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whats the truth folks ???

strakerstraker Posts: 1,851
edited 06/11/2012 - 8:46 AM in Chronic Pain
fusions .for the last 12 months i have read loads of posts /emails and various items about fusions .i have never seen such conflicting information in my life !! some DONT DO IT ..it was the worst thing i eve did .then others say the best thing i ever did ...and this is not just the patients .doctors are undecided about this kind of surgery too .over here in the uk many hospitals wont do ADR and are reluctant to do a fusion .but i have talked to patients {on here and other sites that have has very good results} as many of you know i have a discography coming up on{23 sep} and i thank you all for you support via emails and PMS .this may lead to a multi level fusion .as you can imagine i dont want to make another mistake .i have a wonderful surgeon ...but i am only human and i am scared stiff about being made worse ..i dont think i could stand it ..bottom line are fusions SAFE ????


  • Not sure what the truth really is. Will you die from the surgery, probably not. Will it improve your condition? The odds ore in your favor, but to be honest there are the few who end up with complications. We rarely hear about the success stories cause they have no reason to complain or search for answers. I can only speak for myself. My two level fusion was successful in that my back is stabilized. Granted, my surgery was more than a fusion and decompression, but that's not really important anymore. Sure I have back pain but its more of a nuisance than a hindrance. I do have the Arachnoiditis problem now, but nobody really knows when it started. I guess its a complication from my own procrastination, at least thats how I prefer to look at it. In my humble opinion, fusions are safe and are a necessary evil for those who's back is slowly deteriorating.

    Hope this helps and eases your mind a little.

  • I don't know that I can answer your question as to whether fusions are safe or not. What I do know is that I have had to take the chance that surgery would help me more than it would hurt me. I couldn't continue to live in the pain I was in and it had breached all other treatment options. I was offered a C2 ganglionectomy and I went ahead with the surgery, knowing full well there were some incredible risks involved. Things didn't turn out quite the way they were supposed to and of course there's no "reset" or "undo" button. The good news is it took care of the pain it was meant to. The bad news is it caused a stroke, damage to the eighth cranial nerve and denervation of the muscles on one side of my neck. Not a picture perfect outcome.

    Would I do it again knowing what I would be facing in the aftermath? Yes. Even if my pain wasn't dealt with, I would still do it. I just know that I couldn't live knowing there was one more thing I could try, and not giving it a try. I hope that makes sense.

    I was scared stiff going into all of this. Scared of the surgery and scared of the thought of trying to live my life the way it had become prior to surgery.

    It's kind of like this joke
    joke said:
    As the flood waters were rising, a man was on the stoop of his house and another man in a row boat came by. The man in the row boat told the man on the stoop to get in and he'd save him. The man on the stoop said, no, he had faith in God and would wait for God to save him. The flood waters kept rising and the man had to go to the second floor of his house. A man in a motor boat came by and told the man in the house to get in because he had come to rescue him. The man in the house said no thank you. He had perfect faith in God and would wait for God to save him. The flood waters kept rising. Pretty soon they were up to the man's roof and he got out on the roof. A helicopter then came by, lowered a rope and the pilot shouted down in the man in the house to climb up the rope because the helicopeter had come to rescue him. The man in the house wouldn't get in. He told the pilot that he had faith in God and would wait for God to rescue him. The flood waters kept rising and the man in the house drowned. When he got to heaven, he asked God where he went wrong. He told God that he had perfect faith in God, but God had let him drown.
    "What more do you want from me?" asked God. "I sent you two boats and a helicopter."
    To me it seems as if you are in a similar situation. I know I was, and I had to take that risk. So when the "man in the row boat" came by, I climbed in. So yes the boat struck something and sank throwing me into the flood waters, but I survived. So even though the outcome wasn't perfect, it accomplished what it was intended to.

    I hope this makes sense and doesn't sound too crazy. It's good that you are questioning the procedure, but don't forget your struggles that have led you to this point.

