As the thread title says, I am contemplating L5-S1 fusion surgery and would welcome and appreciate comments and advice, particularly from those with a similar background to me in terms of motivation for surgery, age, symptoms and condition.
Firstly, I am an otherwise healthy 25 year old male who does not smoke and leads a fairly healthy lifestyle.
I have Grade 1 Isthmic Spondylolithesis with a bulging disc at L5-S1 and bilateral pars defects. PT and work in the swimming pool has worked for me in the past and I was able to get back to playing football, but the old tricks do not work anymore. I've also tried steroid injections / epidurals and they didn't work either.
I am never in agaonizing pain - it's more a case of finding myself in constant discomfort - usually mild, sometimes moderate, and occasionally extreme. Sitting at a desk all day and communting on the train makes it difficult for me to overcome this. I can walk as far as a normal person would in any normal day, but I start to get nerve pain in my hamstrings if I go on particularly long walks in the woods for eg.
However, for me, surgery is not about overcoming pain, or even discomfort - it is about getting back to doing all the things I love to do but can't anymore - running, playing football, tennis, long walks etc. I was always such an active and sporty person and it kills me only being able to watch sport on the TV.
The main reason I cannot partake in these activities is not so much pain IN my back, but referred nerve pain in my hamstrings and tightness in my hamstrings and glutes. I cannot seem to shake these problems, no matter what I try.
I am terrified of surgery. I won't have laser eye surgery out of fear that they could blind me. I've heard a lot of horror stories and the idea that the surgery could have complications that cause me pain and misery for the rest of my life is horrible to think about.
My prevailing thought has always been that, unless I am actually in agony or constant pain, then I shouldn't have the surgery. However, the idea that I will never be able to do all the things I love makes me miserable.
I have been seeing John Sutcliffe at the London Spine Clinic for 2/3 years and I trust him. He is extremely reputable and experienced, a lovely bloke, and a leader in the field. He has always stressed that surgery should be the last possible option and has, in the past, persuaded me against surgery.
Now that all the other options have failed, he has recommended L5-S1 fusion across the whole level. He has said that, were he in my position, he would have the surgery. He also said he has performed the surgery on a close personal friend of his.
In 2,000+ surgeries, he has never caused paralysis. The success rate of his fusions is around 90%, considerably higher for people of my age / health. In only three instances has the operation been a complete success and the patient suffered constant pain, the source of which cannot be ascertained.
I know that the recovery can be long. In an ideal world, I would be back to work in 4-6 weeks, starting part time and working back to full time. After three months the fusion would take and I could start physiotherapy and retraining the back muscles. However, I know it might not be that simple.
From everything I have read and following discussions with my surgeon, I have ascertained the following; that the operation is much maligned because it was performed indiscriminately in decades gone by for anybody with back pain. Unsurprisingly, many operations were unsuccessful. Furthermore, people are far quicker to come on to the internet for support when they are suffering, than after having a successful operation.
These days, with new techniques and better diagnosis, fusion is actually a reliable procedure with good success rates, both in terms of pain relief and successful fusion. However, like all things, there can be unforseen complications.
Has anybody been in my situation? Namely, considering surgery not for pain relief but in order to regain fitness.
I would generally appreciate any advice or comments anybody has and would be interested to see if anybody disagrees with anything I have said.
I have spent months debating whether or not to have surgery and I still have absolutely no idea what to do.