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An Article on MSN to consider before pursuing fusion surgery

firewater1981ffirewater1981 Posts: 84
edited 06/11/2012 - 8:47 AM in Back Surgery and Neck Surgery

Above is a link to an interesting MSN article about spinal fusion surgery that is front page on MSN.com today 14 Oct 2010. You don't have to follow the link just go to MSN.com. I'm surprised something like this was front page news on MSN. The article explains why spinal fusion for millions is not the answer. I have been told to abstain from fusion surgery by many people. These people include those who have had the surgery as well as physical therapists and people that take care of people after surgery. I've even been told this by some surgeons who perform the surgeries. In my experience it seems most surgeons just want to operate just because they can, not because they really should. Its and interesting read and insight if someone is considering back surgery. They explain that there is no magic bullet for back pain. I for one am tired of people saying "just get surgery" like it's going to fix it all. It's funny because the people saying this are the ones who usually do not have back pain and or who have not gotten surgery. It's not like it's a broken bone or something that can easily be fixed. Its cartilage that is damaged. Cartilage does not heal ever and getting fusion surgery removes another "shock absorber" disc in the spine. This just puts pressure on the other already damaged discs which accelerates the damage to them. Since I already have 5 herniated discs that would be..... not so good.

Anyway, just a heads up for people with back pain considering surgery. I'm not saying it wouldn't be good for anyone as I'm sure it is sometimes. There are going to be success stories even if they are few and far between. Maybe that success story could be you. By all means get the surgery if you absolutely have to. Just be mindful. I say consult your doctor but be skeptical of his decision. At the very least get a second opinion. I think the point of the article was to explain it's just not as good for "everyone" as "everyone" seems to think it is. To also point out what I am learning in my experiences that doctors who can operate usually will and contrary to the regular held belief it may end up being unnecessary and do more harm than good.

Best wishes


  • Interesting article firewater. I agree with some of what's in there in that there are doctors (surgeons) out there that will cut just to cut, and promise the moon along with it! My NS was fast to say that the 'back pain' portion of my symptoms is NOT guaranteed to go away. What his goal (and mine) is the neurological issues in my legs would be lessoned or gone.

    People who have "back pain" and no sciatica or neurological issues downstream are probably NOT going to get relief, and or too, be in worse shape than they started with! Any spine surgery is serious, hopefully people who undergo one do see improvement. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I also was randomly reading research to put myself to sleep last night, and was reading that unless there's a clear cut herniation causing your nerve issues, surgery is unlikely to be successful. Surgery for degenerative disk disease without disk herniation/radiculopathy does not have much support in research.

    Also, what ever happened to the discectomy and other less invasive procedures? Are the surgeons so hungry that every herniation means fusion these days?

    Here I put off surgery for 3 years for a broken back, and people are out getting multi-level fusions for a herniated disk. I really don't get it ;)

  • This article is similar to another one that we had here recently stating the same bad results. Often times much of the cause problem of backpain is ligament damage and traditional medicine is poor at diagnosing and treating this problem. Surgeons may or may not be greedy but one thing I'm sure of is that they believe that they can perform surgery and heal you. I'm told that not every doctor wants to be a surgeon and that a surgeon is a unique individual, maybe surgeons are arrogant and think that they know best?

    I've done alot of research into Prolotherapy and would absolutely try that before fusion. Prolo can stabilize the spine in a natural way as opposed to fusion which is unnatural and ultimately weakens the back. If Prolo fails, which is unlikely, then surgery could still be done.
    Anyone wanting more info on Prolotherapy can search on Youtube using the term "Prolotherapy Lecture".
    Or get the book Title edited due to forum violations. This is considered advertising for commercial gain. .

    Content edited by Cindy (Neck of Steel) for forum violations.

  • you have to always remember that people that have had successful fusions, for example, don't always frequent forums like this because they're too busy living their lives.

    Also, when diagnostic tests, i.e. discograms, have confirmed (as in my case) that two discs are pain generators then one of the options would be to remove them. I had other issues going on, like facet joint osteoarthritis and right foraminal stenosis and I opted for a 2-level PLIF fusion because the surgeon took away the facet joints, removed the 2 discs (positive for pain) which hopefully then created more space that could alleviate any symptoms from the stenosis. I asked the surgeon tons of questions and felt I was given honest answers, which I very much appreciated.

