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L5/Sc1 Fusion.

copper123ccopper123 Posts: 4
edited 06/11/2012 - 9:03 AM in Back Surgery and Neck Surgery
Hello everyone.

I need someone to help me understand what I am about to go through, please! I consider myself with good intellect, yet I just can't seem to understand what will happen next.

I injured my back at work 7 months ago. I have tried the conservative method...PT, Chiro, Cortisone-Epidural injections and nothing helped. I also had 2 CT-Mylograms done which showed nothing but a bulge.
I decided to seek a second opinion and when I met with surgeon, I retold the tale of my injury and treatment thus far. He looked at the recent MRI and concluded that the last discography done, as read in the file, was done in the wrong disc.
He showed me the MRI and pointed to the disc(L5-Sc1) which clearly shows that all nucleus has leaked from within. There is nothing but an empty shell.
He scheduled a new discography for said disc, and briefly we talked about the possibility of that disc having to be replaced and or removed. (I can't recall which word he used) Possible fusion also.
I am 39, a few pounds chunky but otherwise in fairly good shape. My job was physically demanding, which I performed for 18 years until the day of the injury-Sep/5/11.
Can someone please help me. I know my description written above is somewhat generic but that is pretty much the synopsis at this moment.


  • I have some question because i have had a fusion and re-fusion that we both completely different. So first are they cutting from the back or the front (your stomach)
    2. Will they be using cages?
    3. Will it be the min. evasive surgery or will they cut you down the middle of your back
    4. Who is doing your surgery (i HIGHLY suggest a Neurosurgeon)

    Once i get the answer to these questions I can tell you what to better expect.
  • Eric....
    Thank you for your future help. At this moment everything is up in the air as we await approval from Work Comp insurance, which my attorney tells me it should be soon.
    I found the Ortho Surgeon here in this site, Institute for Low Back and Neck Care. They have been the only ones that have thus far giving me the most solutions out of all of those who I saw before.
    Again, the details of the surgery have yet to fully be ironed-out, but by the sounds of it; as I talked them over with my QRC, who was present at the time, she believes that it will be a fusion but other than that I don't have clear answers yet. Frustration within myself is at an all time high...not to mention stress.
  • Hi,

    It can be VERY frustrating not knowing what to do or what is going to happen. Are you limited to who you can see because its a workmans comp claim? If not then pick whichever Dr. makes the most sense to you and whom you feel more comfortable with. I disagree that a Neurosurgeon would be best. Who is best is who you feel the most comfort with and are getting good answers from. You need to ask about after care also and how itsw going to be handled after you decide what your going to have done.

    Whatever you chose to do has to make sense to you. I know I said that before but it is important. A lot of you frustration will go away once you are at ease with your Dr. Ask questions and ask some more until you understand what your being told and suggested. What you are talking about is a big surgery and even if it goes well you could have problems down the road. I would make sure there is not something less invasive you can do first even if it means another operation. The area of your spine that you injured is probably one of the most injury prone areas of a back as it carries the majority of the weight on the spine.

    I do believe there are a number of other procedures you can look at before having a fusion which is the last thing that can bedone. Maybe just have the disc replaced or have the disc bulge cut out of the way. These are all things you would need to speak to your surgeon about. They each have their own set of issues that come with them and they may not apply to your issues.

    You and your surgeon will have a better direction on what needs to be done after the correct disc is photographed. It sounds as though you have had discograms and mylyograms which are two entirely different tests. One shows what is happening at the disc area and the other shows where there are blockages in the spineal fluid at least how I understand things.

    Good luck on the next test. Let us know how you make out.
  • I disagree and agree with bkins. I agree that you need to get the best clear answer and a clear plan for surgery and recovery, HOWEVER i disagree that it doesnt' need to be a Neurosurgeon. When i was talking to my doctors, friends that have had back surgery and a chiropractor they all agreed that it would be best is a Neurosurgeon did the surgery because there were nerve damage. My pain management stated that he did not want me to have a neurosurgeon to do this procedure. All whom i spoke to stated that it would be best that a neurosurgeon do it because i would have to see a neurosurgeon if there were neurological problems.
    Now L5S1 is the sciatic nerve which is the major nerve that runs down your legs. Now when you mention Fusion i thought it was because of the sciatic nerve problems.
    If you are not having nerve issue (burning, tingling in the leg, toes, loss of feeling, sharp shooting pain, throbbing, ) then i would consider chiropractor for the surgery. As i stated before 1. get the information needed and which doctor has the best plan for surgery and after
    2. Ask the doctors themselves and you will be surprised what their response would be depending on your pain and injury
    3. Talk to people who has already done this research and had the surgery by either a chiropractor and neurosurgeon.
    4. Understand you injury, pain and cause. What it what they are trying to do , why that want to do it and what their percentage that the surgery they perform will solve (how much).
    Good Luck
  • Chiropractors CAN NOT do surgery! They are not medical doctors! Sorry Eric, but if a chiropractor says that they can perform surgery, I would RUN!
    2011 ACDF C5-6 for Spondylosis with Myleopathy
    2012 L4-5 herniated disc and hernated disc at C4/5 2013 Taking Amitriptyline for headaches
  • To all, thank you.....