    Good luck,

  • It's totally your choice...I was very good after my l4,l5 fusion....well after doc went back in after i was fully fused and took out hardware (my screws came loose)
    Now just the ones in my brain are...
    For me i got 5 different opinions and 4 of which were the same...
    I knew all the things I had tried didn't help at all..and it got so bad I couldn't take a baby step without screaming..
    I did what I was told during recovery and my fusion was fine...and yes I would do it again if had to..
    For me I was plain dumb I was working 2part-time jobs last yr and one was very active bending,lifting and too keep my job I tried keep up with the fit 20yr olds....so was dumb for me I way over did it and push thru and ignored the signs something was wrong....
    I now do not work ....outside the home..
    I think sometimes you can also read too much
    And it is very normal to be scared...
    for me fusion was a good thing and I hope you can ease your mind some....
    great words ther C nicely put I wish my brain worked so good...fibro fog here so much
    Hope I made some sense and C love that joke
    gonna copy that one
    tc tony and keep us posted
    neck,bone spurs pain started 04, back issues and fusion l4,l5 06~hardware removed.
    good few yrs. 09 pain sharp, numbness feet,legs, diagnosed fibro, neurop. legs.lung issues.
    daily goal do good thing for someone.
  • It sure would be nice to see some stats on this very topic. I am sure insurance companies keep records of what operations are safe and which are not. Getting to that information is impossible. No two situations seem to be the same so that makes it all the more difficult to try to figure out.

    I agree that most of the people that you read about on this site have not had great outcomes for whatever the reason. This site should be able to do a rough estimation of the number of good outcomes just based on the number of members that sign up, have surgery, recover and don't come back. It would be a great question to ask your doctor as far as what he see's. He may not be wanting to talk about the success/failure rate because no two situations are the same. As you know there are also many different types of fusions and different ways to get to the same end result.

    What are your other choices? It is a life changing surgery for most of us and most have to take a fresh look at what they were doing before a fusion and what is best to be doing after a fusion. Lots of doctors will tell you that you can go back to your old life after the surgery. To me this is nothing more then a sales gimmick. Yes you can get your back feeling much better after the surgery but keep in mind that the loads on the spine now get spread into other areas, top & bottom, and those areas were not designed to carry the additional loads. To me, and this is my opinion, anyone is silly not to protect the spine against added loads. This includes running, weight lifting, lifting weights, and most forms of bending and twisting. Even climbing a ladder will change the load dynamics on your back. It is very hard to face this harsh reality. It is even harder to make the changes that are needed.

    If I had to do it again I would in a heartbeat as its helped me. I am not back to where I wanted to be but I am way further ahead then where I was.
  • all i know is that when i had one, the disc above it failed and had to have another one. now i have trouble walking without pain. you have a hard decisiion to make
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • terror8396 said:
    ....you have a hard decisiion to make....
    That's the key. You have to make the decision Tony. No one else can do it for you.

  • I have mixed feelings on it. I know without a doubt, I could not continue on with three blown discs, but I don't think I'd do fusion again. It was fine at first; I was pain free until my body rejected the metal. I had that removed after a year and was fine again for a couple years. I think had the arthritis not set in, I would still be fine. SOme people get it and some don't. I had 3 fused together, cadaver bone put in the disc space to avoid future issues and bone grafted from my hips and cadaver to form the fusion. Most of my pain now is from damaged nerves from arthritis pushing on everything and it is bad. It has ruined my life. I had a friend out here who at the time had 25 years of service with the gov. She had the same surgery by the same doctor 6 months after me and ended up in the same boat. The only difference was she couldn't or wouldn't find a doctor to help her control the pain, was always off work and late and did not take advantage of FMLA. She ended up having a choice of quitting or being fired. She had to give up all the fun things she loved to do and her husband dumped her too. Last time I saw her, she looked horrible. She used to be like me, always fixed up - did her big hair, boobie shirts, etc. She looked like an old lady, very sad. I think it's just a toss up - there are no guarantee's. What works for some does not for others. My nephew went thru the same type of thing and just had an SCS installed. I know one person whom it worked well for. I guess it's just a leap of faith if you will. Stay informed and take your time deciding which way to go. Personally, I think it all just sucks. :) Best of luck to you friend. I keep all my buddies here in prayer and I hope we all see better pain-free days ahead sometime, somehow.
  • dilaurodilauro ConnecticutPosts: 9,856
    There have been a lot of good comments posted in this thread. I do believe, the bottom line, is that in your heart you have to feel that this is the right thing for you to have.

