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Prior Lumbar PLIF, now L5/S1 disc rupture

Hey everyone,

My name is Steve, I'm 30 years old. I'm active duty Air Force stationed in Minot, ND. I had a lumbar fusion in march of 2004. Originally I had 2 rods and 8 screws installed. In march of 2006 the hardware was removed. My doctors at the time decided this was needed. I have mixed feelings on the subject but none the less its done so thats not an issue.

For the last 2 months I have had on/off sciatic pain. I researched a bit and had settled on piriformis syndrome. Never once did I suspect another back issue. I have had no new back pain in quite some time. Finally something gave way and I had to seek immediate medical attention and I was informed that I had a ruptured disc on my L5/S1. Its bulging 15mm and causing L5/S1 nerve root impingements and sacral nerve root inpingements as well. My left side from the upper hip down to my foot is numb (pins/needles) and severe pain all the way down especially at the upper calf.

I see the neurosurgeon next thursday to discuss treatment. Anyone have any guesses what they might recommend with the prior multi-level fusion? Thanks in advance.



  • RTgirl2011RRTgirl2011 Posts: 512
    edited 01/10/2013 - 12:19 PM
    I had a two level fusion last year, now my L5-S1 is herniated. According to my neurosurgeon, my only option is to have it fused. I am having another MRI tomorrow to check on the disc, since I have basically been on the same restrictions as a person who just had a fusion, this was my effort to get the disc to heal. I am still having sciatica and numbness in my right leg. I go to the surgeon next Wednesday to discuss having another fusion. Keep us posted on how your appt goes. Feel free to pm me if you want, if you have questions.

    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.
  • GreaseMonkeyRR Steve: hi an welcome here.

    There's lots of info here. Suggest you read the FAQ at top of page.

    As your L5/S1has herniated, you may wish to look at http://www.spine-health.com/conditions/herniated-disc
    And http://www.spine-health.com/conditions/herniated-disc/treatment-options-a-herniated-disc

    I suspect your previous fusion in 2004 will not affect what happens this time. Not a doctor so could be wrong here. The normal process is for conservative treatment for a reasonable time period and hopefully recover before consideration of surgery. The type of surgery for herniated disc is usually a microdiscectomy. Reherniations occur in approx 10% of cases.

    Lots of microdiscectomy posts here if your interested in knowing others experiences.

    All the best Steve.
  • Thanks for the reply's. I have started reading some info on this forum, but haven't gotten too deep. I am in the middle of a ton of paperwork that the USAF requires in these situations. I have to see military docs on top of the civilian docs that they referred me to. I wish you luck Jennifer and I will keep updating this post as information comes available. Have a great weekend.

  • The first question Id have is " what levels were your original fusion for?" Assuming the fusion did not involve L5/S1 previously so Im not sure why that would preclude a more conservative option like a MicroD. On the other hand, Ive read that fusions put increased stain of the levels above and below... so if your fusion involved L4/L5, maybe the thought is that 'just' a MicroD at an adjacent level would be less successful/more prone to post-op failure....

    I would recommend you get more than one qualified medical opinion that you trust and take it from there.

    I wish you the best
  • NHback, I have always been told I had L1-4 fused and that they left the L5/S1 alone. The ER doc had assumed like you said that the above fusion put more pressure on the only disc below it. No one has said anything to me about what direction this is going to go except for both docs have said be prepared for the surgeon to recommend surgery very soon. There was never a mention of what kind, I have only seen an ER doc and a primary care manager on base (PA). So I'm not sure which route the surgeon will take. They have requested that I get a hold of the previous surgical records to bring along.

    As far as the recommendation from another doctor that is easier said than done. I only have the authorization to see the docs that are a part of the Tricare network in my region and that the Air Force will refer me to. I can request it but its a small chance that it actually happens. But I can always try and the worst they say is no..haha Thanks.
  • I had my original fusion in Feb of last year. It was on L4-L5. It cause the one above and below it to herniate. I had the one above (L3-L4) fused because a microdiscectomy would just fail. The disc would just re-herniate. That is why my NS is wanting to fuse L5-S1 as well.

    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.
  • I feel pretty lucky that I have made it since march of 2004 before I ruptured a disc. I have been told I have several somewhat herniated discs through out my spine due to several conditions such as slight scoliosis and Lumbar Spinal Stenosis but they weren't bad enough to mess with and I could handle it. I hope whatever decision they make will relieve your pain!
  • Well the doc agreed surgery is the best option and I will have microdisectomy on Feb 1. The cause being pressure caused by the above fusion as the general consensus. 6-8 weeks recovery. I start pre-op requirements today.
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