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What to do???

SueDSSueD Posts: 545
edited 06/11/2012 - 8:41 AM in Lower Back Pain
Hiya! I'm not sure if this is the best place to talk about this, but have any of you had PLIF (spinal fusion) in the past? If so, can you please give me any reassurance on the outcomes you experienced?

I have had trouble with LBP for nearly 5 years and have tried EVERYTHING to try and combat the daily pain I experience. My job means that I am sitting on very small chairs (in a primary school) for long periods of time and the discomfort is getting me down.

I've tried discectomies x 2, 4 and a half years ago, physiotherapy, swimming, radio albations (where the nerves are burnt!), epidural, 7 x facet joint injections, electric heating pad, frozen peas!, cycling, heat patches, numerous different medications (now I am on morphine patches which I change once a week and also take morhpine solution at night). I don't think there's anything I haven't tried.

I went for a second opinion a couple of weeks ago and was advised to have an injection into my disc - and if it hurts then the consultant will know 100 per cent that the pain is coming from the disc and may recommend a spinal fusion (cos I also have arthritis in my facet joints and he can use these to make up the artifical disc or something).

The only information I have been given from that hospital is 100 per cent positive, but I'm not sure if the procedure is successful/safe because there are no case studies of anyone who has said anything negative about having a spinal fusion.

If anyone can offer any advice, I'd be only too grateful to read it.

Many thanks for any help you can give me
2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!


  • Welcome aboard. Sorry to hear you are having so much pain. I had L4/5 fusion, and though I am better than before surgery, I still have daily problems walking and pain. Something you'll hear frequently here is that we all heal differently. What disc are they looking at?

    Best wishes,

  • Hello Marianne
    Oh dear, I thought I posted a reply to this one already, but it seems to have gone somewhere else, because it hasn't shown up here, oops! I'll try again and hope I have more success.
    In answer to your question, I had 2 discectomies on L5/S1 (within one month of each other), and I think the one above is now showing similar signs of degeneration or something (would it be L4?).
    I was told about 3 years ago that it would get worse as I get older (I'm 53 now, but mentally feel like I'm still 17!!). I have already noticed a deterioration and don't want to find myself in ten years time thinking that I should have had the op when I had the chance. I'm scared by the thought of surgery (which won't be necessary if the injection into the disc isn't 'positive', I'll have to wait and see what happens then), I only wanted to get a feel of other people's experiences first before I even need to think about it. Do you know what I mean?
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • Hiya! I'm due to have this procedure this Wednesday (eeek!) and am feeling a bit apprehensive about it. If anyone has had this before, could you explain if it's painful or not? I've had 7 facet joint injections over the past 4 years and presume it feels similar, am I right?

    I cannot believe I got an appointment so quickly after my initial consultation only last month. Because I work in a school and we're off on half term this week, it couldn't have been more perfectly timed - however, I'm starting to worry a bit (as a man I met on Saturday has had a discogram before and said he was 'out of sorts' for quite a few days).

    For the first time, I attended a 'spinal support group' at Nuffield Hospital in York on Saturday and, if any of you are within travelling distance, it's extremely worthwhile. I met many people who have had spinal fusions and the difference the surgery has made to their lives is inspiring! However, there was nobody there for whom the surgery was unsuccessful, but I suppose that's to be expected in a way. There were about 50-60 people there and I would say over half hadn't been before and were all contemplating surgery to one degree or another - so I suppose the event could be seen as good publicity for the surgeon. I don't know.

    Nonetheless, I came away from the 2 hour session having many of my questions answered (apart from the negative comment made about discograms, hence my question above), and on the whole, I feel VERY positive about the future now, which is a good thing. If my discogram confirms that a fusion would benefit me long term, and if it's offered to me as an option, then I am 100 per cent going for it! I don't want to be restricted in the things I can do (like I am now, big time!), and therefore have limited personal/social choices in the future as a result. Or to feel in ten years time that I should have gone for it, but perhaps it could be too late by then. Do you know what I mean?

