other discs. I really hate going through this at only 49. Any encouragement, advice and information would be appreciated.
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Comments

  • Oh my. I'm not really quite sure what to say. Perhaps you should try to get a second opinion from another surgeon. I have had a three-level fusion. The recovery has been long and hard, but I would not say grueling. I AM stiff. I go to physical therapy once a week and sometimes think I could use a few more treatments. The therapy seems to keep me a little looser, but you will end up feeling a bit like you've been nailed to a board. Now -- there are a few here who have had three levels (and I think some fours) who are not quite as stiff as I am. I had a bit of spondy, DDD, arthritis, and three totally ripped across discs, so I didn't have much choice. I imagine your nerves are being fairly compressed. You are right about the ADR not being much of an option for you, but I did see someone here a few days ago who had an ADR at one level and had fusions around it. At least he had some movement in the middle. I don't know how feasible this would be for you. I would say that tennis and jogging are probably over for you. This does not mean your life is over -- you can find other interests that can keep you active.

    All I can say is, read, read, read. Get another opinion. It may be that fusion is your only option, but check all avenues first. Oh, I forgot to say that the decompression might be helpful, but probably temporary at best. I'm 55, so a little older and probably in worse shape than you are to begin with. Hopefully, it won't be that bad for you.

    Linda
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • All I can offer is support.

    I had a 3 level cervical fusion 3 months ago. I don't know if you'll be able to play tennis or run. I know I had to give up sparring in the martial arts, down hill skiing and running but am finding other things I can do.

    I've had to change my thoughts and be grateful I can still walk, snow shoe, lift weights and do other aspects of my martial arts.

    I wish you much luck on your situation. It's easier looking back than it is looking forward for me. When I look back I realize I did the right thing and having to give up some aspects of my life was worth it to have chance of a life with less pain.

    I am a very young 59 year old. I'm sorry that you have to go through it at an earlier age. You should heal faster due to your age so at least there's that. :)))
  • I'm not sure who to go to for another opinion. It takes a month or two to get into another Orthopaedic surgeon and since they are surgeons they tend to favor surgery. I live in the Louisville area and have been to the Norton Leatherman Spine Institute. Who ever you go to seems to favor the field they are in rather then being open and up to date with all the options.
  • You have quite a lot to think about. Definitely get a 2nd or 3rd opinion.

    I had a 2 level L2-L4 PLIF and now need an ALIF (L4-S1 next Wed.). That is 4 levels, but not at the same time. I will be posting after my surgery to let others know how I am doing.

    I will also be needing a cervical fusion, C3-C7, in the future. Thankfully I have the somewhat healthy thoracic vertebrae/discs in between!

    Do as much research as you can. It helps to be well informed. Be careful of chiropractors; they can do more harm than good with certain spine issues.

    Good luck. Keep posting any questions we may be able to help you with.
  • Welcome to Spine-Health. I'm sorry to hear of your spine problems, so regrettably, welcome to the world of the spiney.

    I can suggest a couple of things: get the opinion of a fellowship-trained spine surgeon (can be ortho or neuro) - someone who only works on spines. Their input can be very valuable. At the top of the page near the right-hand side, you'll see a tab that says "Find a Doctor." That's a great place to start searching. Four levels is absolutely humongous and it's wise to get some more opinions.

    I've found that spine surgeons want to try as many conservative methods as they can before they suggest surgery. You can also take the results of any tests you've had (MRI, x-ray, CT scan, etc.) to them for interpretation.

    Take care - please let us know what you find and keep us posted.
    Cath
  • I have scheduled two more appointments to get more opinions. It takes awhile to get into see these guys. One appointment is in mid January. The bad thing about this is insurance. I'm currently on short term disability and it will run out the first of March. By the time I get all this information and if I opt for the major surgery with recovery time I'm sure it will be past that date.
  • What are some of your opinions and thoughts about after fusion surgery. What have you been told about the extra stress on the remaining levels?

    What about long term effects and how long can you expect to get out of this without further problems?
  • Once you have a fusion the discs above and below take the brunt of any physical force.

    I learned the hard way that there is no going back to "before". Once you have a fusion and have been through recovery you still need to be very mindful of your back.


  • Hi, Sorry to hear about your problem. I had an anterior posterior fusion on the same levels as you. I went out of work and found the surgery could'nt be done until 2 months later. I was in the same boat as you are in. I would use up all my short term disibility before I could even go back to work. Could you possibly go back to work until the surgery date? This would stop the short term and you would have more weeks of pay while you are healing. That is what I did. I was very sore doing it, but i'm glad now looking back that I did. Also, ask you surgeon that you would go to any other hospital that he practices at and maybe get a sooner op date. It saved me almost 1 month by doing that. As far as the surgery and flexibility I can't answer that for you. I'm 10 weeks out and I notice an increase in flecibility a little each week. It's a major surgery to go through and I wish you the best. Keep us posted on your surgery and that I can relate to you. Kevin
  • SpineAZSpineAZ WiscPosts: 1,084
    Aidenous:

    Do you have Long Term Disability (LTD) as well? I had STD for 6 months and then my LTD just started at the end of October. The duration of LTD payments is until my age 67 or upon being able to return to work (whichever comes first). My hope is that if I have my posterior and anterior fusion (L3-S1) in December I may be able to consider returning to work in May of 2010. I'll likely have to change my job focus as many of my jobs have required travel and I'll just have to find something that doesn't require travel.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Spine surgery is a big decision. I am now 10 months post op 3 level PLIF from L2-L5 and have done great personally.

    You need to decide if you can survive with the pain, manage the symptoms, or persue an actual treatment such as surgery. I tried narcotics, steroids, stretching, etc, had no affect. I could not work nor live with the pain and I had the surgery and did well. If I was to tell you a % of how I feel compared to how I felt at my healthiest I would say 95% as there is some stifness and minor loss of mobility.

    As far as chiropractors go, they will sell you anything the companies pay them to. I know nothing about the treatment you are talking about, but insurance will only pay for procedures that are proven. (Hince why artifical disc replacements are still not covered by all insurance companies, but are becoming more accepted due to success rates).



  • One thing my internist told me before I got into this whole back game is that unlike many other surgeries, spine surgery will NOT restore you to the way you were prior to injury or onset of pain. Too many people enter into it thinking they just want to be the way they used to be...they can't deal with the pain; they will have the surgery, recover and everything will be just the way it used to be.

    This is an unrealistic thought, and those who enter into spine surgery thinking that way will end up disappointed with his/her outcome. Also, when surgeons speak of a "successful outcome" be sure you understand how they define that term. "Successful outcome" does not equal pain-free.

    Obviously, if you need surgery, there really aren't too many options. Just be sure you have really done your homework, explored all options and know what you are getting into. There is no turning back or changing your mind once you have the surgery.

    Good luck with your decision.
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