    I do agree with some of the comments posted. My good friend is a Chiro and she CANNOT perform surgeries. She also said that it would be a personal preferences whether a Ortho or a Neuro. I do not show signs of nerve damage yet, but I am having the normal issues... tripping on my feet when walking, not quite lifting the leg while walking upstairs... feel like my spine is falling while squatting or sleeping on my back... on n on.
    As for pain and tingling, yes I have those also. If I stand or sit too long, my buttocks get numb as so does my tailbone. when walking for too long I get the tingling throughout my legs and calves and toes.
    All I know is that it has been 7 months and I am soooooooo frustrated I just can't put it in words.

  • @ Bkins....
    To answer some of your questions.
    I have not been limited to who I can see as of yet. Work Comp insurance has been ok thus far.
    They sent me to see an IME(Independent Medical Examiner) an he was the one that suggested the first discography procedure. He also is the one that told me that perhaps this will be permanent and that maybe my line of work is in jeopardy due to my injury. From there I decided to take the Bull by the Horns, sort of speak, and ask my Dr. for a discogram... as I wrote, the first one was in the wrong spot (L4-L5) therefore I felt nothing but pressure. I found out about the new surgeon I am now seeing through this site. He was the one that indicated that the MRI indeed shows that all the nucleus from L5-SC1 is gone.
    Therefore I feel I can trust him.
    As of where this goes from here, it is but a mystery to me. That is why I wondered if anyone could give me some info as of what I am looking up at, since all this is foreign to me.
    Again, to all...THANK YOU!
  • Kwilson400KKwilson400 Posts: 42
    edited 07/15/2012 - 4:34 PM
    Good luck!
    June 2011 L5-S1 Lamenectomy/Discectomy
    Dec. 2011 Repeat L5-S1 Lamenectomy/Discectomy
    June 2012 New tear L5-S1 w/ Perm. Sciatic Nerve Damage
    Currently- restrictions (including no work duties) for a min. of 3 months to allow disc time to heal
  • My apologies...i did not mean Chiro but Otho. So sorry i was thinking of the wrong practice but I still stand by Neurosurgeon. In my experince MRI's were less effective and telling the Contrast CT.Why? well i had 5 MRI's and then they did a Contrast CT and i was given a clear answer what was wrong. I was told that the imaging was clearer and defined vs an MRI. So if you could recommend it being done vs. MRI then i would do that. Not sure if that is something we/you could recommend. I am retired military(medically) so we really dont get to recommend to often.
    Kwilson give some sound advice that i have no experience on. I was bless to be AD during the time.
    She also restates what i already mentioned about the sciatic but i would like to add or warn you of one thing....once you start losing feeling in your toes foot or leg....you better start grabbing the attention of your doctors.
    I had to do a EMG and some other painful test done with electric conductivity on my nerves because i was losing feeling in my foot and legs.
  • Kwilson400KKwilson400 Posts: 42
    edited 07/15/2012 - 4:35 PM
    June 2011 L5-S1 Lamenectomy/Discectomy
    Dec. 2011 Repeat L5-S1 Lamenectomy/Discectomy
    June 2012 New tear L5-S1 w/ Perm. Sciatic Nerve Damage
    Currently- restrictions (including no work duties) for a min. of 3 months to allow disc time to heal
  • Eric, how are you now? Did the tests diagnose the problem? Are you still experiencing numbness? Have you had any form of treatment to relieve the pain?
    June 2011 L5-S1 Lamenectomy/Discectomy
    Dec. 2011 Repeat L5-S1 Lamenectomy/Discectomy
    June 2012 New tear L5-S1 w/ Perm. Sciatic Nerve Damage
    Currently- restrictions (including no work duties) for a min. of 3 months to allow disc time to heal
  • In addition to the advice you've already been given, I also suggest you choose a surgeon and facility that will provide you with an excellent aftercare program. It is so important to build up your core strength in order to protect the fusion site. A common after effect of a fusion is for the vertebrae above and below to take on all the pressure which can cause degeneration and need for more fusions. Strengthening your core and learning techniques to avoid further injury is very important after surgery. I worked with an occupational therapist immediately after surgery to learn how to get around without bending or twisting. Also, my surgeon ordered intense physical therapy (3-5 times/wk) starting in the 3rd week. It was very difficult at first, but I have recovered rapidly and I strongly feel I would not be in this good of shape without the continuous follow up care.

    I hope this advice helps. Good luck to you!!
  • all that i speak of has been in the past (thank god) i am doing 80% better due to the pain pump. I had surgery (4th one) on 6 Feb. No more numbness, very little burning to the point where i rarely notice is, very little pain (that is ignorable) little throbbing, little pressure. I am walking unassisted, working out in the gym 4x a week, off all medication but what is in the pump (morphine and bupivacaine). Life is beautiful and great now. This is almost 10 years in the making, going from 13 pills a day, countless CAT Scans, MRI's, EMG, 12 injections and other treatments. It would appear that the surgeries, SCS and pump work all together. There is still bad days but overall it is great. It has been a long struggle and battle with this. This is a brief time that i am going to enjoy. All my doctors told me that as i get older there is a high change that things will get worst. Until then i plan to live it up. How are you doing?
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