    I can not imagine going into any surgery and not really being convinced about the outcome. As Dave stated, is it life threatening? No. But still you would like some understanding that when its over, will you be better or worse than today! I only wish we all had a crystal ball to give us that information.

    I do believe that you do your homework, you understand the surgeries, you understand the conditions and various treatments. That makes your decision based on an educational and informative basis. But we also make so many decisions with our hearts.

    Is Fusion Safe ? Yes
    Does it work ? Yes
    Does it fail ? Yes
    Are patients pain free after wards ? Yes
    Are patients in more pain after wards ? Yes

    So, you almost have to throw out all the various possibilities.

    Trust in yourself, trust in your gut. You have a tremendous ally with you, your wife Kathy.

    Tony, my friend, I wish I could tell you the magic words that would ensure 100% of all good for your surgery. Instead, I will hope and think about you and I know just from getting to know you these past couple of years, you will make the right decision.

    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • my surgeon {who happens to be one of the finest in the UK and Europe to be more to the point } said to kath and me at the last visit {and this is what is worrying me} ;as you are a high risk case you will have some dark days post surgery and you will hate me ;.i asked why i am i so high risk? he said that anyone that ends up at his door step is out of options .my surgeon has carved out a niche in sorting out back problems when other surgeons have either made a 84LL5 up or refused any more surgery .my other surgeons have all declined more surgery because they feel it would be inappropriate and i would not gain anything from it
    so my options were to stay as i am {taking large amounts of drugs and doing hardly anything in life and i could feel my life draining away...so this for me was not a real option .i am 44 for god s sake ! so after a long talk with my wonderful family doctor and kath we decided that if MR 5 can operate on me i should take him up on his offer .i have read many things about him and most are very good .he has a patient in a similar position to myself ..and after his operation he is going very well ..and this man was told ..no more surgery .go home and be happy that you are alive kind of thing..i think what bothers me the most is i know that i am going to have a big operation and i know the recovery is going to be hard work and i know that i will never be totally out of pain ..but i am also aware that i could die or worse stroke out or even be made paralyzed ..the last two options i don't think that i have the personality to manage that kind of life .if i die then its only the family that suffers .but if things go wrong and i end up as mentioned what will i do ?? i am a very private person regarding my body things like going to the toilet and being washed etc would freak me out .i am about OCD regarding personal hygiene and if i was unable to take care of myself that would drive me nuts .i know it sounds a bit shallow and maybe you think i am a bit nutty .i know i am in good hands with Mr 5 and i know he will do his best ...but what if his best is not good enough?? as Jon said i have a hard decision to make ..i think i have already made the decision if its possible {discography being OK} i will have the operation ..i am sure about that ..at this stage we don't even know what operation Mr 5 can do ..do wont know until the discography has been done .i may not be able to have any surgery if the discography is no good {i have been told that by the surgeon } he has told me that if we a good to go i have to see the rep from medtronics to see if a piece of kit can be made for me ..as the standard kit wont do ...hence the high risk bit ..i think ...so folks its more complex than a normal fusion .Mr 5 is hoping he can help because he genuinely want to help and the hospital is geared up fir my kind of surgery .i believe the operation will cost in the region of 30 thousand pounds ..so its not a cheap operation .i know i have waffled on a bit but the discography is not that far away and what happened next could be life changing or ending!!
  • I think you would be hard pressed to get a "true" answer to your question because there are so many answers that are dependant on who is asking the question.

    You have patients who (lets face it, are the ones living with it all afterwards) who decide works/not works based on how they feel now, compared to pre-surgery.

    You have doctors that may decide the surgery works if it did what it was "supposed" to do... regardless of whether you are in pain. (we see a lot of that here... similar to what Dave said above... it fixed what they wanted to fix).

    As for statistics...well, as someone who daily manipulates stats based on what someone else is looking for... I can tell you that it would all depend on the definition given as to how they could be tracked...similar to doctors that feel the surgery was a success (because it fixed the problem) but the patient feels like it was a failure because they still hurt, or they hurt more, or something else now hurts. There is no rock solid number :(

    As one that has been hiding my head in the sand rather than deal with all that is going on back there, I really cannot offer you an answer... other than to discuss it with the doctor when you see him, TELL HIM what YOU consider as a success and explain your fears. Make sure YOU feel that he understands where you are coming from....and is not just yessir'ing you.

