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What do I need to know when looking for a dr. to perform my multi-level lumbar fusion?

blackberrybunnybblackberrybunny Posts: 157
edited 06/11/2012 - 8:45 AM in Back Surgery and Neck Surgery
Hello everyone,

I am losing weight and getting myself ready for the multi level lumbar spinal fusion I have been I need. I have gotten 3 opinions from different doctors so far; they all agree I need the fusion, but they also all agree I really should TRY to wait it out longer, because I am so young, and they all think a fusion now will only lead to more problems--fusions--down the road for me.

Well, I am at the point now where I am on morphine every day and I am miserable. I am not only miserable, but I am making my husband and mom miserable too. They don't know what to do for me, and there is nothing they CAN do, other than serve me like butlers, and I hate it.

I have reached the point where I am angry. And so I'm motivated again. I'm losing weight and want to start planning for this surgery, maybe in a year or so? I figure that'll give me plenty of time to lose weight and to find a good doctor.

I need your help. I know we can name names here, and that is okay, but I need some help learning what KIND of doctor I'll need for this. Heck, I imagine it'll take a whole team, as I've been told they will have to cut me open on my belly and my back at the same time, to put in the screws and cages, etc.

Can you guys help me prepare? Give me all of your "IF I could do it over again, I would have...."'s please! I am scared to death and if it's this stressfull on me and mom and my husband NOW, then what is it going to be like when I DO have the surgery and am in a full body brace for months on end?

Please help me prepare and understand what I am facing. Thank you. Mom and I really need your help, as lately we both are depressed and desperate, spending hours on the phone, crying with each other, over my situation, which seems to be getting worse.


  • I'm sorry you need fusion surgery, but almost all of us here understand what you're facing. For many of us, the pain becomes too much after all conservative measures fail and we decide that a fusion is better than trying to live with the chronic pain every day.

    My personal preference would be a fellowship-trained spine surgeon, ortho or neuro, but one who ONLY works on spines. I found mine at a spine center which is wonderful because they also have a physio and PT on-site, so when it was time for PT after my TLIF, the PT could just go to the next room to look at my x-rays and MRIs.

    What you're describing is a 360 degree fusion - they work on one side first, then roll you over and do the other side. It's inherently a tougher surgery and recovery than a non-360, and you certainly can expect a long recovery, but it by no means needs a team of doctors to accomplish. I think these are more common than you might imagine. It's possible you'll have one or two surgeons, a neuro person making sure no nerves are damaged during the surgery and the obligatory anesthesiologist and nurses.

    But, with that said, please try not to be too terrified. With all spine surgeries, there are risks, but if you have total confidence in your surgeon and follow his post-op instructions, then you'll get better with time and eventually feel that it was very worth everything you went through.

    I know there are a few here that have had a 360 surgery and I'm sure they'll be along to tell you their experience. But please don't worry and cry too much about this. It sounds awful, but so many of us will tell you that the anticipation is worse than the surgery itself. And if you cry too much until then, girl, you'll be too dehydrated come surgery time!! (LOL)

    Just hang in there. I think you're doing things right by getting everything in order, like losing weight, before taking the leap into surgery. I applaud you for that.

    So take care and try not to worry too much. Once you have a great surgeon that you trust and have confidence in, you might find it much easier to deal with than you expect.

  • SpineAZSpineAZ WiscPosts: 1,084
    For me all of my fusion surgeries have been good decisions. I've seen both Orthopedic Spine Surgeons and Neurosurgeons but for me the OSS has worked best for my needs.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Thanks so much, you guys. I am searching for an OSS now, hopefully they have one at the University's hospital. I'm so overwhelmed, I don't know where to start. So thank you for the help. I am really praying I won't need the 360, and can get the TLIF I've been reading about, but I don't know.... all of the TLIF's I've seen so far were only dealing with 1 bad disc, and I've got 2, maybe more by the time I get around to the surgery.

    Thanks for the support!
  • BBB-
    TLIF's can be done on multiple levels. I am having L4-S1 fusion with L3-L4 soft stabilization next Friday. I have had 2 previous diskectomies/laminectomies in the past year. I have reherniated twice at L4-L5 and have bone on bone at that level. As my MD says, my back "is a mess." I am fairly young (40) but being pretty active they feel this is my best option to lead an active lifestyle that I am accustomed to. I use an OSS and he is WONDERFUL!!

    Good luck!
  • Hi Ballmom,
    I hope your surgery goes well next Friday! Can you tell me, please, what is L3-L4 soft stabilization? Does this mean at that level you will not need hardware, but you will need at at the other lower levels? I am just now learning what 'cages' are. This stuff is scary.

    Can I also ask you, you said you have bone-on-bone; can you tell me what that feels like? What kind of pain it produces? Thanks.
  • BBB-
    Thanks for the well wishes. This will be my third surgery in less than a year, so I am just ready to get it done. As far as the soft stabilization goes, I have DDD at the L3-L4 level as well, so they are using flexible rods at that level in hopes of protecting that level from further damage and no cage. At the L4-S1 they will use rigid rods and put cages in between to get a fusion.

    As far as the bone on bone pain goes, it is mainly just a lot of localized pain. I can actually feel it grind if I have been sitting too long and then stand up. It causes stenosis so sitting also causes radiculopathy. I have annular tears at L5-S1 and L3-L4 as well, so it is hard to differentiate.

    I have a wonderful physician, so I know I am in good hands. When I went for the results of my discogram, the PM doc told me he didn't know if anything could be done because my back was such a mess, but if any surgeon could help me, it would be the one I have used. He really tried to avoid fusion by doing the previous surgeries, but it just didn't work.

    Good luck with decision. It is scary, but when you find the right doctor, things will be much better!!
  • Ballmom, you and the others here are just so brave!

    I made an appt. today with a couple of dr.'s in Gainesville, FL. They work at a Neurology center and are spine specialists. We'll see. My appt. is for the 31st, a Tuesday.

    Now I have to go and dig out those MRI CD's from last year. They are about 15 months old now, I guess. I wonder if they'll want new ones taken? I kinda hope so. I'll let you guys know what they say.
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