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Upcoming fusion on L4 L5 and need advice

My doctor and I have decided that I will have the fusion surgery. I have to do an EMG, CT scan, flex xrays and return to him for discussion. What questions should I ask? He said that he would probably do TLIF. I have had several MRI's done and also had discectomy last year at the same level. I have pretty much constant pain for the last year. I have gone the route of epidurals and radiofrequency ablation. I have taken physical therapy and now this fusion. I can't say that I am scared because I just might just be pain free after this (of course I will have plenty of surgical pain). I can't understand why I am having a CT scan and EMG. My surgeon is ortho spine and I have a great deal of confidence in him. Any hints for questions or preparation would be appreciated. Thank you.



  • JoeWJJoeW Posts: 36
    edited 11/16/2012 - 6:56 AM
    and my ortho said that a CT was a waste of $$ - he saw all that he needed with the XRAY's.
    XLIF 2-4 on 11-20-2012
  • Shell2ySShell2y Posts: 80
    edited 11/17/2012 - 9:40 AM
    Hi. I had an L4 L5 PLIF I. September. Re the scans , my neuro definitely wanted an MRI in addition to the X-rays - my view was that this was major surgery and the more he could see so the clearer his decision on the surgery and how to approach etc the better for me. My understanding is that X-rays don't always give the true picture of where and how nerves are being impacted. Re questions an s preparations, I found the post op must haves list on this forum great - my only amendment was nighties instead of pjs for a low lumbar fusions. Re questions - what surgical approach will he use and why ( so ask him to step you through it - is it going to include laminectomy, full instrumentation, cage and interbody graft etc and where will the incision be) recovery time, what you can do to prepare your body for surgery (there is also some really useful information on this site for that) ' where and how follow up visits , rehab and physio will occur, and how confident is he that this is going to be successful. Good luck and stay on the forum - I have found it a great support
  • I had a CAT scan as well as MRI before my ACDF. If the surgeon wanted a different view or approach in some area he might have wanted a CAT scan. I know from an EMG I had on my legs that I have chronic nerve damage at L5S1. Maybe your surgeon is looking for the extent of nerve damage?

    I want to thank Shell2y for the suggestion of nighties vs. pjs - I'm having an ALIF at L4-L5, L5-S1 next month. I have my pre-surgery meeting with my surgeon's PA on Tuesday and I need to get going on my list of questions. There is a lot of helpful information and good people on the site.

    JoeW - good luck with your surgery! What approach is your doctor taking? Any advice for us who are having surgery soon?


    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.
  • tran92ttran92 Posts: 183
    edited 11/17/2012 - 4:08 PM
    i have had 2 fusions, one cervical and one lumbar. for my cervical the doc went solely on the MRI and x-rays. But my lumbar, he had recommended the CT scan as well as the MRI and x-rays. I think part of it was because i had already had 2 surgeries in the same location and he wanted to make sure he knew exactly what was going on there.

    It was a big help too, as the MRI showed the herniated, but not the 1/2 long bone spur that was pressing into the nerve root. that showed up on the CT scan, and was the reason i had to have the fusion as opposed to another laminectomy.
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • Most of the work done from the side then screws/rods from the Back. I have one disk completely gone the other 1/2 so they use titanium screen with bone goo to Help the fusion take. They say I should gain almost an inch in lost height!

    Been doing a lot of reading / relaxing and walking as much as pain lets me. One more day of at work then Tuesday's operation. Don't see doctor again till January the 4TH for followup.

    Best wishes - Joe
    XLIF 2-4 on 11-20-2012
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