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Upcoming L4/L5 fusion

mel v.mmel v. Posts: 59
edited 06/11/2012 - 8:43 AM in Lower Back Pain

Scared!!! Dealt with pain for the past 4 years. Go to the gym 5 days a week, doing core exercises, chiro, accupuncture, swimming, :< lumbar traction, many rounds of PT, epidurals that once lasted 3 months are only lasting 4 weeks. All non-invasive modalities tried and 4 ortho-spine specialist later... say L4/5 fusion needed. In this last month, I will be building my thigh muscles and my arm muscles to help with movement. Eating super healthy and trying to lose a little weight before surgery. I am not overweight, I do not smoke, I exercise regularly, eat well and generally a happy person. Trying to keep positive. Scared I'll be in pain the rest of my life if I don't do the surgery, and scared I'll be in pain for a very very long time if I DO DO THE SURGERY. I debate the question...how long should I wait to do the surgery if it is inevitable? Doing it next month gives me (3) months over the summer to have a slower pace of life and be selfish with rest and have people help me because school is not in session. I already feel that our life here with my two boys (16) & (12) and husband of 18 years have been compromised by my back pain. All vacations and leisure activities are dictated by my pain level. I am either in pain or don't participate. So.....how long do I wait ?


  • Mel,
    Welcome to SH. Sorry you had to find your way here. Glad you did. You will undoubtably get a host of answers here. Most will tell you the same thing in the end. "it's up to you!" Only you can decide if and when surgery is the right thing for you.

    Reading your post I think you have pretty much made that decision. (And done a fine job thinking it through too I might add.) Now you just need to convince yourself. LOL!

    Many will tell you how they made their decisions and hopefully it will all help sooth the bundle of nerves. Bottom line, it's a personal decision. You know when you are ready and when your family can best handle it. Honestly, when is there ever a good time for surgery though? Right?

    As for me, after 5 years of exhausting all conservative routes I was bone on bone. It was time.
  • If you could provide a bit more information, it would be helpful. Why is surgery recommended? When I first read your post, I was surprised how much you are able to do...going to the gym five days per week, swimming, etc. But if you have been assured that there are no options other than surgery, only you can decide when the time is right.

    It sounds like you have done your homework and it is more convenient to do it when it is good for you and your family than waiting and possibly ending up in a situation where emergency surgery is needed.

    It is perfectly normal to wonder IF it is time to have surgery, and to be frightened. We can help with the being scared, but you'll have to decide if the time is now.

    Good luck with your decision.

  • i have sent you a pm
  • I believe Frog really put it best that in the end it is up to you but Gwennie also made a point that really screamed out to me when reading your post.

    You have been able to do quite a bit and most people look to surgery as the last option after they usually have pretty much reached the point that the quality of life has reached a very low point.

    The only reason I bring this up is that a fusion is pretty much one of the last steps people do to deal with the pain and low quality of life issue. As many can tell you once you do a fusion there is no turning back. Also you can read through the many threads here of people who had no success or some success and than failure with a fusion.

    I have not had a fusion myself but going on 1 1/2 years of fairly chronic pain. I personally would not do surgery until a 5 year period similar to Frog has passed and the quality of life has reached a very low point. Ofcourse you and I would listen to my doctor closely but may get multiple opinions.

    Please understand this is just my opinion but if you do the fusion I really hope you can finally attain a pain free life.

  • Welcome to Spine-Health. You'll find a lot of information on this site and might want to check out the articles and videos concerning lumbar spine surgery.

    Like the others have said, the choice to have surgery is a very personal one and only you can decide when and if it's time.

    My choice came when all conservative measures were exhausted and I simply couldn't function on a reasonable level in my life. The time was right for me as well, so I went ahead with it. At four months post-op, I'm glad I had it done as the pre-op problems are gone, but I'm not going to lie - it's a painful surgery with a long recovery. And every surgery will forever alter your spine, many time for the better if you're having severe pain or your spine is unstable. Another thing to consider is if you'll have permanent nerve damage if you wait.

    Nobody can tell you what's right for you, but I've shared my story with you as others have.

    Good luck on making your decision. We'll be here to support you whatever you choose to do.
  • Welcome to Spine Health. As has been stated, whether or not to have surgery is a personal decision between you and your doc. Only you and your doc can know the long term prognosis of having or not having the surgery.

    I commend you for working to make certain you are in good health and good condition in order to make your recovery go better. I too am one of those who did everything possible to get into as good of shape prior to surgery as possible. My husband would cringe watching me force myself to work out knowing how painful it was and would always be there with ice and a helping hand afterward. I also found that the endorphin release from the exercise was some of the best pain relief I could get and I hated knowing that it would only last through the exercise and a short time after. It was enough though to help make that difference. It all depends on the specific injury though as to whether we can do any kind of exercise. As you can see, many feel they are unable to do so. Being an exercise junkie, I find it is one of my only "comfort" places to be.

    Of course key to this, is ensuring my surgeon gave the okay prior to. I was told I could do whatever I could tolerate. I hope you have checked with your surgeon as to whether or not pre-surgery exercise is okay for you.

