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Decisions to make : lumbar ablation v fusion

Hi. I am pleased to have Lund this really useful site and forum.
I have suffered with low back pain since my mid-20s and am now late 50s. Have 'severe' arthritis at L4, L5 and S1 with all the facet joints there involved, plus a synovial cyst and considerable disc thinning. Sciatica changes from side to side and sometimes both legs together with pain often worst behind my knees. Sometimes mainly leg pain and not awful back pain with it, sometimes back is aching a d very sore too ... Hate the pressure of chairs etc.
Have tried all sorts of injections from cortisone on the spot, epidurals, facet joints etc. Swapped orthopaedic specialist to a rheumatologist to try and keep me away from surgery, but time between episodes just gets shorter and shorter and now have two options left. Do I try ablation which from these forums has mixed success and mixed stories of how painful it can be afterwards or bite the bullet and go for the fusion?
I love to be with my three very small grandchildren and normally love to be out and about, so after having had other gynae. Ops over the years, already know the frustration of long, confined recovery time stuck in at home.
Would anybody here say fusion really gave them a full life back or did it cure some things and cause other problems?

Currently taking diazepam, amitryptyline and coproxamol ... Hated tramadol which did not work at all for me.

Many thanks for reading my long first intro post.


  • LizLiz Posts: 7,832
    I am sure that you will find your time on Spine-Health very rewarding. This site is a powerful and integrated system that is dynamic and continues to grow.
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Hi, I have had a 6 level lumbar fusion, T12 to S1, and a 3 level cervical fusion. Plus having a spinal cord stimulator implanted and removed. My main complaints before the fusion were low back pain and leg and feet pain caused by degenerative disk disease. The cervical fusion was a complete success, but that's another story. My lumbar fusion was and was not a success. It made my back pain more tolerable but now I have pain in my thoracic spine because it is trying to compensate for the lumbar spine not moving. This only occurs after standing or walking for too long and if I'm pushing a cart it is no problem at all. My doctor went back in and took out all the hardware in my lumbar spine hoping that would help the leg and feet pain, which unfortunately it did not. As of now I'm taking 15mg of Methadone twice a day and that pretty much takes the pain away in my legs and feet. I was never offered ablation and I would ask if you do ablation and if it doesn't work could you still do the fusion? In my opinion I think fusion should be the absolute last resort. The reason being is once it's done it's done and there is no turning back. Of course everyone is different so please take all the info you get with a grain of salt and make the choice with your doctor. Good luck and let us know how it goes.
  • She can even run. She runs at the gym now. I am so jealous because I love running but can't. She lives a pretty normal life now and she isn't in pain like I am. We have different back issues- mine is scoliosis and hers was a herniated disc at age 21 which she should have done the fusion first instead of 3 other operations. Her story is long and complicated but they finally fused L4-L5 and that is what helped her, but she was left with nerve damage from waiting so long to get the discectomy/fusion. For the first 2 years after the fusion, she had a spinal cord stimulator which worked. But now the leads have moved and it no longer works. She would have to have another surgery to take it out so she is just leaving it there for now. She's doing a PhD in BioChemistry at Ohio State University. If she stands in the lab all day, she has pain. She tries not to do that but sometimes it can't be helped.

    If you are going to have surgery, then do the fusion. But it is a "last resort", I agree with Sampson217. I have discussed nerve ablation with my chiropractor and he said that since I'm still young (I'm 32), that it would create a lot of scar tissue and I would be worse off than before. But since you are in your 50s, maybe your body wouldn't create a lot of scar tissue. I would ask the doctor about that. I've never had it so I can't give you advice on it, except to say that I decided against it for myself. Also, my chiropractor said that for some people it only lasts for a month or 2. You could try ablation first and then do the fusion if it doesn't work. But if you really are at the time that you are considering fusion as your last resort, and you can take time off work (or if you don't have to work) and concentrate on healing, maybe you should do that. You know it will take time and you have been through it before. I hope others chime in with their experiences about the fusion surgery.

    Can I ask you how you coped through being pregnant with chronic pain? Sorry I know it's not on topic but I am curious. I would like to have a child in the next year and I know I have to get off the pain meds first. It's going to be an interesting journey.
    Chronic pain since 2007. Have scoliosis. Had ACDF surgery for C5 Dec 2011. Sick of dealing with pain. I just turned 32 and struggle through but work full-time in IT.
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