    I wish you the best of luck with whatever you decide on, and definitely hope that you have pain free, good living days ahead.
  • What is the deal on a discography and how does that effect what does or doesn't happen. In a lot of fusions the disc is taken out so what am I missing?
  • Bkins, my guess on the discography is that the doc wants to make sure that its the disc that is causing the problem. When I had my fusion, my doc wouldn't proceed until he had the results from mine and even then my results made the decision to do a 1 level or 2 level more gray.

    Clandy, just a side note, my surgery fixed what I wanted fixed. Just ended up with other problems afterward.

    Tony, it sounds like you have made your decision. I hope everything works out for the best for you.

  • It sounds that you have figured out your next step and what is right for you. That is all any of us can do. You know everyone here will be praying for you and God willing - it will be a blessing in your life! Best wishes - Marion
  • you asked about the discography .??
    in my case the surgeon want to see it=f the disc about the damaged levels that would be {L3} is sound because if its not he cant do the operation .he need at least one healthy disc to attach the hardware to .and another problem that differs to most fusions .as i mentioned before many fusions require pre made normal pieces of titanium and they are fitted together lick and meccano set in theater .but in my case ..due to the amount of disease and damage there is not a standard piece of kit that my surgeon can use .SO is its a green light on the operation my surgeon want to do a CT scan and re MRI me then after take some measurements then get the medtronics rep in to see is a piece of kit can be made to fit my spine ..he described it to me like as if i was having a custom kitchen fitted to an odd shaped room {i could not just nip to B and Q get something off the shelf .i would have to get a joiner in and have something built to fit {i used the kitchen analogy because the surgeon knows that we have not long since has a custom fit kitchen fitted!
    {its amazing what get talked about during a consultation!!}.so a lot depends on this discography
    TO ALL
    i do value all your opinions and PM s a fusion is not something to be taken lightly but i am out of options now ..i mean its 3am and yet again i am up .when i should be in bed ..its been like this since the last operation nearly 4 years ago ..surely that's not right is it .
  • Tony,

    Fusions as you know work for some, and not for others; or there are after surgery complications that are rare. My first fusion 'gave me back' my life, no question. I wasn't 'major' educated on 'adjacent level failures, but even if I where, I would still have had the surgery. Everything has risks, right? My last one, not so good - more intervention coming for that mess. In hind site, I still would have underwent my last surgery - (lol) but would have insisted on a plate not my 'wing.' :)

    From what I've seen of your posts Tony, "internally" I think you know what you need to do. I truly hope that the discogram results are such that this experienced surgeon can bring you back to some sort of normalcy. You and I both know, NO surgery is a guarantee, but with what all you have been going through, your choices are getting "easier" (hate that word) to make? Please let us know how it goes. You're really good people Tony. **HUGZ** :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Here is how it is -- you know i've been there and am living it every minute. YOU WILL NEVER BE THE SAME AS YOU WERE WHEN YOU WERE A YOUNG MAN. You need to accept that -- right now. You are a miserable bag of pain at the moment -- yes, you are -- I know -- I've been there. You will have the surgery and the first few days you'll think - this isn't so bad, I think I'm going to be okay. Then you will have days of searing pain again. You will have stiffness and soreness and burning down your legs again and you'll think "why did I do this to myself? I'm so miserable. Why didn't I listen to those who said multi-level fusions were not a good idea?" Then after about 18 months to 2 years (yes, it REALLY takes that long), you will think - "hey! I feel really pretty good!" This is the most DANGEROUS time. This is when you decide you can lift that load of gravel in the wheelbarrow to take it into the back yard. You can split wood if you want from a felled tree. NO YOU CAN'T. You must accept, before you head into a multi-level fusion, that your spine is not normal. Yes, they can fix it for you. Yes, in time the pain will be much relieved. But, you will never go back to doing all you did before. If you do try that, you will damage the discs at other levels. The fused part of your spine with be a fulcrum against which you can damage all your other discs. Resign yourself to a limited physical life, but one without the excruciating pain your are now experiencing. Know that you can have relief, but you must always guard your spine. I really believe you'll be fine. I am -- as long as I make myself realize that I have to take care of my back.
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • After a fusion there will be certain things you won't be able to do again. In my case though, I couldn't do them before because of the chornic back pain - so I'm not too bothered that I can't do certain things now, 6 weeks after a 2-level fusion.

