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L5/S1 problems after L4/5 fusion

Cath111CCath111 Posts: 3,702
edited 06/11/2012 - 8:41 AM in Back Surgery and Neck Surgery
I don't know how many of you were told this, but my doctor and my PT at the hospital told me that because of the fusion and decompression (TLIF) that was done at my L4/5 level, I'll have to forever be mindful of my L5/S1, that it could be injured very easily. He said I'll need to logroll in and out of lying down the rest of my life and be as careful of my lumbar spine as I'm being now to keep the L5/S1 safe. Right now I have nothing major going on at that level, just mild degenerative changes involving the facets bilaterally.

Has anybody else been told this?


  • Sounds like your Surgeon is on the ball. Most of us know that once a fusion, the above and below discs take the brunt of force. I had an L2-4 fusion done, and not taking care like I should have, recently needed L4-S1 fusion. Being reminded by your Dr. from the get-go is great.

    I think we always need to remind ourselves that we are not "fixed" after surgery, just different and need to treat our spines with kindness, forever. Not an easy thing to do!
  • ...and L3-4 in addition to L5-S1. Adjacent disc disease, anyone??

    L4-5 takes the brunt of the body's twisting and turning movements...and gets the most action of any vertebral segment...followed by L5-S1. Since L5-S1 adjoins the sacral area which is basically fused by nature in most people, it makes it that much more vulnerable.

    So things like postural alignment become that much more important...as does using good body mechanics at all times, not just when you happen to think of it!! It's kind of a drag at the beginning but does eventually become second nature.

    As Lisa says, surgery doesn't fix us. We must always be mindful of our spines. When I parted company with my PT, she told me to make my goal not needing further surgery. Nice idea -- didn't quite work out for me, but a noble goal....

    How are you feeling by now?
  • I haven't had surgery but because of the facet joint problems I have in that area and mild DDD and possible remnants of L5-S1 HD I still log roll out of bed and use my rolling office chair to pull myself up. But once you have surgery you have to be careful of the other levels as you're whole spine is affected from surgery. Someone told me about the log rolling here and thankful for that tip. Hope you're healing well. TC Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • MY L3-4 2 years ago progressed to the L4-5 just a month ago.No one told me,until I talked to my current surgeon about it.I did read that it is not uncommon.I know I didnt take care of my back as I should have,but no one can know if that is going to happen to them.Try not to be afraid to move,just be careful.I will be waiting to see what the dr. says.Jeannie
  • My dr told me the same thing. Once you have a fusion you will be more inclined to have future problems as it causes more stress on levels above/below the fusion. Also, like Gwennie mentioned L4-5 is the most abused areas, in fact, my dr says that is one of the most common areas people have problems at, L4-5 and S-1. I was different to have L2-4 like Lisa! My dr warned me that once I had the fusion I would have to be extra careful, actually be more mindful of what,how I did things forever. I'm already having symptoms related to L4-5 and it scares me! Anyway, the log roll is a good idea and be mindful of BLT not just as you heal, but for the rest of your life. We know once we're a spiney we're always a spiney!

    My husband is having problems at L4-5 and had his 1st epidural which seems to be helping him so far, thank goodness! I'm already watching him like a hawk, reminding him not to bend like he does now, not to bend as often and to be careful when he lifts groceries,etc. One of us needs to be in better shape and since it's too later for me it has to be him! LOL!

    Take care of yourself and start training yourself to move the right way now while you still have after surgery pain when you move that way by the time the pain is gone you'll be more mindful of how you are moving. I catch myself doing a No-No then scold myself not to do it again! LOL! I hope you can avoid futute problems for many,many years or forever would be even better. I think your recovery is going very well so far! Keep up the good work!

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