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Questions about spinal fusion

ezraeezra Posts: 72
edited 06/11/2012 - 8:47 AM in Chronic Pain
Today my dr. Started talking to me about spinal fusion. He doesn't know if it will help me and he really doesn't want to do it ob me because I'm only 23. But it seems more and more likely that that is where we will end up. He pretty much told me if I were 50 he would do it in a heartbeat. So what I'm really posting about is wanting to know who has had it, what pain did it help, recovery time, and how you are doing now?

It was a pretty big shock today that we went from talking about one surgery to talking about fusion. It would be levels l4 l5 and l5 s1. But anything you can share about fusion would help me a lot


  • Ezra,

    Howdy!!! I haven't had back surgery yet, but have had 2 (soon to be 3) cervical fusions. Here is another way to look at your situation...YOUNG. Nope, not a negative. Your doctors are seeing a 2 level fusion, but with your age, you might heal up great, and be great for years, or yeah....flip the coin and you are on the short road to multiple surgeries. It is a hard one to answer. You will heal quicker at your age (I am 48), and as such with your other disks hopefully in good shape, you might be great for years and years to come.

    It is going to come down to you and your surgeon, and weighing all the pros and cons. Assuming surgery goes 100%, with your age, you could do great for years. Me...looking at 2 levels in my upper lumbar, and as it goes (age), I am holding off (If I can) for fear of additional levels going. (see my history). I've not been nice to my spine. (G)

    What might help? Write down all your concerns, and bring them to your surgeon. I do that, because otherwise I almost always forget an important question; and too, you might want to bring a family member or trusted friend to talk with your surgeon, as 4 ears are far better than 2!! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I'm not going to do the whole "have you tried all the conservative treatments" routine here, because at 23, I'm assuming that if your doctor is suggesting thinking about a fusion, you have tried it all.

    So, with regards to lumbar fusion, I had a 1-lvl TLIF at L4/5. I'm not sure what your fusion would be for - is it for disc problems, stenosis, facet problems, spondylosis/spondylolisthesis or a nice combination? Mine was not disc-related, it was for stenosis, facet problems and spondylolisthesis and was a posterior procedure.

    I can tell you that it's a long recovery after lumbar surgery and the first few weeks can be difficult, but at your age I think you'd have an excellent chance at a faster recovery than some of us older folks. At 9 months out, I'm feeling much better and consider my fusion a success. I still have pain issues when I stand too long or life too much, but I'm improving steadily and glad I had the surgery.

    I wish you luck on your progress and hope it doesn't come down to surgery, but if it does, with a good surgeon your chances for success can be high.

    Take care and please keep us posted as you move along your journey.

  • My problem is disk herniation in both areas that have not healed dispite 2 years time and all of the more conventional treatments. There is also DDD, stinosis, as well as facet arthrosis in both areas. I also have most of these problems minus herination at all levels between l1- s1. We have never tested any other area of my spine so that is all I know about. They think my pain is from the herniated disks. Since my pain did get better as far as my legs go the l5 s1 did heal some I'm guessing they may be right.

  • my pat answer
    i have had 4 back surgeries
    1/3 get better, 1/3 stay the same and 1/3 get worse
    my first was good but fusion will put stress on your good discs. it happened to me so i had to have another one and another. now i can't walk or stand without extreem pain. it is a big decision but if pain and walking are too much, i would get one
    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 always feel bad when people, especially at your age start talking about fusion. I know many who have been helped, and many who have not. I had it about 12 years ago. They grafted bone from my hips around the site, and also used cadaver bone, pins and screws. About a year later, my body began rejecting the metal and I had it removed because it hurt so much. I had one more decent year, and then things got bad. It seems anytime you have bones fused together, arthritis starts. Some people don’t get it so bad, others do. Mine is bad. It pushes on nerves and causes non-stop nerve pain down my butt and leg with every heartbeat – it’s horrid. I also know others who have done very well after fusion. I would make certain that there are no other options before doing something like that – sometimes there just aren’t; you have to do something. I am so sorry to hear you have this issue at 23. It just isn’t fair at all…
  • You said in your last post that 'they think' the pain is coming from your discs. Are they going to perform a discogram test (or something similar) to establish if the discs are in fact the pain generators? Because pain in your back can come from different sources, it would be upsetting if you had fusion surgery, only to find out afterwards that you're still left with the same pain.

