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Advice kindly required pre possible L3/4 spinal fusion

Hello all. Apologies in advance for what I know will be a particularly long post. I am a seasoned back pain sufferer but yet this is my first attempt at contact with fellow patients.

My name is Amanda. I am a 27 year old cardiac nurse in the NHS.

I have suffered with back pain for about 15 years or so. I also come from a long line of back sufferers. As a teenager/young adult I would experience regular mild pain which I would treat with a visit to the chiropractor/osteopath once every 3 months or so. I generally didn't think a tremendous about it although I was aware that it was there. Then I trained and qualified as a nurse. In may 2009, only 6 months after I had qualified, I noticed a sudden and severe escalation of symptoms, particularly in my legs that required 3 months off work and extensive pain relief etc etc etc. MRI showed at this point a degenerative L3/4 and a large prolapse impinging heavily on the nerve roots. Those fellow NHS patients will understand that the wait for diagnosis and treatment at this time is just soul detroying. It took 7 months since onset of pain and much physical therapy and a tentative return to work on light duties to evntually get my first steroid epidural (woohoo).

In actual fact that first epidural worked quite well. I was able to rehabilitate and very very slowly get back to work. It took me another 9 months to get back to work full time and on full duties (and by full duties I mean 13 hour shifts and lots of manual handling, hours on your feet in stupid positions and just occaisionally having to pick up a fully grown man by yourself because there is no one available to help... Sad but it happens). I was back as a 'proper' nurse for a whole two months which takes us up to November 2010, before I had a particularly heavy set of night shifts. Suffice to say that will be the last night shift I ever do.

I noticed a dramatic difference in the quality of pain at this time, and not just from the reherniation. After a hospital admission, repeat MRI and bilateral steroid epidurals, I finally got to have a disogram, which proved to be very positive at L3/4. By this time I also had an degerating L1/2 although I did not have a discogram on this. I was firstly offered a disc replacement which I was terrified of (a little knowledge is a bad thing) and actually in the end my surgeon decided it would be too high up in the abdomen so a little too risky. He then offererd me a spinal fusion, which I was also terrified of. You hear nothing but bad of them from other health care professionals such as physios. So we went for a minimally invasive discectomy in May last year, with the full understanding that due to the degneration it may not cure all pain and that the end game would probably be a spinal fusion.

Surgery was a success. I noticed a rapid relief of leg symptoms and a little of back. I was able to get back to work, albeit on much ligher duties and shorter days. I will never be a proper ward nurse again. I also dedicated much of my time to keeping fit and keeping the pain at bay. For about 6 months I went to the gym 4 or 5 times a week (I didnt have a boyfriend at the time!) I became fitter than I have ever been and may ever be again. I could do the plank for over two minutes. Then life got in the way of this unrealistic level of commitment. Who really has time to go to the gym 5 times a week?! I got a boyfriend, moved house, had exams to do. Within a couple of months of not getting to the gym regularly, altough still doing almost daily core exercises, the pain returned. A repeat MRI two weeks again has shown a reherniation. The good news is the L1/2 doesnt seem to have got any worse. The bad news is there is now athrosis present in the facet joints.

Now onto the question part. Im not going to bore you all much with how much this has affected my life. I think that is obvious for us all. It has virtually destroyed my beloved nursing career. I am 27 years old, and I have never been travelling. I dont think theres many countries that would happily let you in with that much tramadol. I have never been to a festival. I have been on antidepressants for three years. I am in thousands of pounds worth of debt due to going off sick so many times without pay and having rent to pay and food to buy. So.... What do I do now?
My surgeon has made it very clear that the only next surgical step is a spinal fusion. I am very apprehensive about this surgery. Not only for the surgery itself but for the possibility of it either not working or, heaven forbid, making it worse. He has already told me the possibility of accellerating the possible degeneration of L1/2. I am seeing him in 3 weeks but I just wanted some advice really, from people who have been in possbly a similar situation. Has anyone regretted their surgery? Or found it made their pain worse? Are there any other younger sufferes who waited and in actual fact it got better in their 30s/40s? I don't have any children yet but I would certainly like to in 5 years of so - how was this impacted on anyone with young children? One of tharguments I can see for having the fusion now is actually that I am in a position to take some time off work and recover properly, without having to run around after kids. I assume ts must be terrible. Also I am still relatively fit (I can still do the plank for over a minute... I just can't walk :) ) , is it perhaps better to do this now when I am young/fit and have time to recover fully?

I appreciate that I have to discuss these anxieties with my surgeon (who is Khai Lam incidently, if anybody from the UK is also under him. Hes amazing). I would so much appreciate any advice/thoughts/suggestions from anyone else though who has gone through/is going through similar. I also appreciate there are many of you out there with far far worse spinal disease, and you have my utmost sympathy. This is however, decision time for me. I want to do whatever it takes to try and get back to living my life. If this is even possible.

Many, many thanks in advance for your responses and your time reading this.


  • RTgirl2011RRTgirl2011 Posts: 512
    edited 07/25/2012 - 6:55 PM
    I am respiratory therapist was tremendous back problems. I had two microdiscetomies before I had my fusion. I had a recurrent herniated disc at L 4-5 which left me no choice but to have a fusion. My only issues now is I had tears in my L 3-4 and L5 S1 which has caused them herniate due to pressure from the L4-5 fusion. Unfornately, I had a fusion at L3-4 two months later. I am also having an MRI on Monday to see how badly my L5 S1 has herniated. Since I am having symptoms like sciatica and numbness again. If you had a fusion it may very well affect your L1-2.

    I am 32 years old. I know how feel about losing your career and having tons of debt pile up. Here in the states it seems impossible to find a job once they find out you are patient that has had back problems. If you have anymore questions feel free to ask. i will answer anything to the best of my knowledge.

    Discectomies 05/08 and 04/11, fusions L4-5 Feb 9,2012 and L3-L4 June 28,2012, Staph infection washout 3/2/2012, Bulged L5-S1. SCS trial on January 17th, 2014, which was a success! Permanent SCS on February 20th.
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