    You will see that there are many people here who have had mixed results from fusion surgery. The statistics are swayed by the fact that many who have successful recovery from surgery no longer feel the need of the support from this group of people. So they move on and many that remain, are those who are still struggling. It is something to consider, but please keep in mind that what you see and hear here might paint a gloomier picture than normal.

    Once again welcome to Spine Health.

  • Hi Gwennie17,
    I've had (4) years of pain. Tried chiro,, lumbar traction, accupuncture, accupressure, message therapy, numberous rounds of P/T at local hospital, swimming, and now (5) epidurals over 16 months, yoga and pilates. My last epidural was March 22nd and is wearing off quickly. My problems are thus: Grade 2 spondlyo., herniated disc btw. L4/L5 and spinal stenosis. I've been working diligently for 4 years of avoid surgery. But as the the epidurals wear off, saiatica kicks in, sleeping is worse, walking around the block with my small dog kills me, standing in the kitchen cooking for my family is painful, walking any distance hurts. I've been to (1) neurosurgeon, & (3) ortho-spine specialist for opinions. I've had (2) sets of MRIs and countless x-rays....I should be glowing. They all say "L4/L5 fusion via PLIF method.
  • Mel,
    Each surgery is a separate entity and although my fusion failed it should not be used as a reflection for others, our medical status all differ and as said, only with evidence from a doctor should we decide when the opportune point is, it is a leap of faith and you are entitled to that chance without is being tainted from the minority. It is natural to have some trepidation of the future and if this is your last option then you can do not more than that, you have worked with your condition and maximised the chances of success, through your endeavour and positive strategy.

    All pain impacts on family life and this is a team event, we need that close support and encouragement, all those helping wished you had no pain and that is something they cannot provided it is not easy for them, watching someone they love in pain.

    Doing nothing is only an alternative when you are evaluating change or that has been a medical recommendation. You have to feel confident in the decision you make and delaying the inevitable surgery when this is the appropriate action, does you and your condition no favours. You wait as long as you have too, only you know when the time is right, at times our condition itself determines the time scale, my time came when I could not walk well or stand up straight, what alternative option did I have.

    Quantifying improvement cannot be projected and if the chance of improvement is greater than staying where you are now and doing nothing, then the decision is made your ortho has suggested this on the basis that it will improve your quality of life and many here wish you well in the months ahead.

    Take care and good luck.

  • Your symptoms are similiar to what I had before my surgery, though I also had gotten to the point of incontinence, spasms that kept me awake for days, and almost complete inability to walk. Fusion is the treatment of choice for spondylolisthesis. What impresses me the most about you is your level of fitness. This will be a big plus in your favor for recovery. I still have pain after my fusion, but the worst of the symptoms I had are gone. I am glad I made the decision to have the surgery.

    Best wishes,

  • Hi guys, I'm new to this (first posting and all). Can relate to 'Mel v'and am very sad to hear all your experiences. I had the same dilemna, sort of,pain was unbearable, my wife in tears watching me struggle to take even the smallest of steps,etc (won't go into it all).
    My doctor referred me to a specialist who explained to me an alternative to fusion and that was having an implant. He gave me a choice between a 'Wallace' implant and a 'DIAM' implant as they would do the same job as fusion in regards to pain relief but allow full movement of the spine. This option sounded good to me and I chose to go with the DIAM implant in the L4/L5.
    That was March 2006, now over 4 yrs later. Relatively pain free, still take 'brufen' and I don't do much with regards to activities, but my quality of life is vastly improved. I say all this because nobody seems to say much about these implants or offer them to people as an alternative in your posts. Hasn't anybody heard of them. Any way surgery worked for me so, I say go for it. 'But of course' it is up to yourself to decide.
  • I can so empathise with you. Your history is very similar to my own.

    I've had back/r leg pain for five years now and have also tried all conservative methods first (like 7 facet joint injections, 2 epidurals, radio frequency ablation therapy, umpteen MRI's and x-rays, pain management programmes, physiotherapy, chiropractice, a plethora of prescriptions [which I now rely on such as morphine patches, amitriptyline, ibuprofen and extra morphine oral solution as/when], joining a gym to improve my core strength, electric heating pad, TENs machine, losing 5 and a half stones in weight and even applying FROZEN PEAS! Over all the years after seeing 2 orthopaedic surgeons, 4 consultant anesthetists and numerous doctors and occupational health visits later, I am no further forward in my quest to relieve my pain! It's so depressing.

    I'm facing the same quandry as you - I actually read an article in the Mail on Sunday last September about a spine surgeon with success in PLIF's. This seemed to kill my 3 problems with one stone, so-to-speak (DDD, facet joint arthritis and right foraminal stenosis). I requested a second opinion from him through my local GP. After more MRIs and a positive Discogram at L5-S1 and L4-L5, he has recommended a 2-level PLIF. I have 100 per cent faith in him and his team and so have been put on his waiting list.

