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Surgery ???

blazerblazer Posts: 785
edited 06/11/2012 - 8:52 AM in Back Surgery and Neck Surgery
Update: i had a 2 level l4/l5 l5/s1, on 3/19/10. TLIF
Most recent CTscan 1/11, shows l4/l5 completely fused.
L5/s1, no signs of fusing.
I get another CTscan in 6/11, and see my NS on 7/6/11, and was told if no improvement, i will need a ALIF with a plate put in there. I assume to stabilize my spine.

O.k. my question is, and i looked around this site and could'nt find an answer.

Is that a necessary surgery?
Meaning are there any future compliciations if i dont get that surgery, or if w/c will not approve the surgery.
Can my spine just stay in that condition, or will i eventually be worse off, then i am now.

I'm well aware these are just opinions, and there are no Dr's here.

Thank's in advance.


  • How do you feel? Is your pain getting worse, or are you functioning OK, and its just a matter than the films don't look good? Why did you have the fusion in the first place? Where there any suggestions of bone stimulator or is there a danger in waiting for second level to fuse? I have seen some research that suggest your body can still "fuse" between the first and second post-op year. I would guess that if your solid at one level (L4-L5), that puts the adjacent levels (L5-S1, and L3-L4) even under more stress, so it probably is going to need "something" done at some point. If they are suggesting a plate, they are probably concerned that one vertebrae is slipping over the other, which yes, does need to be fixed.

    I think if I were in your boat, I would wonder 1) why didn't I fuse the first time (activity level too much, smoking, NSAIDs etc.), and make sure that doesn't happen a second time and 2) what are the risks of a second surgery? Is there something that can be done differently, i.e. BMP, Mastergraft etc. to make sure you fuse the second time? Most surgeons will tell you second or revision fusions are much less predictable than first surgeries, so you are appropriately concerned.
  • Thanks; and yup my pain levels are the same as they were as before i had my 1st surgery.
    Bad pain in back and butt area. And pain down left leg. Also the cold wet feeling in parts of left leg and right leg.

    I have fused before 2 cervical fusion in the early 90's and now the l4/l5, I do smoke, but i wonder if i did to much to soon regarding movement. After my back surgery.
    NS put BMP in the disc space, and i used a BGS, for 6 months. And a back brace for 4 months.

    If i do need another surgery, i will be in a worse situation then from the 1st one, cause my kids live with me, and my son is buying a house with his fiance, and they will be gone, so it will just be my daughter with me.

    And my fiancial situation is getting worse, as this house is gonna be foreclosed on pretty soon if it dont sell 1st.

    So i guess i just hope for the best, and wait to see my NS in july.

    Thanks again.
  • thats no good you still have all your pre surgical pain still happening..... that may give you an answer there to your dilema

    you have some time before you see your surgeon and if you decide to go ahead with surgery, try to schedule at a time that isnt so stressfull, re house, and organizing things , so your recovery will be in the most beneficial state that you can make it

    sorry your having thses difficulties
    hang in there
    ohh and ask the surgeon, if you dont have surgery, what is the likely scenario, its your choice and you dont have to have it , if you feel strongly enough that you dont want it
  • Hi; and thanks.

    Yup, i think i know what road i'll be heading down.
    To the operating room again.

    Guess i was just hoping for other options. With this being a w/c injury, my financial and having a home for my daughter and myself situation will not get any better until i reach MMI.
    Every day i'm in so much pain i cant function and would like to go lay down, but i never do because thats just not me.
    I've always worked all day long, i just cant get used to not doing anything.

    I'm gonna ask NS what will happen if i dont get surgery if i need it, but i dont think he will have any good answers for me.

    O well, anyway what are your doctor's telling you?
    Is there anything they can do to make you more comfortable? Hpoing so for you.

    Thanks again, and my best to ya.
  • Howdy Jim,

    Sorry to hear you're going through this. I'm about to get updated MRI's, blood work and nerve conduction all redone to see where I am at. Since I had a cracked vertebra, chances are there for me to hit the OR again too. Since I don't know, I have been doing the what ifs in a calm fashion. I pretty well know my answer if I am still cracked.