    I'm not sure I agree with the notion that having a fusion always puts added stress on the discs above and below and therefore it seems that people have gone on to have further fusions at adjacent levels. The reason I say this is because when I first hurt my back 5 years ago, it was confirmed at the time through MRI that L5-S1 was the only disc causing the pain.

    After loads of treatment, 2 discectomies etc. (you know what I've had Tony), when I eventually had the discogram before surgery, it confirmed that two discs were pain generators - hence the 2 level fusion 6 weeks ago. What I'm trying to say, and probably not explaining myself very well, is that I ended up with a 2 level fusion when I thought I was going to have a one level.

    Suppose I had a one level fusion up to 5 years ago - then experienced chronic back pain again and had to have another level fused, I would have automatically thought that the first fusion had done the damage. When in fact it was degenetive changes that would have happened anyway - do you see what I mean?

    It may be that at some point in the future I MAY experience further back pain and may need further surgery, who knows - but I firmly believe now that these changes could have happened anyway and may be nothing to do with the surgery I've just had.

    The most important lesson I have learned over the years is that I did not (and would not) do anything to make my back worse. I may decline to do some social activities if I feel it would compromise my back - but I would have done that anyway because of the resulting pain it would give me - I know there are certain things that I won't do again, but to be quite honest, at 53 would I honestly expect to be doing things now that I could do when I was 20 - I don't think so. And I'm more than happy with that.

    If I continue to be protective of my back I don't see why I cannot enjoy life to the fullest of my current abilities. If my circumstances change, they might have changed anyway. The most important thing about having the surgery is that I DO NOT HAVE THE SAME BACK PAIN AS I'VE HAD FOR THE PAST 5 YEARS - AND THAT'S A SUCCESSFUL OUTCOME as far as I'm concerned.

    There are no guarantees and I think you've voiced what everyone facing surgery feels. Your specialist, I'm sure, wouldn't offer any surgery unless he thought you had a good chance of experiencing a better quality of life afterwards.

    It's a decision I also agonised over - but ultimately what kept me going was positive thinking. To be able to fly long-haul to visit my daughter who now works in the USA - all I need now is to be able to try and save the money to get there (which is difficult now I'm on half pay at work!). There are pro's and con's with everything, but I couldn't carry on the way I was. Working was becoming such an issue that, in the end, if I didn't have the surgery it would have affected my ability to do my job. I'm seeing the Occupational Health peeps this Friday who will determine if I'm fit enough to return to work in a months' time - but to be honest, if I'm not, I'm not going to worry because I know I WILL be fit enough to do something else perhaps.

    If I don't do anything stupid, then the surgery would have given me the chance to have options that perhaps I wouldn't have had before.

    It's not long now till you have the discogram - everything seems to depend on the results of this. With your faith in your surgeon, I'm sure whatever the outcome, he will advise and reassure you so that whatever decision you make (and you seem to favour surgery if it is offered) you'll be a 'patient' patient - knowing that for a time you will need the help and support of your lovely wife and family. Accept it with the good grace that it is given and when you're able, you will hopefully be in a position later on to help them if ever they need it in the future.

    I know you're worried about 'personal cares' etc. but that's what family is for. Maybe, Social Services could offer a care package from a male assistant for a short period of time until you are able to do things independently - could you contact them to discuss your concerns first and see what action you may need to take (if that is an option)?

    I hope I'm managing to explain myself properly Tony.
    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 !!
  • have both made very good points and i take it all on board .i think at 3 am this morning when i was up again in pain i start to worry and panic and as a result i tend to get on spine health and just write down what i am feeling .it helps relive the fear!{i know most men would look at other web sites at 3 am in the morning !! if you know what i mean}but not me ..
    yes sue the discography is nearing and i am not too worried about that .i am worried about the results though .and lsteller i understand and agree with you totally about all your comments ..very well put
    i remember my gran at 82 telling me that in her mind she still felt like she was 18 its just her body let her down her mind was a sharp as ever.its hard to think at only 44 my body has let me down and even if i can be fixed i know that i will be restricted in what i can do even if i feel like i an able to do more ....i find myself telling others on here the very same thing ...today i am very tired so all i intend to do is rest
  • I so relate to Linda...and she is certainly the voice of reason!!