    I think there comes a time for everyone where the thought of progressing in life as we are now (and I have been told it will get worse as I get older, which has been the case so far - I'm 52) is too depressing to contemplate. In my own experience, I am only existing to work, and that's all. I cannot make any social/work choices for fear that it could render me unable to work in case it makes my back pain worse. I don't do anything too strenuous at the weekends and don't go out in the evenings - just to make sure I can function at work, which is difficult as I'm always tired due to lack of quality sleep (although the amitryptoline is supposed to help, it doesn't do enough and taking too much makes it dangerous to drive in the morning!). Most days, I come home from work and lay down (sometimes flat on the floor) just to relieve the pain in order to be ready for work again the next day.

    I work in 3 local schools and although it's a relatively new job, the constant need to bend over to listen to the young children talk (because I am tall and also have a hearing loss!) and the tiny chairs/desks, has resulted in an increase of back/leg pain. Also, with any luck, my surgery may be scheduled for July, which means I can use the six weeks holiday to recouperate without any loss of pay!

    My daughter has been offered a promotion at work and hopes to move to start her new job in Pittsburgh, USA, in July 2010. So with everything I've said above, I now have a definite goal in mind - to be able to fly long-haul, which I've not been able to do for 2 years now.

    In the end, it is definitely something that only you can decide, but you have to weigh up the pro's and con's about what you can and can't do now, and whether having surgery will ultimately improve your quality of life and give you the freedom to make social choices you desire, without the constant worry of whether your back will be worse for it - if you see what I mean? If you've been told that your condition is degenerative, this doesn't always mean your symptoms will get worse. And, those people whose surgery has been successful are out living their lives, which is why I suppose you see more negative posts on this site.

    Discuss your concerns with your family and how surgery may impact on them, find out what support is available if you need it and try and get as much professional advice/information as you can in order to make an informed decision. If your medication was reviewed, and is more successful in combating your pain, then you may be happy to give yourself a year or two before having to make a decision about having surgery.

    I'm sorry my post is so long (I got carried away), but I just wanted you to know that you're not alone!!

    Perhaps you can let us all know how you get on?

    Take care
    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 !!
  • although i have not yet committed to having the fusion {a 360multi level from L5/S1 as my life stands .or in my case reclines ! i am nearly 44 and i am fit for nothing as much as i am scared stiff of such an invasive operation and all the horror stories i too may be going under the knife soon .so i can empathize with you i think when you are out of options and you have tried everything like we have then surgery{again} is the only option .at first when i was told i needed this op i said no way but as time had gone on i am thinking what have i got to loose as my day consist of taking pain killers an reclining i want my life back ..or at least to be free of pain or as near to it as i can get .what every you do do it for you and i wish you every success
  • Mel,

    It seems you are in excellect shape, physically. That can have a really good impact on recovery. You also seem to have a decision in mind.

    I can only tell you, my decision came down to quality of life. Without surgery, I would have so many continued limitations. After 4 yrs. of the same Merry Go Round of PT, ESI's, Facet Inj. Rhizotomy, MRI's, discogram, etc. I decided to go for it. Recovery has been tough, but I know it is a long process. I have had some additional issues, but I am hoping those are just little bumps in the road.

    Good luck with your decision. Please keep us posted. This is a great forum and really caring people. Especially after surgery. And before surgery, be sure to check out the surgery must haves posted in the Back and Neck Surgery Forum. There is a list of post surg. items for use at home, etc. It's very helpful.

    Best Wishes,
  • Hi SueD, I did it a week ago 5/19/2010. Pain yes....but no nerve pain going down either leg from day one. That was great. The swelling around the incision and back was unexpected. My whole back is black and blue, it rather looks like a hump-back whale. Sleeping is hard. Every 3 hours you are instantly awake to receive pain meds. The meds I'm on manage my pain pretty well. They gave me Lyrica for nerve pain, Dilauded (a form of mophine) for pain, Tylenol and a muscle relaxer. Pain is bad, but not unmanageable. Keep ahead of the pain. My daily life is sitting for 10-15 min., getting up and walking around for 20 mins., and lying down for 30 mins. and repeat. I find walking and climbing stairs to be the easiest.....it doesn't hurt at all. That's my up date. Have people lined up to stay with you most of the day to help and do. Let them do for you!!! I)
  • Hi SueD, I did it a week ago 5/19/2010. Pain yes....but no nerve pain going down either leg from day one. That was great. The swelling around the incision and back was unexpected. My whole back is black and blue, it rather looks like a hump-back whale. Sleeping is hard. Every 3 hours you are instantly awake to receive pain meds. The meds I'm on manage my pain pretty well. They gave me Lyrica for nerve pain, Dilauded (a form of mophine) for pain, Tylenol and a muscle relaxer. Pain is bad, but not unmanageable. Keep ahead of the pain. My daily life is sitting for 10-15 min., getting up and walking around for 20 mins., and lying down for 30 mins. and repeat. I find walking and climbing stairs to be the easiest.....it doesn't hurt at all. That's my up date. Have people lined up to stay with you most of the day to help and do. Let them do for you!!! I)
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