Hello everyone i need some help in choosing between surgeries. microdiscectomy or fusion. Here is a brief summary of where im at
26y/o male. First herniation was dec 08, was due to work related accident.(firefighter)
Had microdiscectomy march of 09 with one of the best surgeon in florida
I was in great shape before the accident, so i recovered pretty quick. And was back to working full duty.
Not long after low back pain started. Nerve pain would come and go but low back pain always there.
Back pain got so bad that it would feel like the muscles were torn off my spine whenever i would have to do physically demanding training at work.
March of this year i had to leave the job i loved.Then Things seemed like they were getting better over the summer until a month or so ago.
I had to be taken to the hospital in severe pain, MRI shows re-herniation at same level. L5-s1
I am unable to stand straight, walk for more then a couple minutes or sit. I know that surgery is def needed.
My problem is deciding between fusion and another MicroD.
I have been told by half the Docs i have seen to avoid fusion at all costs and the other half says it could potentially bring me back to the level of fitness/shape i was before the original accident. If everything heals correctly. As we all know back pain/surgery is not black and white and this obviously leads to confusion. To make matters worse it is highly profitable and alot of people take advantage of that. Because of that i have noticed that so much of what i think is actually research studies online turn out to be paid and sponsored by certain companies. This is a shame because honest people who are looking for rational statistical information in their decision making process get dooped into the wrong procedure.
So my main problem is trying to decide which procedure will provide me with the best long term results without having additional surgeries. I would also like to chose the procedure that will allow me to return back to competitive sports/fitness. Fusion or a second MicroDiscectomy? At this point i am leaning towards having a MIS TLIF fusion. Some reasons are, my first MicroD left me with chronic low back pain, i could not be as active as before the surgery and it eventually re-herniated. Also, it seems to me that high level athletes seem to go the fusion route. (tito ortiz) (Nate quarry) these are UFC fighters but i have heard of some football players doing it. Is this because a fusion if healed correctly is better? Another reason is i really do not want to have another microD just to have a fusion down the road. I cannot afford the disruption in life of back pain and another surgery down the road. I lost my job and many other things because of the first. Now i have to start over so i feel like if i have to have surgery it better be the last time.
Some of the things i am worried about are.... The adjacent segments going bad after fusion. I have heard this is almost ALWAYS the case by some. Others have said L5-s1 isnt much of a motion segment to begin with so its not that big of a deal. Also, my first herniation was caused by an injury not genetics so wouldn't that be in my favor as well? And last but not least having a fusion and ending up worse off, i know its rare but still a concern.
I guess the moral of the story is would a fusion allow me to be more active then getting another Discectomy at an already damaged level. Im sorry for my disorganized rambling. It is tough putting together well structured thoughts under immense stress and pain meds. Oh did i mention i am trying to decide before thursday, that is when im set to have the MIS TLIF. lol
Thanks in advance for whoever responds. It would be a great deal of help to hear from people who are around my same age that have had fusions and continued with high level athletics, fitness or physically enduring profession's. Thanks again! - Ryan