    Anyway, I'll stop rambling now. If you're curious at all, I would thoroughly recommend the "Kspine" website. It's full of tons of information on different procedures and advice etc.

    I hope someone can allay my fears about having the discogram??? I wanna know everything about it, warts and all!!!

    Bye for now

    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • Welcome to Spine-Health. You'll find tons of information on this site including articles and videos and the members of the forum are knowledgeable, caring and supportive.

    I've never had a discogram so you might want to peruse the Injection area where members discuss all kinds of injections, including discograms.

    But something you said really struck me as strange:
    The only information I have been given from that hospital is 100 per cent positive, but I'm not sure if the procedure is successful/safe because there are no case studies of anyone who has said anything negative about having a spinal fusion.
    We'll all agree here that most doctors/hospitals tend to pain a very pretty picture of spine fusion surgery and that's just great - if it were completely true. I'm not posting to scare you, just be realistic - spine fusion is no walk in the park and is considered major surgery. As such, there is pain involved, a fairly long recovery time and there is not a 100% success rate. The statement above - "there are no case studies of anyone who has said anything negative about having a spinal fusion" is not surprising, I suppose, but it's not true.

    Read these boards and you'll find that fusion surgery is a difficult surgery and there are many successes, but failures as well. These boards may be a bit skewed, however, because those members' whose surgeries were successful tend to move on and live their lives, therefore they no longer post here because they don't need support any longer.

    But, with that said, making the decision to have fusion surgery is a serious one and it's suggested that you to your homework before making that decision. Fusion surgery is considered a last resort and it indeed sounds like you've exhausted a lot of conservative treatment so fusion surgery may be for you.

    Anyway, I just wanted to be the voice of reason from my experience here and with spine issues and wish you the best of luck with your upcoming tests and final treatment decision.

    Feel free to ask any questions on the forum - there are over 11,000 members here that can share their experience and help you with all the questions that come with spine problems and treatments.

    My personal experience, having had a 1-lvl lumbar spine fusion and decompression at L4/5, is that I consider it a success because I no longer have most of the symptoms that caused me to make the choice for fusion. The lower back pain success is still out for now because the pain of healing in that area is pretty intense and I'm not through the pain associated with that yet.

    Take care and keep us posted.
  • I've had a discogram and yes it is painful, but it is supposed to be in a way. They usually inject the suspect disc plus one above and one below. They don't tell you which one they are injecting. I found each disc was painful in it's own way but the only one to recreate the exact pain that I had been suffering was the suspect disc.
    They will ask you to tell them everything you feel, so try to be specific in what sort of pain you're experiencing and whether it is the pain you usually get.
    It seems a lot of people get sedation, I wasn't so fortunate but I survived.
    Best of luck with it.
  • You have certainly tried a lot of options to deal with your back pain. I don't have anything like the experience you have, but am facing fusion surgery as I have been told that I face being in a wheelchair because of severe stenosis, if I don't have it.

    I've read that although the discogram is painful, it is very useful to determine where the pain generator is, which is most important to dealing with it.

    The Spinal Support Group at York sounds very good and I wish I was close enough to go. I am in the UK, but in Sussex. I also work in a school and know just what you mean about sitting on those little chairs!

    It is very encouraging that you got such positive feedback. I am surprised however, that you have been told that there is 100% success rate. My surgeon said he would give a 90% chance of being able to successfully deal with the problems caused by my spondylolisthesis and my stenosis symptoms. He also told me of the possible risks of nerve damage etc., at 1 or 2%.

    I suggest that you research all you can about spinal fusions. Hopefully the discogram tomorrow will provide the information to enable a decision to be made as to what your best treatment options are. Hope it goes ok and that you cope with it fine. Do let us know how you get on.

    Take care
  • Hi Sue, Ks1/2 here also, Get a bigger chair, no sitting on those small ones, no lifting bending or twisting, does your employer know your circumstance, what reasonable provision are they making.

    Does it go down either leg, or increase when coughing, both or one.