    For me, the decision to have surgery was fairly clear. I was in terrible pain; my legs were numb. I could not continue to work at my job...I was...disabled.

    I was going down fast, and the fusion seemed like the only option to become "well" again. I had to take the chance since I did not see much hope without surgery.

    Now...what is "wellness". It certainly isn't what it was 5 years ago for me. I had to have endoscopic surgery last week because of the scar tissue, and have to have it again in 2 weeks, then maybe one more time. I have to wear a bone stimulator, since there was little fusion noted on my 6 month xray. That was 3 months ago...so I'm in limbo for now.

    So, I've had a few wrinkles in the recovery, but I will not look back. As Linda said...the is a long road. I'm still hopeful that I will go on to fuse, and maybe in 6-9 months I will have a similar story as Linda to tell...

    Take care,


  • Hi Straker,

    Sorry to hear your news. It has been a while since I have been on here and I was sorry to see you are still having troubles.

    As you may re-call (or not) I had a PLIF followed by 2nd TLIF next level a year later. Like others have said, I am a success in so far as lower spine finally stable, I'd say my original pains are "gone" (mostly) but I was one of the complications persons (migrated cage crushed L5 and was left for 6 months) and now my pain has been replaced by iatrogenic pain / nerve pain and mechanical pain. Am I worse off? No, not really. I have traded one pain for the other. Do I regret my surgeries? No, I was desperate (and prepared to die.I had reached the end of my rope, as it was then.)

    If you are desperate and can embrace the risks (you should discuss them with your doc and consider what that mean long term) then I think you know what you need to do. If you have doubts, you need to soul search. Is this the right time for you?

    Yes this is a HUGE surgery, huge risks but many people do regain a quality of life post surgery. Hope Straker. I wish you the best in what ever you decide.
  • here are the statistics i have heard 1/3 get better, 1/3 get worse, 1/3 stay the same. After 4 i believe i am in the 1/3 get worse category. ist one was good then when my other disc blew, stress from first fusion screwed up my other disc, things got worse. now i can't walk more than 100 ft without stopping
    good luck
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • I believe that both have valid arguments. Sue, I am inclined to agree with you however with a twist that leads into the mechanics of it all that Bkins explained. It being that the adjacent disc would have eventually failed, however the fusion just accelerated the process.

    Kind of like having a defect in the sidewall of your car tire. You may never know it exists if you always drive around town. However if you place additional load on it by traveling many miles on a bumpy road, it reaches a point where it can no longer handle the added stress and it blows.

    Most surgeons will tell you that they try to do only the very minimum that is needed to stabilize the spine. If the adjacent level is found to be holding its own at the time, they will gamble and leave it be, in hopes that the patient will get a few more years without it being a problem. It seems that very few surgeons will do "preventative maintenance" when it comes to the spine.

    Tony, I hope you get to a point where you are able to get some sleep. One thing that I have done to help alleviate my fears, is to write them down. Write them out in exactly the words that they create inside my mind. I then go back and read what I wrote down, and it somehow no longer has as strong of a hold on me. It's not something I would write to share with others, but the gut wrenching reality that I have inside, that needs to be let out.

  • I've read most of this, been a while since I had time to come visit.

    Anyway, I agree with many and "C" in particular as to not being able to deal with the what ifs should I turn down a possible improvement. I would forever be wondering what if. My wife and I did the very same questions when I underwent my second arthroscopic procedure. Knowing that if he found the dead bone had softened the cartilage the I would wake up with a partial shoulder replacement and months to years of recovery time. Yeah, you guessed it, of course here I sit 2.5 years later, with the titanium cap and? yeah, my shoulder still hurts. Do I regret the procedure? No, I fully believe that I would be far worse if I had not had it done. Not only would my shoulder hurt, it would not function properly on top of it.

