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Forum Input Regarding TLIF Revision Surgery

airborne72airborne72 Posts: 245
edited 06/11/2012 - 8:59 AM in Back Surgery and Neck Surgery

I send SueD a private message last week asking her for her advice regarding my situation. She responded with a detailed message, and she also recommended that I post this question to the Forum.

I had a TLIF (L4-S1) in Jan 11. For a couple of months it was a great improvement, but then I began to develop pain in my legs and lower back. It has continued and worsened (controlled by Percocet 10/325). MRI, CT and Xray show bone growth. EMG detected minimal nerve damage. PT did nothing. At my 1 year anniversay appointment last Thursday with my surgeon he listened to my symptoms and then stated that I most likely did not fuse and that he recommended another surgery to perhaps replace some existing hardware and to insert more. I asked for another 60 days of healing time. He ordered me an external BGS to wear during this time.

In March I see him again and must make a decision, one that some of you have made - defer or submit to surgery. By the way, I trust my surgeon. He has been very communicative and loyal (has yet to release me).

Here's my questions: 1) Was your revision surgery as brutal as the original (pain, hospital stay, limitations, etc.)? 2) Did your insurance company balk on the "revision" procedure? 3) As a veteran of these types of surgeries, did you struggle with mental acceptance/preparation? 4) What did your surgeon say about the revision procedure that offered any higher level of confidence of success than was stated prior to the original fusion surgery? 5) Did you seek second opinion or did you use the same surgeon?



  • Hi Jim,

    Sorry you have to make this kind of decision yet again.I know the mental anguish your going thru as I just had a revision fusion done L4-L5 on Dec 27TH.

    To answer your questions 1)I won't lie yes the pain
    was just as brutal,but in a way easier as I had a fair idea of what to expect unlike the first time.

    The hospital stay sucked,I don't think I got more that 20 min of sleep at one time the 4 days that I was there,constantly being poked prodded vitals checked...ect. My limitations are same as the first time no BLT 5-10lb max. My first surgery was done as out patient.

    2)I didn't have any problems with insurance.

    3)You bet I struggled with it,who wouldn't,these surgeries aren't exactly a cake walk as you know. For me it was more of a question do I want to live in constant pain or do I take a chance and try for a pain free or even moderately pain free life.

    4)My surgeon didn't offer me any percentage of success he only stated that it may work or not,no guarantees. I was ok with that I like getting information straight as opposed to it being sugar coated like it was the first time.

    5)My first surgeon abandoned me after my first follow up and from then it took me awhile to find a surgeon that I was comfortable with.as it turns out I got lucky and found a great one that specializes in revisions.

    So far I'm happy that I went for it I seem to be bouncing back faster mobility wise in my recovery,as for pain it's still to early to tell but I'm optimistic about that as well.

    What ever you decide I wish you well.

  • How in the world could you undergo this type of surgery (initial) as outpatient? Did they escort you out the front door and then sneek you in the back door for additional restorative care?

    Hope your ultimate outcome is better and beneficial. I just thought the first "surgery decision" was difficult. Subsequent surgery decisions are even more so and I can only imagine that the waiting time for evidence of benefit can be excruitingly slow. Good luck.
  • With the first surgery outpatient isn't quit accurate.I went in at 6am and went home at 6am the next day. as far as insurance is concerned it's considered outpatient
  • Did you have BMP during your fusion surgery? That affects how I would answer your question. I had a TLIF L4-S1 with BMP. No fusion, wore BGS, many complications. I would have different perspective if I did not have BMP.
  • ER Nurse:

    My surgeon noted growth on an xray 6 weeks after my surgery. He was happy and I was too. He never recommended a BGS and I suppose that type of continued diagnostic evidence did not support the use of one.

    But I am clueless about what a BMP is in medical terms. I remember it from my days in the army, but it had an entirely different meaning (Soviet light, mobile, wheeled assault vehicle). Some things we never seem to forget; others we never seem to remember.
  • a compound that encourages bone growth(fusion). bone morphogenetic protein
  • Ernurse:

    I am on the road. When I get back home I will review my med records. However, I do know that the surgeon used the bone fragments that he extracted from my spine. He referred to it as "going green" and recycling my bone.

    By the way, my favorite Jackson Browne song is "The Pretender." Specifically the verse..."And when the morning light comes streaming in, I'm going to get up and do it again." This can be a very painful philosophy for a Spiney - unless we alter the way we go it again.
  • Jim-ROFL! It is a great song. Thanks for the spiney spin to it, needed the laugh tonight!
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