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Impending L4/5 fusion surgery.

Scott in the UKSScott in the UK Posts: 136
edited 06/11/2012 - 8:46 AM in Lower Back Pain
In February this year I had Percudyn Stabilisation Surgery at L4/5 and after a few months it became apparent that there was a problem again.
I revisited my surgeon for a follow up and had an x-ray taken prior to the consultation.
During the appointment I told the surgeon that the pain was returning and I wasn't happy.He stated that according to the x-ray it seemed as if one of my implants appeared to have retracted a little.
Following a CT scan and a Bone scan over the following three weeks I received a letter stating that after seeing the other scans it was confirmed.
My surgeon is now suggesting fusion of L4/5 following the removal of my implants and I have an appointment to discuss this on September 9th 2010.

What should I expect if I have the surgery as far as recovery times etc,pain levels etc,etc.

Can anyone think of questions I should be asking my surgeon at the consultation next month ?



  • I had an L4/5 fusion on January 6 and I consider mine a success, although I still have stiffness and pain in the back area. Mine was for stenosis, facet problems and spondylolisthesis, so I don't know if recovery from L4/5 fusion for disc problems is different than what I had fusion for.

    But in any case, it's considered major surgery and you can expect a fairly long recovery, although like Jelly said, it really varies from patient to patient.

    I've included two links below, one is 38 Questions to Ask Your Surgeon Before Having Back Surgery:


    and the other is Preparing to Meet with a Spine Surgeon or Specialist:


    These come out of the SH FAQ section.

    The questions Jelly suggest are good ones, but I think it's fruitless to ask the surgeon how long your recovery is expected to be (just my personal opinion). It really is what it is and although you'll get an answer, it might make you worry if it's taking longer or if it's shorter.

    I've read that generally you feel better at 6 months and back to normal at a year. I can't tell you if that's true, but that's the normal expectation.

    Take care, Scott and please update us on your appointment.

  • i am so sorry that your procudure has failed before you have you operation read my PM TO YOU

  • Firstly, each person has a different experience of recovery from lumbar fusion surgery.

    Some have a really difficult time and others (like me) are surprised and very relieved to find that it wasn't as bad as they feared.

    I went into surgery prepared for the worst but hopeful for the best.
    I got lucky!
    I have been told by several medical people, that my recovery was amazing, and they think that all the walking and exercise I was doing before surgery, to try and avoid it, helped with my recovery.

    It has still been hard at times and very long!

    There is a thread on here of questions to ask your surgeon.
    Some things that come to my mind are:

    Will you have to wear a brace?
    What access will he use - posterior (back), anterior (front) or side?
    What type of bone graft will he use? (autograft, allograft or synthetic, BMP type)
    What post surgical restrictions will you have while you are recovering?
    How long does he think it will take to recover? (Often surgeons are very optimistic here - mine said 3 months, but I was warned it was likely to be more like 6 months. Actually at 3 months I have been pretty much recovered, from the worst of it. :-))

    I'm sure that others will have other ideas.

    I suggest that you do go well prepared for your appointment, with questions written down. It is so easy to get distracted by something said, and then forget the questions that you wanted to get answered.
  • nearly 4 weeks ago and I definitely feel it's been successful. The pain I had in my back totally disappeared immediately after the surgery was done - and has continued to stay away, thank G-d.

    I had a fusion at L5-S1 and L4-L5 and although I'm left with pain if I sit for too long, which I'm told is due to the dynamics of my back being changed during surgery and post operative swelling - and residual discomfort in my legs from time-to-time (if I overdue it too much) - on the whole I'm delighted with the result.

    Everyone has different reasons for back pain obviously and some outcomes will therefore be different, but on the whole, I think if you can improve your core strength, get as fit as you can within your physical limits, have a good support network and have trust in your surgeon there's no reason why your outcome can't be a good one.

    Like someone else said above, I was expecting the absolute worse after surgery, but with the right pain medication and good physio, I was walking up/down stairs the very next day, which really surprised me.

    Here in the UK they don't tend to use a brace - I think that sounds extremely uncomfortable and restricting and there's no reason why you cannot move more naturally with your physio's guidance. I am not able to bend, lift, twist, push or pull (although I don't know for how long - probably until the fusion has been successful I guess?) and do try to protect myself from doing so as I don't want to compromise the good work of the surgeons.

    The reason I had the fusion was because of degenerating disc disease, facet joint osteoarthritis and right foraminal stenosis - the surgery sorted it ALL out in one go as far as I am aware.

    You will have loads of questions - I asked about 30 when I went for pre-assessment! (and alot of the questions under FAQ were extremely helpful). Also, the surgeons showed me exactly what my problems were on the MRI and what the surgery aimed to achieve. They also said how many procedures they'd done over the last 15 years and what the expected success rate was (but I do appreciate you cannot always take this as read because everyone's experience is different).

    I also attended a spinal support group in York which was invaluable as the people there had gone through very similar procedures over different lengths of time and were able to answer lots of my other questions. They were very reassuring and the surgeon attends these sessions as well. Their next one is on Saturday 25 September at 10.00am - if anyone would like more information on this group, send me a PM and I'll happily give you all the details OK?

    Find out as much as you can and what you might need to do in the meantime to improve the outcome, if indeed you are a suitable candidate for such surgery. Also ask the surgeons what you need to do immediately after surgery to help yourself and when you can expect to drive/work again etc.

    There's probably lots of things I've forgotten to say, but I've been sitting for too long already (browsing!) and need to go and lie down!!!!

    Please let us know how you get on OK?

