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L5-S1 spondylolithesis with dynamic instability + disc prot.

Reuben30RReuben30 Posts: 3
edited 06/11/2012 - 8:42 AM in Spinal Stenosis
Hi Everyone,

I am a 35 year old female dx with L5-S1 spondylitic spondylolithesis with a disc protrusion and a dynamic instability at the level with degenerative facet atrhopathy at L4-5 being greater at the L5-S1. I have been battling this 2007 and the vehicle accident I had in 2008 caused me to undergo injections. They did help for awhile (took care of the right leg pain, but now the original left leg pain has resurfaced. Some days, it doesn't bother me as much maybe a 2 to 3 on the pain scale, but sometimes it's debilitating at a 6 to 8 and makes for some challenging days. The physiatrist feels I more intable at this level than I was a few years ago, and feels that a fusion at the L5-S1 level may be beneficial since I am still young. It may fix the issue. However, all the posts I read, it seems there is the potential for other new symptoms and issues to occur. At this point, I know the evil I deal with on a day to day basis at this point. I have a new injection scheduled for friday and follow-up with the ortho surgeon whom I have seen once before. Anyone else experience this issue or suggestions, I am open. I just don't know what I should do. If I can get better that's wonderful. It's the complications that I don't know that scares me. Thanks. Jackie


  • Obviously I am not a doctor nor do I have any medical training, but I have spend the last five years very occupied with with issue of spondylolisthesis and instability.

    People can have a spondylolisthesis and not be aware of it. In and of itself, it is not necessarily a cause for concern. However, it has been my experience that once a person develops pain, it is usually an indication that there is active instability. Once this starts, I don't know of anyone who has had it revert to being stable and/or causing no pain. Can it happen? I don't really know.

    Prior to having surgery, when I was gathering MANY opinions, each spinal specialist took one look at my studies and said "Fusion." And my spondylolisthesis was just a Grade I. They made it clear that I did not need to have surgery immediately, that it was my decision...that I would make it when I couldn't stand the pain any longer. And I did manage without surgery for several years.

    I think this is what you will experience, too. If your spondylolisthesis is unstable, it eventually will cause sufficient nerve compression that conservative treatments will not provide much relief.

    I kept thinking if I could hold out long enough, technology would provide a newer procedure than fusion, which has been around since the 40s. In my case, I couldn't wait. Perhaps you can. Every year there are new technologies, etc. I would have said this with more conviction up until last week with the passage of Obamacare. Now, I'm not sure what this new way of doing business will do to developing technology. Trials are very expensive and I do not know if companies will still be able to move ahead with developments that are currently "in the works."

    But, I digress! Sorry. For you, there are now minimally invasive ways of performing fusion, particularly if you just need one level.

    When you get to the point that you are seriously thinking about surgery, be sure to do your homework very careful. You will want to gather several opinions from fellowship-trained spinal specialists. These can be either orthopedic spinal specialists or neurosurgeons whose practices are devoted to issues of the neck and back.

    Remember that on this forum you are not seeing a real indication of the success of fusion. Most people that have a successful outcome do not continue to post after their surgery. The ones who remain usually have some sort of issues or questions.

    Many people do have successful procedures and are out living their lives. A one-level fusion has a better change of succeeding. Additional levels make it more problematic.

    There are many physician-written articles on this website that you can read to further increase your understanding of the various procedures that are offered today. Learn as much as you can. Gather opinions. The decision is ultimately up to you.

    I'm happy to try to answer any questions you may have as you move forward.

    Many people on the board have had fusions, so we have a variety of experiences represented here.

    Good luck. It is a hard decision to make....


  • I think after my visit with the ortho surgeon, I will request a second opinion with a neurosurgeon (even maybe a 3rd). Thanks. Jackie
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