    After suffering chronic back and right leg pain for 5 years and after having tried all conservative treatments, it is true that I saw PLIF fusion surgery as the 'gold standard' treatment (in the hospital I attended) and the possible ultimate solution (other surgeries were recommended by other surgeons, but I wasn't happy with them). I was made very aware of ALL the risks involved. My surgeon has been doing PLIF surgery for 15 years and I attended a spinal support group meeting a few times before surgery - this allowed me to talk to patients who had had the same surgery and who answered my questions, warts and all. I felt I had gained as much information and done lots of research before making the decision to go ahead with surgery.

    I think by way of an answer, I had experienced chronic back/leg pain for so long and had tried different conservative approaches like: trying numerous medications, physiotherapy, chiropractic techniques, facet joint injections, epidurals, radio frequency ablation, discogram, TENs machines, core strength exercises, swimming, losing 5 and a half stones in weight, joining a gym, buying expensive MBT shoes and quite alot of other things as well. Over the 5 years, I used any strength I had to work full-time and very often would end up flat on the floor as soon as I got home (or on the weekends) to relieve the back pain just to be fit enough to return to work. I also sought FOUR individual consultant opinions during this time. There came a time for me when I found a surgeon I had complete faith and trust in who made me very aware of the risks involved in the surgery he proposed.

    I can honestly say that for the first 6 weeks of my recovery, I considered the surgery a complete success (I had the fusion in July 2010). My original back pain had gone and I was delighted. However, it was totally my own stupidity that exacerbated my pain, which continues even now. Like many others, I have learnt the hard way - that it's a much slower recovery process than I thought and when you're feeling absolutely great and do something silly (like I did whilst driving) then your back soon lets you know about it. That's the most frustrating thing - knowing that the pain I have now is through my own lack of understanding and awareness of my surgery, or thinking I could run before I could walk.

    If I had read that article before my fusion I would have been in more turmoil about what to do. It's a hard enough decision to make at the best of times even when you have been told what all the risks could be. I was also told by different consultants that my back condition would get worse as I got older (and the recovery from surgery could take even longer if I delayed my decision by say 5-10 years) - but overriding all this, was the possibility of achieving a better quality of life, taking less medication (which I do now compared to before the surgery) and having more stability in my lumbar spine.

    I am still pleased that I had the surgery. I feel as if I have been given a second chance. If I strive to look after myself well, be more mindful to protect my back in the future, then I believe I can still achieve a successful outcome. Of course, only time will tell.
    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 !!
  • Thanks for the link to this article. My first reaction is that it doesn't say anything new. I'm 2 weeks post 2-level PLIF and was told before the surgery that this surgery was NOT to cure back pain, it was to relive the pressure on my nerve root and hopefully correct the curvature that caused the pain to begin with. Yes, all my lumbar discs have degenerated and in fact my surgeon found them to be worse than he had anticipated. First herniation was 35+ years ago and had herniated down and outward in two different directions, then it had calcified. He had to use a chisel to get the disc out. It turned into a 6 1/2 hour surgery instead of the 4-5 hours he had anticipated. Yes, I'm having nerve pain post-op which has been severe for a couple of days, but we're getting that under control and I think I know the culprit in that pain--my back brace, for one, and my stupidity for sitting in a 2 hr board meeting earlier this week. Even though I stood up frequently and tried to walk around a little, those two hours were very bad for my back and I shouldn't have attempted them.

    Having said all that, I have to say that I've had (and continue to have) a very strong sense that this surgery was very good for me. My back was such a mess and now there's room for the nerves to live. If I continue to have occasional nerve pain, so be it, at least we've done what can be done to help straighten out the mess that is my lumbar spine. :)

    I also want to agree with SueD who hit the nail right on the head with her comments about doing stupid things when you're feeling great. I've done that once and hopefully I've learned my lesson. Everything can't be blamed on the surgeon--patients have to take responsibility for the large part they play in their recovery.


    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • I'm glad to see some discussion regarding surgeries. It seems that so many times I read something saying it is a cake walk. Spine surgery is serious stuff, and while some recover easier than others, there are no guarantees. I am not against spine surgery at all, I have had 2 of them and would do it again if someone could help me. But I do advocate for people to do their own research and to always get a 2nd opinion before getting on the operating table. I am one who took my first spine surgery lightly. I just thought I would go in, the surgeon would do his job, and I would go back to living my fast paced, over-achiever lifestyle. Needless to say, that didn't happen!

    The article refers to back surgeries. The same information applies to cervical spine surgeries. Often people think that a neck surgery is no big deal and a quick recovery. What people don't realize is that the risks are far greater for something to go wrong than with a lumbar surgery. In an ideal situation, the pain level should be less than with a lumbar fusion surgery, but this is not always so.

