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Question concerning my dad's upcoming fusion

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:41 AM in Back Surgery and Neck Surgery
Hi everyone,

I haven't been around in ages. But the people here helped me when I had to make the decision of a fusion or no fusion. I'm still experiencing some pain in my legs but nothing like before. I haven't had any surgeries yet and continue to see my neurosurgeon for progress.

But this subject is about my dad.

First of all he's 77 years old. He had the same prognosis as me and they performed a microdisectomy on L5/S1 in November. They scraped the excess disc that was on the nerve. He never recovered from the pain. He had another MRI done that showed his disc is degenerating at a rate where it herniated again. They gave him the prognosis of a fusion.

From the research I did and the people here, I have questions because his doctor is telling him things that have me scared for his life. I'll list them and please, those that have had this done, tell me if these are true.

1. He'll be in the hospital 1 day
2. He'll be able to drive a car in 2 weeks
3. NO BRACE????? He doesn't need one according to them
4. He'll be able to resume a normal life with limitations after 2 weeks.
5. Healing will be approximately only 3 months?
6. This condition is hereditary.

This is what I was told and researched for the same list:

1. Hospital stay 2-4 days
2. Have to have a doctors permission to even sit in a car after 3 months
3. A brace is mandatory to restrict movement after the surgery.
4. Might not even be able to sit until 2 weeks
5. Healing with take approx. 6 months to a year
6. I have 3 doctors (spinal specialist and 2 neurosurgeons who disagree because there isn't enough evidence out there to prove this.

Please help me to calm down for this. My dad even received a second opinion and the second doctor concurred that a fusion is what is needed for him.

Hope everyone is doing well.


  • I cant comment on your Dads surgeon but I had a two level fusion in Dec 08. I didnt have to wear a brace. I had it PLIF. I dont know what type he is having, maybe that makes a difference. My Dr told me that the brace only leads to muscles deteriation from not using them. I was in hospital for 5 days. Didnt drive for almost 3 months. Healing was at least a year. Sitting was limmited to potty times and eating and no more than that.
    Maybe he needs a second opinion. Just thought I would tell you my experience. But everyone is different. Good Luck, Love, Robin
  • I am 2+ months out from my second 2 level lumbar fusion. The first time was done posteriorly, no brace. Was in the hospital about 5 days. Can't recall how long before I drove. Rods, screws and my own bone were used.

    This time I had an anterior fusion. Less than 2 days in hospital. Day 10 was given the OK to drive. Have to wear a brace this time because my surgeon said the anterior way has a slightly smaller success rate and he wants to be very conservative. A plate, screws and cages were used. I don't drive much at all yet because it is so uncomfortable getting in and out of the car, especially with the brace on.

    After 2 weeks a "normal" life? Not my experience, its a long recovery. Also, the older someone is the slower the healing.

    Like Robin said, everyone is different. You might want to do some more reading in the back/neck surgery forum (if you haven't already). You can get a better Idea of what others have been through.
  • Hi Renee,

    Is your Dad having an open or minimally invasive procedure? Minimally invasive procedures don't traumatize the areas as much, but, it's still a heavy duty surgery. I had a MI L5-S1 fusion w/ all the 'trimmings' in July, 3 day hospital stay, no brace, no BLT, no driving or lifting, limited sitting (10-15 mins at most), walking as much as tolerated and doing my stretches every day. My OSS feels that your core has to be as strong as possible and bracing dosen't encourage the muscle development needed for this. At six week mark, I was cleared to lift nothing more than 20 lbs, could sit for longer periods, and could resume driving once I felt comfortable doing so - I held off since I still had a significant amount of weakness in my right foot and was afraid I'd have an accident. Healing is to be expected at anywhere from approximately the year mark to as long as 3 year
    mark. If there are nerve compromises, no guarantee is given that the surgery will bring back full function and this is generally the longest part of healing since nerves heal so slowly. I'm 52 and was always an active type - I'm getting back to more of what my normal was, but, it'll never be the same as before.

    Hope this helps, please keep us posted.

  • I would be a little surprised that, given your dad's age, they would keep him in the hospital for one day. Even if the surgery is done minimally invasively, it is still a big surgery.

    Braces used to be standard with a fusion, but that thinking is changing. Previously surgeons did not use hardware to hold the spine together while the bone is knitting together, so the brace had more of a purpose. Now with titanium holding the patient together, there is less need for a brace. This is really a matter of opinion among surgeons.

    More than anything, driving depends on how long he would be on pain medications. I think two weeks is a little early, but I know others who were driving short distances by three weeks. I didn't drive until 8 weeks with my one-level PLIF two years ago.

    Point #4 -- THIS IS INSANE!! I don't care if you're twenty. After fusion you cannot resume a normal life after two weeks. I was barely conscious at the two week mark because I was on such strong pain medications. Even without meds, you'd still be having a painful time of it changing position, walking, dressing, etc.

    He will be able to sit. I think I recall sitting in a chair at the hospital after surgery. Then you are supposed to limit the amount of time you sit to about 15-20 minutes three times a day at least until the first post-surgical appointment...and usually for the first couple months.

    Sometimes bone growth is not observed at 3 months. You have to be very cautious for the first six months to be sure you aren't doing harm to the fusion. It takes a good year for the bone to set up and be strong.

    I've never heard or read anything about it being hereditary, but I'm not even sure what "it" refers to!

    This topic makes me really crazy and is probably the main reason why I started posting on the forum. Too many doctors let patients believe that back surgery is easy and that it will resolve their pain. In my opinion, this borders on the unethical.