    I'll also find out if my back needs to be done. Sigh.. I relay this Jim because internally "we" "our bodies" know the answer. Again, sorry you're in this boat.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • your not use to laying down and resting, but you no it may give you some relief from the pain, prhaps you could give it try

    thanks for asking about me , i just got off the phone with my dad and told him about my disease and there being no cure, then i started crying

    its kinda funny, he quite old and doesnt like that he cant walk as far without some mild pain, he walks 5 klm a day

    anyway he told me not to give up hope

    well you never no jim , you may still fuse that level yet, and if not , considering you have had succesfull fusions , if you decide to go ahead , all may turn out really well

    take care
  • I think we are in the same boat blazer. I was about to ask the same questions that you asked.I had the same back surgery on 01/09 l4 l5 s1 .well the w/c sent me to a QME doctor and he is saying that l4 l5 is not fuse .I told my doctor and he recommended a ct scan which i did but i don't have the results yet. i have a feeling that there is still something wrong with my back because I can't stand the pain. I really don't know what i am going to do . if the ct scan is positive .that means more surgery?. we are in the same boat together.
  • Brenda, hi and i fully agree. After you go thru this one time you dont forget the sympton's or pain. You know whether you wanna admit it or not what road your gonna be going down. Good luck with your future Dr. visits, and hope for the best but expect the worse.

    Flower, i wish i could offer a resolution for your pain, but i cant, i can only offer support for you.
    I can totally understand your dad"s feelings. When your child hurts we as parents also hurt.

    payo,yup the pain is the same, and with me even if i push on something i get the sharp pain in my lower spine,and i can feel the instability.
    Good luck with your ctscan, but like i told Brenda you will always recognize the pain, after you have gone thru it once.

    If we get a designated driver we can drink some beers on the boat.

  • I am really sorry to hear that you are facing another surgery. @)

    I agree with flower, that you should try lying down when you have bad pain. I find that it really helps me, and after 20 or 30 minutes, I am generally able to carry on much more comfortable.

    I would imagine that if you don't get that level stabilised, the pain will just get worse.

    I really hope that you can find a solution that will set you on a new road to getting your life back.

    You may have read that I am having problems with my neck now, but hoping that conservative treatment can help me without resorting to another surgery. There are 2 discs indenting my cord though, so not sure that they will be able to get them to pull off the cord.

  • blazer said:
    Brenda, hi and i fully agree. After you go thru this one time you dont forget the sympton's or pain. You know whether you wanna admit it or not what road your gonna be going down. Good luck with your future Dr. visits, and hope for the best but expect the worse.

    If we get a designated driver we can drink some beers on the boat.

    Thanks very much Jim. I have the MRI's on Thursday, and the blood work on Friday. The Neurologist assessment and nerve conduction is on the 13th next month. Tick, tick, tick, tick (as time goes on!)

    Make sure there is some Bud Lights there my friend! (G)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • blazer... make room on that boat for me too!

    I am also facing another surgery due to non union, I am only 8 months out from original stand alone un plated ALIF.

    Ok, so I am in the mist of a crash course in non unions, I want to share what I've learned.

    First, the ct scan is as good as it gets for determining fusion status. Please also ask your surgeon to take plain film ext/flex (if you haven't had recently) as this is a good way to determine if there is any micro motion / instability in the segment.

    I just learned via ct scan & xrays that I have significant motion at my surgical level. This instability is causing me pain both in legs & back. I also am not fusing, I have fibrous (scar) tissue growing where the bone should be.

    I have been offered a surgical fix 2 out 2 surgeons. For ME it appears that another surgery is the only way to fix the problem.

    While I am contemplating my next move, do surgery now, or wait a little longer, try a BGS, which I haven't had, and see, although it seems unlikely that waiting will help, my OSS has placed me back on full BLT restrictions and also back in my brace, to STOP the micro motion as much as physically possible.

    Perhaps you can ask your NS if wearing your brace, resting & avoiding BLT will help you. I know its hard, but I've been 6 days in brace and my back pain is improved :-) . So for me, YES the instability, the micro motion = pain :'(

    I am very sorry to hear that you are in this position, because it just plain stinks!

    You have a little time before your ct scan, I pray that maybe a little fusion miracle is possible for you.

  • Brenda; Let us know how your appts. go. And you got it. Bud lights, for you and miller lite for me.
    But we still gotta find a driver.