    I had 2 level fusion (L5-S1 + L4-L5) in July 2010. I only just returned to work last week, with some problems, but I'm in the process of hopefully sorting them out with 'reasonable adjustments'.

    Am I pleased I had the surgery done? YEP! I have had chronic back pain for the past 5 years due to DDD, facet joint osteoarthritis and foraminal stenosis (it sounds pretty similar to you, but I'm 53 and not 23 like yourself - ha! wish I was!). I had two discectomies in 2005 (within one month of each other 'cos the first one failed) and I've tried all conservative treatments since. My original back pain has GONE! Recovery is slow and for the first 2 weeks I was frustrated at not being able to do much. Even though I am still in recovery now I am aware that I need to protect my back to ensure the fusion is successful. I understand it can take up to 2 years for the fusion to be 100 per cent complete and for any remaining nerve pain to settle down.

    If you have the surgery, you may need to adjust your life choices in future to protect your back, i.e. no bending, lifting or twisting. This obviously is imperative just after surgery, but being mindful of it when you're feeling much better is important as you won't want to stress the discs at other levels. 6 weeks after the fusion I was feeling amazing. I felt I could conquer the world. I went driving and, when I came back, I reversed into my driveway. I inadvertently twisted around to look behind me (as you do) and felt a sharp pain in my back. I thought I'd damaged the hardware, but thankfully, after x-ray I was told it all looks fine. However, I experienced a significant increase in back/leg pain for 3 weeks after that - I am certainly more careful now.

    I think age is definitely on your side. You can always do physiotherapy exercises to improve your core strength before surgery as this may help with your recovery afterwards.

    Someone else has suggested to write down all your questions before you see the surgeon. It's so true that when you come out you think 'oh, I should have said this', or 'I should have asked that' or you cannot remember what their answers were. Writing it all down definitely helps.

    Good luck and I hope my comments have helped you a little.
    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 !!
  • Yes they will do the discogram. He talked to me about that as well. I really don't want to end up having surgery but I do want to feel better and at this point I'm pretty desperate to feel better. Thank you for sharing your experiences.

    Also if anyone can explain annular fissures. It didn't show on my first MRI but did on the most recent one. With the information overload on the surgery talk I forgot to ask my Dr. I will have to start writing things down I always forget.

    This I know will most likely get the answer of do what is right for you but I want to ask anyways. If it were you and you had a normal pain level of 3 with it increasing with movement and activities. Normaly it will go to 3-5 pain on a good day and 7-9 on a bad day. I have more "normal" days than bad ones. So if this was your pain would it be worth it to you to go through such a surgery. I can handle the good days after this long and some of the pain I've felt in the last two years 3 is a breeze but it is the bad days that get me.

    The fact that my life has become so limited that I can't do much of anything anymore my mom and husband don't even let me clean anymore, mom won't let me on the floor which I really love them for taking care of me and helping do things that they know hurt me but I feel so useless. I guess that leads me to one last question chronic pain phycologist, have you ever been, do you recommend it?

    Thank you again for Sharing your experiences and giving advice it really do help
  • ezra said:
    If it were you and you had a normal pain level of 3 with it increasing with movement and activities. Normaly it will go to 3-5 pain on a good day and 7-9 on a bad day. I have more "normal" days than bad ones. So if this was your pain would it be worth it to you to go through such a surgery.
    If it were me I would try Prolotherapy first (and I am). I take Surgery seriously because the joint will be forever weakened from the surgery and that's not a good thing.

  • Thank you for the suggestion but after doing some research my insurance company will not pay for Prolotherapy. I don't have extra money sitting around to pay for things like this. In case this sounds weird to you I have insurance that covers every cent of my medical bills as long as it is something they cover. So I would have no insurance help at all. With a family of six supported on one paycheck that simply isn't an option for me. But I really do thank you for the suggestion
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