    Doctors routinely tell their patients the recovery time is shorter than it is. They do not go into any detail about recovery and what it entails. We all learn much more on this board than from any surgeon!!

    We end up with new people posting who think they will have a multi-level fusion and be back to a strenuous job in a couple weeks. Then in a month, when they are still in pain and have no energy, they are devastated and think their situation is unique, that the surgery is a failure and they are scared.

    No one should leave a surgeon's office with the idea that fusion or a discectomy, for that matter, is a quick fix. First, it is not even a "fix." Patients in almost all cases, are not restored to the way they were when their spines were teenagers!! Surgery is done to stabilize the spine and for pain relief. But there are never any guarantees that the pain will be relieved. When dealing with nerves, no one can predict how things will turn out. Once you have surgery, there is no turning back the clock. Once you have spine surgery, you will never be the same. I feel this is a concept that is very important to understand prior to entering into any spine surgery.

    It is very important to choose your surgeon as carefully as ANY decision you've ever made in your entire life. Nothing is more important than choosing a well-qualified spinal specialist!! (followed by a hospital that has a low infection rate)

    Gwennie on a rant
  • I totally agree with you. I know first hand how long this surgery can take to make you feel half way normal. I am not there at a year. Drs should tell their paitents their is no textbook on how long it takes to heal, and not sugar coat it. I thought by a year I would be much better. Nothing is guarenteed with this surgery. Especially relief of pain.
    You are dead one right. Hopefully people will listen to your words and take them to heart. Love, Robin
  • 1st, I agree with Gwennie on her rant! :)

    OK, I'm not trying to offend here, hear me out. I think structural deformities should be corrected before a spinal cord stimulator is offered. BUT, you know how long it takes to recover from a fusion. I'm wondering with your dad's age and if he has any other medical problems if it might be more appropriate to think of meds and a spinal cord stimulator for relief. For example, if he has a bad hip or knee, he's going to walk differently after a fusion and put more stress on the joints. I don't know how unstable his back is, but if he knew the true details of fusion, especially at his age, he might want to ask about if he could benefit from a spinal cord stim trial.

    My intent is not to offend at all, I don't want you to think I'm writing off 77 year olds. I'm just thinking he may be more interested in pain relief if that is what can be done without invasive surgery. Minimally invasive surgery vs. open surgery patients have the same 2 year outcome rates. In fact, in complicated cases, minimally invasive clamps left in place too long can cut off oxygen to the tissue.

    I think docs like to give the prognosis in terms of success of fusion(the bones growing together) and not in terms of pain relief, so it confuses patients because we aren't on the same wavelength. Also, it is my experience that folks of your dad's generation take everything that a doctor says as gospel.

    It's just a thought to ask about management with meds and/or spinal cord stim.
  • Oh thank you everyone. The brace thing for me was the most nerve racking. My mind is a little at ease knowing that maybe he really doesn't need it.

    He will be transferred to a rehab facility a day after surgery and under a nurse's care for 2 weeks. Then, he can supposedly drive home. UGH, that scares me.

    My dad is not active. He sits in his chair and loves to watch the Game Shows. LOL I've tried telling him sitting will be minimal.

    He works as a volunteer sheriff and has spoken to others who have had the same procedure. They told him they were back to work quickly (2-3weeks). They told him the pain wasn't bad. But were any of these people 77? I think not.

    My father is like what one poster said. The word of the doctor is gospel. This is the same doctor who performed the first surgery. This is the same doctor that told me my condition (which had the same symptoms as my dad) was hereditary.

    I just can't come to the thought that only night in the hospital is going to be enough, but thankfully he'll be in a rehab center where if he IS in extreme pain, they can do something for him. He is the type of man who refuses pain medicine. He's a retired Army soldier and very very stubborn.

    He has no other problems except for his shoulder. He had his rotary cuff fixed almost 5 years ago and it's to the point he can't lift his arm. They told him that for that it's bad arthritis and all he could do is put up with the pain or have a shoulder replacement. I say that because he tried physical therapy and tried a cortisone shot and neither worked. That factor has me worried too. How is he supposed to sit on the toiley with only one arm working? You know?

    My main concern is his age and the fact he lives alone. I can't go down there again and take care of him like I did with his first surgery. I have to take care of my family here. I just don't want him screwed up more than he is.

    His only thought is he wants the pain gone. I can't get it through his thick skull it won't be right away and that it will take longer than 3 months to heal at his age. I just hope he does more research like I keep begging him too.

    And I did state previously, he had a second opinion and they concurred with the fusion. Yet, neither of them took the spinal X-rays for stability like my neurosurgeon did for me. He says he doesn't need it and just wants to be rid of the immense pain he is in.

    Maybe I need to direct him here. He has a computer and maybe he can hear it from others who've had the same procedure and know what to expect, even if everyone is different.

    Thanks again everyone!!!
  • Wow - 2 weeks to be normal. Wouldn't that be nice. I think that some of these docs talk rubbish. Mine was not totally honest with me and it is only now that he has come clean and admitted that it will be more like the 6 month mark before I begin to feel more like myself.
    If I hadn't read these boards I would not have been prepared. As it was I had read all this stuff and knew what to expect. My GP was more upfront and my physio even more so. Maybe the surgeons don't realise how long it takes because they see us so infrequently??
    Any way I am 15 weeks post PLIF on the same level and am still not normal. I didn't drive till week 7 ish as I had a wound infection. I didn't have a brace either.
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