    Jelly, hi surgery twin.
    Yes i read your post, just i havent been posting much lately, Sorry Hoping they can get the disc's off the nerves for ya. Thinking that they might offer you to do traction therapy, to see if that works. They tried that on me in 1992, for a cervical but it didnt work. So that might be an option for ya.
    I know i should lay down and take'r easy, which i do relax in the evenings watching television, but that is the only time.
    A big opstacle is acceptance for what it is. And dealing with the situation at hand.

    virginiap; hi and sorry that we both are dealing with this non-fusion.
    You will probably need to get a plate put in there also.
    I can feel the instability in my spine. And it's painful as you know.
    The PM i go too is also a spine specialist and he told me to put my brace back on. I showed him also the CTscan and he said i will be needing a alif as did my NS. I guess i know the answer, just looking for a way out of it.
    My back does feel better with the brace on, like you it prevents movement of the spine.
    I'm getting the same pain in all the areas that you are.
    And when i look at the CTscan, you can clearly see where i'm fused and where it is not fused, so there is no denying the facts,
    Well best of luck to ya, and i'm sure you will probably have your surgery 1st. I guess if we need it, might as well get it over with.

    So will see if the next 2 months, a fusion happens or not. I'm not holding my breath tho.

  • Jim,

    Beer is set, my hubby will drive! We might think we are drunk though as he will be zig zagging and having a blast! Will do on the appointments.

    Braces. As you know, no back surgery here yet but I have found what helps me if I go shopping with the hubby and think I might stand with nowhere to sit? I have an under clothes brace a little firmer than you see the Home Depot guys wearing. Not a fix, but it makes a huge difference. Maybe you can put one under your hard brace? Double duty?

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • The brace i have is an Aspen, and the hard turtle shell can be removed, so you just have the soft brace.
    My PM told me it's o k to take that out and just wear it as a soft brace.
    That makes it a little more comfortable to wear.
    Altho it is still a little bulky.
  • Jim,

    I've seen the Aspen back brace online, but didn't look real hard, so didn't realize it was a dual brace if you will. (G) At least my thoughts of 'soft under hard' wasn't too far off the mark!

    Me, mine is just to give me some staying power as I am trying to put off my back as long as I can. :)

    PS, you know we are playing post ping pong right now? My thread, your thread, have a thread! Sorry, couldn't resist!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • on the post ping pong.

    Havent done that in a long time.
    I'm here everyday, but because of alot of stuff building up, with everything going on here i'm just not in the mood, or the right stage of mind to post or respond to other people's post's.
    Heck i got a stack of bills i gotta get going on, and pay, before the utility co's get mad at me.

    But just kinda go thru the day zombie like, if you can understand that.
  • Jim,

    I hear ya big time! Last week I was a 'bed bug' for a couple of days, didn't even get on the computer! And yeah, when the pain ranks on the high scale, maybe will read, but won't post as I sometimes just don't get out what I mean to! So "Roger that", I get it for sure!!

    Today or tomorrow is my Billpay day online. I've already organized what I need to pay, but haven't gone to my bank online to input the money - might do that tonight! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I pay bills online also.
    Then i get out the paper shredder and shred the sheets with my personel info. on them.
    The motor in my shredder is gonna get a work out today.
  • I also have the two part Aspen quick draw brace. Blazer, my OSS said would be optimal if I could do the full (add the hard shell) but if not the corset is better then nothing.

    Brenda, my Aspen looks soft in front, but even without the shell the back is mighty stiff, it has bars in the back. Very pricey, I believe my medical insurance carrier paid over $2000 for it, that was the insurance discounted rate! Steep! Prior to surgery, about 5 years ago I bought a Muller lumbar support brace and it is pretty supportive and its held up nicely. Was about $50.

    Blazer, yes we need to keep each other updated on our progress, ok. Comfort in numbers, sorry it has to be something as devastating as surgery. Yes, plate for sure. My original ALIF was supposed to include an anterior fixation plate but during surgery NS opted not to use it, makes me wonder, had he used it would I have this micro motion.

    I have a recent thread, "fibrous non union & micro motion" detailing what OSS wants to do. Spinous plate, facet screws, facet fusion & foramanotmy. Due to my petite stature, he will not perform a PLIF.

    Again hoping & praying that something **FUSION** happens for you to avoid another surgery.

  • I just emptied the shredder shreds - messy. Mine does that cross cut, so the pieces are tiny. My hubby and I also have a 'burn box' that we fill. Once the dry season is over, we get a glass of wine and burn all that crap in the Chiminea.

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