    I guess my point is make sure your surgery is NECESSARY before you do it. Exhaust every other option, unless of course there is an emergent reason why you can't do conservative treatments first. Then, if you need the surgery, find a qualified doctor whom you trust and be prepared for what you are doing. Don't take it lightly--this is serious stuff.

    Thanks for posting this topic. I'll get off my soapbox now, lol.
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • Cindy,

    I was kind of the opposite. My first surgery I was in freak out mode for over a year - put it off for 2 years. I was terrified that anyone with a razer sharp knife near my spinal cord! Then of course I woke up and virtually all pre-surgical symptoms were gone! Here's the opposite. When my next level went, I was a lot calmer, and felt the same result would come of this second surgery - didn't turn out to be the case. Now facing more surgery in the neck, and now too the lower back.

    I guess with all that, I got to see the 'good' -great result, and now I am seeing the down side. Did the surgeon (in my opinion) screw up? No, the nerve reactions were pretty much the same before surgery as it still is over a year out. Nerves are fickle, and don't like being entrapped, slapped with a herniated disk, or impacted from crashes.

    I got the impression from that article that it was more geared towards those with the more common back pain, and people going to surgeons to "fix" them so their backs don't hurt, and maybe skip conservative efforts. I guess for me, gonna do like my first surgery...drag my feet as long as I can. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • The real question about having surgery is why. If you are having a fusion to stabilize the spine or fix a break that makes sense.

    If you have a herniation that can often be fixed with a microD but many surgeons seem to jump right to fusion. We talk about trying the least invasive solution so it would make sense that in most cases a microD comes before a fusion. It's only when you need to remove too much of the disk that you need to resupport the spine.

    As in all things the patient needs to be their own advocate. Ask why you need a surgery. If the surgeon is being honest they will show you what and why. Getting a second opinion should confirm this. And ask lots of questions.

  • The question is, why are surgeons doing so many surgeries, and especially so many multi-level surgeries. There have been a few reviews that found that a not all were necessary- that they could have been less invasive surgeries or conservative treatments.

    And that's scary, to think of people being put under the knife who didn't need to be, or put through a more complex surgery than necessary. Most people go into the surgeries thinking that they will cure their pain, but spinal fusion usually only "fixes" very limited types of pain- basically radiculopathy. And how many people are experiencing future problems (such as the herniations at levels below) due to fusions that were unnecessary in the first place?

    I don't think everyone is told that the fusion won't fix their back pain. If they were, I bet the number of fusions would go waaaay down, because radiculopathy is not nearly as common as back pain.
  • happyHBmom said:
    I don't think everyone is told that the fusion won't fix their back pain. If they were, I bet the number of fusions would go waaaay down, because radiculopathy is not nearly as common as back pain.
    I agree whole heartedly with you HB!! My NS told me right out of the box that the 'back pain' portion might not go away. For me, Radiculopathy and Neuropathy. My surgeon goes more on that, and too numbness and weakness in the extremities. I know with mine, if I went in with only back pain as the presented symptom, he would turn me around to other measures...chiro, message, shots etc.

    Same for a hernia. If the pain is located to the back only, he would have you go through alternative treatment - if issues are shown not to get better *and* radicular or Neuropathic issues come up, possibly new plan. Lyrica is keeping me in check for now, but weakness has increased as has the neuropathy, ...but still gonna try and hold off. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Very interesting.

    I for one read all the articles and really believed that if I waited 2 to 10 years my back would heal on its own. I was willing to wait. Despite the blinding white stabbing pains shooting down my leg.

    Then the caudal equina symptoms ratcheted up.

    I had surgery. I had complications. I had another surgery. I have a numb leg. I had a hardware removal. More complications, (pain med allergies). Three back surgeries so far back there.

    And now...

    Doing SO much better that I can't believe I didn't get it taken care of sooner. ZERO CES symptoms post-op. And only infrequent back aches. ZERO flashing blinding shooting nerve pain down my leg.

    I think you just have to make a decision - if you hurt so bad that a daily backache seems like heaven comparatively, then go for it. (knowing that there are risks though, scary, dangerous risks).

    I honestly don't think we will ever be pain free. And I won't be rushing into another surgery (I feel like I've been beating the odds and am not eager to push those odds). But surgery worked for me and I can't imagine what my life would be right now if I'd not had surgery.

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