    Unfortunately our condition sometimes determine the next step as we endure the pain and try to carry on as normal, my fusion outcome will not be your experience as you are an individual, the majority of fusions done based on the volume are successful, all surgery carries some risk that that is hard to quantify, statistics are only appropriate when we have a successful outcome. The key is to know that you have taken all the relevant advice and equated the options, be positive and realistic.

    Have a good hols, rest and pace.

  • Thanks John.

    I was provided with a specialist ergonomic chair in my previous job (as well as from the Open University, who were excellent!), however, this job involves me working between two schools and going into different classes on a daily basis, it can be 4 different classes some days, (as well as supporting the teaching staff), so it is not feasible to have my own chair. It wouldn't fit under their tables anyway and I carry quite a bit of 'stuff' with me too (which doesn't help my back either!!).

    My employer doesn't know the full extent of my back problem, but I did fully complete the occupational health questionnaire giving all my history - which included the operations/facet joint injections and time off etc - before I started, and they passed me fit for work. Ive been 100 per cent honest (there's no point not to be), but they didn't ask any further questions or call me in for examination.

    In fact, if they'd bothered to ask, they could have looked up my previous notes from the organisation's Occupational Health Physician, who I used to see. But they didn't. I used to work for the same place 2 years ago (for 13 years).

    I used to have sciatic pain down my right leg and that's why they did 2 discectomies within one month (the first one didn't work). I only get leg pain now if I exert myself too much, but it's the low back pain that's always been the problem.

    The discogram is tomorrow, so I'll see how that goes. It could even be that the pain is coming from the scar tissue, but I know from the MRI/xray that the disc space at L5/S1 is very narrow compared to the others and there's some sort of blockage (a little black area) on the right side.

    If I'm feeling OK, I'll post something tomorrow to let you all know that I survived!!!!

    Thanks for all your comments guys, it's much appreciated. I certainly need my beauty sleep now, so goodnight!
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • Sorry, John, I also meant to say that I sympathise with you about your failed fusion. Afterall, we put our trust in the surgeons 100 per cent and expect NOT to be one of the very small amount of 'failed' statistics. Do you think, in time, they would consider doing it again or have you gone to other consultants for a second opinion (I did, hence the further test I'm having tomorrow).

    I also hope your half term is most enjoyable. Better make the most of it, because it'll be over far too soon eh?

    Bye again
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • Thank you for your kind words I have sent you a PM, hope all goes well today and your route to some help comes soon.

    Come on tell us how it went.

  • Thanks so much for your message John, it was much appreciated.

    Well, I'm home and alive! I had heavy sedation and I know it was extremely painful. However, when I came round and returned to the ward, I wasn't quite sure if I told them how much it hurt because I don't remember talking to anyone!

    I know at one stage the pain went right into my left foot, which really surprised me as the problem has always been on the right side - to say I was confused was an understatement. I don't know if I shouted in pain or just went 'ouch'. The heavy sedation was marvellous - wish I could have it at night when I go to bed though.

    They gave me a piece of paper afterwards which reads:

    L4/L5, high volume, low pressure, POSITIVE FOR PROVOCATION and
    L5/S1 low volume, high pressure, POSITIVE FOR PROVOCATION - I obviously, at some point, must have made my feelings clear then!

    I'm glad it's all over. I'll wait for an appointment to discuss the results and see if there's anything further they can help me with. I'm not sure what all the high/low volume or low/high pressure means, but no doubt they'll tell me when I go next.

    I'm feeling pretty sore at the moment, but wanted to let you know how it went. I'm going to copy this and post it on my other thread in case people want to know.

    If you know what the 'positive' results mean, perhaps you can explain it a little?

    Thanks again John for your support and I really hope you can get a second/third opinion from someone who might be able to help you in the future. I've only heard good things about the consultant I'm with now and would trust him 100 per cent (after having had 3 to date who've basically said 'go home, get on with your life, you'll get worse as you get older' etc. etc.).

    Good luck and G-d bless
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • you made it through, jealous that you had sedation though :&
    Let us know how you go with the specialists.
    Take care
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