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L4-L5 Fusion with Possible L3-L4

Here it goes. I've dealt with back pain for the past 7 or so years. I'm a slightly overweight 30 year old female but otherwise healthy. Until last December, I had had no doctor take me too seriously about my back pain. I had a herniated disc at L4-L5 in August of 2010. I healed from that meaning that I had no more pain in about 6 months. I went back to work 1 week after disc was herniated. Lo and behold, I started having pain again in August of last year. It started out mild and my PCP thought I had arthritis or something mild. She tried ibuprofen, Ultram and finally Lortab in December before I got relief. After a couple of refills, she sent me for a MRI in January. Her nurse called a few days later and said "Your back is pretty screwed up. You need to see a specialist." I made the appointment for my neuro for February. I had to get a copy of my MRI. When I looked at it, I knew something was very wrong. After some examination from my neuro's assistant, the doctor came in. He introduced himself and said follow me. He told me my only option was a fusion. It's beyond repair. He told me he didn't expect me to be walking after looking at the MRI. I was dumbfounded. Shocked. He refilled my meds and we tried epidural shots. They gave me relief. The pain in my legs was tolerable finally. He refilled my pain meds and told me if I needed anything beyond this, I would have to go into pain management. I've been in PM since June of this year. I've had 2 series of epidural shots through the PM doctor. I'm on Robaxin 500 mg 2 times a day, Neurontin 300 mg 3 times a day, Percoset 10/325 4 times a day and morphine 15 mg at night only. I have an app that reminds me to take the Neurontin and Robaxin. My body lets me know when I need the pain meds. I have a couple of concerns. First, my last set of epidural shots was at L4-L5 AND L3-L4. I had this terrible pain in my hips. It felt like a hot cattle brand was being pushed into my hips. So PM decided to try the L3-L4 level and it worked. I have a lot of relief from that. Does this mean that disc is going out too? If so, would you get it fused along with the L4-L5? Considering I went back to work and toughed it out only 1 week after the herniated disc, what is the time look like going back to work after a fusion, both 1 and 2 level? When I used the measurement tool on the MRI, it looked to be 1 mm long and 1.2 mm wide. It balloons into my spinal canal. I know I need surgery. I'm not debating that. I'm just scared $hitless (sorry for the French but that's how I feel at this point) of this surgery. I know my pain level after couldn't be anywhere near what I experience now. Going more than 6 or 7 hours without taking my pain meds is extremely difficult. One day I ignored my phone for whatever reason and didn't take anything until well into the afternoon and the pain was unbearable. I'm scared of how long I will be out of work. I have a desk job. If I didn't have this, I couldn't work or have the insurance to get this done. I'm worried because I only have 2 weeks of paid time off between sick time and vacation time. If it's beyond that, me and the hubby are screwed. My check pays for gas, food, etc and his pays the bills but barely. I put off the surgery until next March because my company's insurance plan renews then and I'm switching to a high deductible health plan so for $3000, my surgery, PT, meds, etc are covered 100%. Any help is appreciated. Thanks!


  • There is lots of web articles and posts about your exact situation here that will help you understand the circumstance that you now find yourself in.

    1) need to assess your health insurance coverage situation, as your 2 weeks paid leave will not be enough. Will your work hold your job open for you for a longer period? You need to read what is normal recovery time from others experience here and talk to your surgeon. PS; many have found that surgeons quote very optimistic timeframes (best possibly case) and some here say that double may be closer, but we are all different.

    2) you are a young healthy person which may help in your recovery

    3) overweight - not good. Need to loose that ASAP. (No offence intended). It's probably contributing to the damage of the discs. There is a fantastic thread in the weight loss forum on this site that if you have the fortitude to follow, will reduce the weight. I did it.

    4) you are scared because you need to learn lots about your new life as a spinal patient. If you have the knowledge you will not make avoidable mistakes or allow doctors to do inappropriate things. You need to take accountability for what happens from here on. Read heaps here and you will see why.

    5) need to understand the risks of having surgery vs not having it. Your surgeon can help here.

    6) suggest you get 2nd or more opinions, because you want to get the best surgeon who will look after your interests if things do go wrong (see stories where dr or PA don't want to know the patient when this happens) and to get multiple eyes reviewing the case and opportunity for you to learn more from different doctors.

    I know this is tough, but that's the hand you have been dealt with. I've been there. The quicker you you can get over 'why me' and focus on becoming a spine expert to make sure you are getting the best treatment, the better off you will be. That's the fact of your new life, get into it.

    The advantage you do have is the wealth of knowledge at your fingertips here in one place and the help of fellow members here. It's hard to explain this to a newbie, but its worth a lot in $s and what money can't buy which is good health.

    Wish you all the best.
  • Fusion recovery everyone is so diferent so its hard to say how long it will take to return to work, At best might be able to return to desk job posibly in a month or so, Total fusion can take 6 months to even a year but if there is no serious pain issues might be able to get back to desk job soon after surgery.
    Thats of course when all goes ok ,

    Its very hard to say for sure, But if it has to be done best to get it out of the way,

    Best of luck,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
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