    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 !!
  • Hi Sue and others,

    First of all thanks for your replies and I can only apologise for not replying sooner.
    I forgot to 'tick' the box asking to be notified of any posts on my thread.
    I've got my 'Pre-Surgery Appointment' tomorrow to take bloods etc and make sure I'm fit for surgery.This usually means that surgery happens within a month of this appointment but I haven't got the appointment yet.
    The list of questions to ask will hopefully prove very helpful so thanks for that.
    I just want something done now but it's a viscious circle.I was always really fit and teaching judo as well as working in a prison,but now I've managed to put on almost 2½ stones in weight due to inactivity so I'll be starting post surgery with a hill to climb.
  • how you get on as you know i too require a fusion
  • scott , watch out for that elusive op date ,
    I had my pre ops in may , but wasnt given a date , Like you I thought it would be within a few weeks ,
    i only just got my date last week ,
    Its still within the 18 week policy !!
    So you could wait 18 weeks for your op date !!!
  • Blimey Jamie,
    That sounds a bit crap to say the least.
    I went to Coventry this morning(70+ miles)for my pre-op checks and I found out that there is a surgery due to take place on October 19th but there are 3 other people waiting for the same procedure as me so it all depends who the surgeon thinks is most urgent.

    Fingers crossed.
  • the 18 week wait has been abolished ..so you could be waiting a lot longer than you think {or not} the reason the wait has gone is because it was clinically impossible to achieve if you were seeing a hot surgeon ,what they would do was {in some cases} is give you a date as close to 18 weeks as possible then at the last minute alter your appointment ,,so our new government has scrapped it .the reason i know this to be correct is that my wife is in the medical industry
  • is that you guys/gals in the UK get all your pre-op bloodwork and checks done and then wait for months after that for surgery. In the healthcare system I use, 30 days is the maximum amount of time your pre-op stuff is valid for. If it goes to 31 days, it all has to be reaccomplished before the surgery can take place.

  • haglandc said:
    is that you guys/gals in the UK get all your pre-op bloodwork and checks done and then wait for months after that for surgery. In the healthcare system I use, 30 days is the maximum amount of time your pre-op stuff is valid for. If it goes to 31 days, it all has to be reaccomplished before the surgery can take place.

    I know !! maddening is'nt it ,
    I reckon i will have to do everything again , thats bloods , x-rays , Blood pressure ETC !!
    i have my Msra swabs on the 10th sept , but since my pre ops was on the 28th may , i think it will be the whole shebang !!
    the good thing i CAN say is that ive lost weight ,
    Hee Hee . ive lost 11lbs so far !! and have stopped smoking for the 2nd time !!
    I had packed up for 4 months , but was so upset that they hadnt got a date for me at the preop meeting in may , and said it was likely that it would not be before the 18 week deadline ,
    i went and started smoking , stupid me .
    Glad to say , ive stopped and staying stopped but it is so stressful waiting for that date .
    I have been off work for a year !!
  • hi everyone i am a health visitor in the bury area .and tony has asked me to explain about the 18 week wait .so here it is .from the government taking over the 18 week wait has been abolished.and the reason for this is it was impossible to achieve .especially for consultants with a large lists or complex operation to deal with .if any patient had had a preoperative assessment and it goes over 30 days prior to the operation {bloods .CT scans etc } they will be repeated 2 weeks before the operation date they also test for MRSA at this time and on admission .we work hard in the NHS try to accommodate all but with financial restrictions and staff shortages sometimes this can be a tall order.the 2 week for caner and Brest and chest rapid access clinics are still enforced .they are in my area anyway i hope that this helps
  • Well I did a 176 mile round trip today to have a consultation with my surgeon.The appointment was set for 3:15pm and I eventually got called at 4:00pm.
    I was then told that because my consultant was so busy I would be seen by one of his team.I saw a lady consultant that I'd seen previously and she went through my options which were limited.
    I asked about ADR (artificial disc replacement) and I was told it wasn't a procedure that my surgeon did so I have agreed to go for the fusion after being told about the procedure and recovery times etc.
    There is still a chance that I'll get in on October 19th but I have to wait for confirmation.
    The sooner the better as fdar as I'm concerned as the pain seems to getting worse on a daily basis.
    Ah well,time will tell.
  • if you want ADR my surgeon will do it for you and i can give you his details via PM if you want its a far better option if you can wait .he is a busy man and you would have to wait about a year .but i guess you wont want to wait that long .any way mate keep us informed and you can phone me anytime .how the new car ?? take care scott i will be thinking of you as will we all .
  • Hi Tony cheers for the offer.
    I saw one of my surgeons team yesterday as he was running 45 minutes late and we travelled about a 150 mile round trip.
    I asked about ADR and was told it wasn't a procedure he does and has placed me on the waiting list for fusion.
    I was asked if I had any questions so I checked on time in hospital(4-7 days)depending on the individual.I asked if there was any onsite accomodation for spouses as my wife doesn't drive but would like to stay overnight on the day of my surgery.No -was the answer but we were told that there were quite a few hotels,bed and breakfast places etc.
    As for my car,I've got to wait til next Tuesday at noon before I can pick it up.It's a bit irritating because my blue badge has arrived(for U.S readers-it's like a parking permit for people with disabilities that allows you to park in most places),and my new satnav has arrived.
  • that everything goes well for you this time Scott
  • Hello All,

    I'm been recently diagnosed with a mild lumbosacral degenerative disc disease, largely confined to L5-S1 region. Oh by the way, I can't forget about my herniated disc C4-C5. I didn't have to do surgery for the C4-C5. Lots of PT and chiropractor did the trick.

    This L5-S1 is very weird. My right leg from my foot up to the right side of my hip feels like a warm/tingling/weak feeling while my left leg kinda feel like dead weight if you understand that.

    Anybody ever experienced these type symptoms and if so, what did you do to remedy it.


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