    I try to look at it this way, when my Bi-polar depression lets me. I try to compare my now to my just before surgery days. NOT to the days before the accident! Most of us don't ever get those days back.

    I bought a T-shirt while on vacation, it says "Scars are tattoos with better stories" (not realy helpful I know, I just needed a new T-shirt! :D )

  • SueD said:

    I'm not sure I agree with the notion that having a fusion always puts added stress on the discs above and below and therefore it seems that people have gone on to have further fusions at adjacent levels.

    Let me throw a theory out here.

    The reason that I believe, and has been explained to me by two different surgeons, that the upper and lower discs are at more risk after having a fusion is that those areas, the upper and lower discs, have to carry the load that the fusion area previously carried. It is really just basic mechanics.

    Think of what a pryamid looks like with a very wide bottom and a very small top. The reason for the wide bottom is to be able to carry the load of everything up top. As you go up to the top less and less downward force is present and therefore less size and width is needed to support the load.

    Our spines are much the same in that the top, cervical area, is much smaller in size then the lower lumbar areas. The one big difference here is that our spines in order to be able to move have a disc between each level. When you take out a disc and fuse two levels together you are creating more load on both the top and bottom adjacent levels. The added load that is now not being cushioned by the area(s) in which a fusion took place gets transfered to the lower adjacent level mostly but some also gets transfered to the above level as well. All discs in our backs were designed to carry a certain amount of weight, or load, and when discs are taken out that load has to go somewhere. If you look at the discs between each level in a spine you will see that they not only are bigger in height, and wider in width as you go from the cervical area down to the lumbar area.

    Does that make any sense?

    Anyway, from a engineering standpoint it makes sense. A fusion will always add more loads to adjacent areas that were not designed for it. This may or may not create more problems as it in a large part depends on the health of the adjacent disc's. You and everybody else are wise to protect your back from further loads once you know there is a problem.
  • Tony,

    In 2008 I had horrible arm and shoulder pain along with what I call "old man neck" (at 46 at the time). I had a 2 level ACDF on C5-C7. Woke up with no pain and almost no surgical pain. Over next two years, things got worse again. Found out one level previously fused had cracked and the ones above and below were bad. Plus the foramen on several levels were blocking or rubbing nerves. Just did a 4 level posterior fusion 8 weeks ago and was scared to death. My ortho told me the same thing that this one was going to be rough. Ultimately did it and now 8 weeks later I still have some arm and shoulder pain, but not enough to take pain killers for. And that says a lot since I was on 80mg of Oxycontin plus 5 to 10mg of Oxycodone IR every 6 hours for breakthrough pre-surgery. Could I justify still taking some of the meds at my pain levels? Yes, but I want to give my body a chance to not only detox off of the drugs, but to tell me what really still hurts and what doesn't. Ultimately I had to sit down with my wife and weigh the "what's most likely" options of doing or not doing the surgery. For my part, I'm glad I had it done. But I will admit with a 4 level posterior fusion, the first 2 weeks were tough. But then it improved quickly. Best of luck and our prayers are with you.
  • I'm basically in the same boat as you. The surgeon offered surgery...a fusion for my cervical discs, but he gave me 50/50 odds. That's just not good enough for me. I hope you figure it all out and God bless!
  • In the US, there has been an upswing in the number of fusions, especially multilevel, done. This is coincident with the change in the US psyche to the belief that higher intervention levels are universally better.

    Anyway, there were recent studies here basically showing the increase in fusion numbers were NOT linked with better outcomes (in other words, stating the obvious, that fusions are NOT helpful for people who are not good candidates, and is in many cases harmful), and suggesting that doctors should be more careful about choosing their fusion patients, especially for multilevel fusions.

    Anyway, I think the answer is- no, fusions are not safe. No operation is safe. But is it as or more safe than living with your damaged back? When the answer "yes" and the surgeon can offer some hope of improved functioning, it's time to start planning the surgery.

    Because that is the scary truth- it's not safe for us to live like this either. Sedentary, with chronic severe pain chipping away at us, taking multiple strong painkillers. That's kind of a frightening life to look forward to.

    You've chosen your surgeon well, you're doing all of the tests, and you're really trying to do this right. You are not the audience toward whom those warnings are aimed.

    I have my fingers crossed for you!
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