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I have a really stupid question, but it's an important one.

OK, here goes, the disks between l5-s1, l4-l5, are bone on bone and l3-l4 is getting there. (and yes it hurts) My question is, if i can live with the pain, for now at least, is surgery REALLY necessary? I have not seen a surgeon or anything, my family doctor (who is a retired osteo surgeon) just referred me to pain management and pain management has simply kept me on the same meds as the family doc, which is 3 10/325 percocet, 3 10mg baclofen, and 3 800mg ibuprofin a day. I tried Cymbalta but it made me sick, AND i don't have the sciatic type nerve pain. Any thoughts or idea's would be most welcome 8-) Thanks!


  • dilaurodilauro ConnecticutPosts: 9,865
    is never good. Even if you can deal with the pain, that condition can potential make it very difficult to perform surgery at a later date.

    I would definitely discuss this with your doctor(s) to get their formal medical input. Mine is only base on personal experience.

    I do know specifically, that when I had both of my shoulders totally replaced, the surgeon told me they needed to do the surgery BEFORE the Bone on Bone condition went to far. If it did, he would have a very difficult time doing the surgery with a level of success.

    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • None of us likes or wants pain. But we lo don't want surgery either, normally. So when is enough, enough?

    A recent post discussed this extensively and there have been many others. Lots of factors affect the decision making, as you know. And it's an individual one. The risks are high for surgery. A book I recently read stated; "If a patient has complicated spinal reconstructive surgery, the worst case is as bad as the worst cases can be."

    The question may be; Is it really worth the risk? Many of us have said; 'YES'. However, their are also many that now say; 'NO, it wasn't, I wish I had fully understood the risk'.

    I had ongoing nerve damage with motor function loss (some leg muscles stopped working - partial drop foot) and managed sciatic pain. It was still a difficult decision.

    Hope this helps.
  • airborne72airborne72 Posts: 245
    edited 11/02/2012 - 5:31 AM

    I totally concur with the comments that Ron made. My L4 - S1 verts were touching because my discs were gone. I lived with the pain for several years; rarely had any sciatica because there was nothing left to herniate.

    When I finally elected to have surgery the surgeon had to sew up his first incision and then seek permission from my wife to modify his surgery because my spine was a mess. He could not accomplish the fusion as planned because he could not gain access as planned, which was based upon photographic analysis. He tactfully mentioned to me after the surgery that I had probably waited too long.

    And, I also agree with the comments made by DaveFusion. This forum has several threads regarding the issue of "spine surgery or not?" Read them all.

    Good luck with your pain and with your painful decision.

  • FrancineSFFFrancineSF Posts: 318
    edited 11/02/2012 - 6:11 AM

    I am by no means an expert on the subject, but you also have to consider being on any drugs for long periods of time. While it may allow you to manage things for now, the truth is, there are also far too many known and even more unknown long term consequences to the drugs and the doses (which I imagine will increase over time as you build up resistences to current doses).

    If you haven't seen a qualified doctor recently, it sounds like it is time. I don't know when you had your previous surgery, but if it was a long while ago, so much has improved in the way of helping to anticipate what is needed before surgery.

    Of course, there are risks either way.
    I sit here in my Miami J Collar, just one week after my C3/4 and C4/5 fusion.

    I wish you well.
    10/26/2012 ACDF C3/4 C4/5 surgery
    No pain; no pain meds - thank goodness!
    04/01/2013 - 5 months + 1 week - FUSED
    Doing some physical therapy for even better range of motion
  • My last MRI showed the l5-s1 disc had collapsed. I too was getting heavy low back pain, but most of my sciatic pain had gone away. (still had compression on a couple of nerves from herniated discs, and a bone spur, but it wasn't causing issues.) i had been putting off the fusion after 2 laminectomies for about a year and a half. i tried all the conservative treatments, and the last flare up which lasted 2.5 months was the final straw. i couldn't take the daily level of pain and finally told my surgeon i was ready for the surgery. had it in june this year. so far. i'd say i am better than pre-surgery, but not great. i don't take as many narcotic pain killers. i can get by without or with motrin for now. so that is an improvement. i can stand around for longer periods of time. standing at my daughter's soccer games no longer put me in bed for the rest of the day. but i still hurt, i still stiffen up as the day wears on, and by 6 or 7pm i don't want to know from anything but my bed. i don't regret the surgery. i wish i had less pain overall, but i'm doing ok.
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • Thank you everyone for your kind thoughts and advice, i really appreciate it. I guess I've got some thinking to do. One other issue is, I'm the breadwinner and being off of work for more than a week will for one; cause a massive problem at work and two be a financial disaster for me.
  • Hi there, Pain --

    I am not sure if you are an employee or own your own business, but if you are an employee, I believe you can apply for disability during the time you are out. Of course, it is not the same as if you are making your full wages, but it can help.

    Unfortunately, I own my own business and I am not able to apply for disability.

    If you had not thought of that, I wanted to pass along that option.

    Mostly, it seems like you need some more current information and assessments and can start planning ahead since you are still functioning.

    I wish you well.
    10/26/2012 ACDF C3/4 C4/5 surgery
    No pain; no pain meds - thank goodness!
    04/01/2013 - 5 months + 1 week - FUSED
    Doing some physical therapy for even better range of motion
  • After reading FrancineSF's response to my post I read my post again and realized that it may have been confusing. Let me clarify.

    I did have a two level fusion (L4-S1) while on the table. The change in plans was that orginally it was supposed to have been a minimally invasive surgery, but that changed when the surgeon realized what he was actually dealing with.

    Now I am 22 months post surgery and my pain level is higher than it was prior to surgery. I currently take percocet on a daily basis (3 x 10/325). Prior to surgery I took aspirin. I can no longer stand erect and as the day progresses I list forward even further.

    Bedtime has been moved from 9 p.m. to 8 p.m. My body demands at least 10 hours in the supine position. Getting out of bed is one of the more painful, mentally challenging things I do. It takes about 1 hour for the first pill to kick in. I keep reminding myself of all those who are worse off than me, and then I stop moaning and attempt to do something for the good of mankind. It may not be much, but it allows me to focus on something/someone else besides myself.

    I am trying as best I can to make that same "quality of life" decision regarding a revision fusion. It's a tough place to be.

  • Thanks for clarifying, Jim. I really hope that you are able to get done what needs to be done and that you are finally out of pain. What an awful way to wake up each morning. You've got the right spirit and I hope it all works out once you decide what you need to do. - Francine
    10/26/2012 ACDF C3/4 C4/5 surgery
    No pain; no pain meds - thank goodness!
    04/01/2013 - 5 months + 1 week - FUSED
    Doing some physical therapy for even better range of motion
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