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Surgery or not?

I am new to this forum as for the 1st time ever I have back pain & have been told I need surgery. I am a 65 yr old retired firefighter. I started having mild
back pain about 3 years ago. I have been seeing a chiropractor at least 2 times a week for a couple of years. This past year the pain was so severe that I actually went to the ER. I followed up with my primary care dr who ordered x-rays and eventually. an MRI. My diagnosis after theses tests is spondylolisthesis in the lower lumbar vertebrae. He referred me to a neurosurgeon who reviewed my films and suggested TLIF spinal fusion surgery. I am pretty healthy and not obese. I only take 1 rx for high blood pressure. I have read all I can about this surgery including the success rates. Now, everyone has an opinion; get the surgery, don't get the surgery. I would love to be pain free, but if I' m still in pain after the surgery, I don't want to go through it. Also, I have been told I would have limited movement (bending, etc) after the surgery. If anyone on this forum has had TLIF spinal fusion and can give me an opinion, I would appreciate it. Thanks


  • sandisandi Posts: 6,343
    edited 08/12/2014 - 8:51 AM
    Movement, bending , lifting , twisting restrictions are put into place in the immediate post op period to allow the fusion process to happen. Depending on the level of the lumbar spine involved in the surgery, you may not notice any restriction long term.
    Fusion is a big surgery, no matter what kind you have, and the recovery can take a year or more before fusion is complete and you know what you are will be left with post op. It is an ongoing process and yes, you wil have set backs along the way, it is a tough surgery. That being said, once the recovery is over, many, many people go about living their lives without much in the way of permanent issues.

  • L333777LL333777 Posts: 109
    edited 08/12/2014 - 9:30 PM
    I am facing the same decision. I was told, by a neurosurgeon, last September, "Exhaust all other measures first because, if I take you to the OR, it will be for a fusion." Along with an unstable L5 vertebrae, I have a bulging disk at L4-L5, a herniation at L5-S1 (which recently got significantly larger), moderate to severe spinal stenosis, S1 nerve root compression, modic changes at the endplates, & narrowing of the neural foramen. I have done every kind of conservative tx out there, from chiro & PT to ESI (x5) & rhizotomy (x2). The facet joint blocks & subsequent rhizotomies have been bilateral on 3 levels. Today, I am awaiting another neurosurgeon consult (8/19) & in excruciating pain nearly 24/7, while I try to keep working full time & raise a young child. I've also sent my MRI & flexion/extension images off to a friend, who lives in Michigan, to get his opinion & the opinion of his minimally invasive surgeon. So, I understand what a difficult decision you are faced with making. I have talked with others, who have had various back surgeries & some say it was a Godsend, while others say it was the worst thing they ever did. The widely varying spectrum of these experiences only complicates matters. I've read a lot of posts in the forum under Surgery Recovery as well. It seems there are a lot of people saying that fusions are done to stabilize the spine, not necessarily to eliminate pain, which is very disheartening. The best advice I have found is to get more than 1 or 2 surgical consults. Do as much research beforehand on available procedures & recovery, so that you are prepared to ask lots of questions. Try to find a surgeon, who has a lot of experience with minimally invasive procedures. I'm in South Florida & I've been told to explore possibilities around EDIT(the latter is someplace my insurance does not cover though). I've also done exhaustive searches on the Top Neurosurgeons in the US. I wish you the best of luck with whatever it is you decide & that you find relief from your pain.

    Post edited to remove name of specific medical facility. by Liz The Spine-Health Moderator Team
    8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
    9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
    10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE
  • I agree with Sandi that you can't tell for a year or more whether the fusion has relieved your pain, and I agree with L333777 that the fusion is to correct spine alignment/function and nerve compression rather than to resolve pain.

    I had a 360 degree fusion 2.5 yrs ago. It resolved the sudden and excruciating pain that had me crawling and unable to load my spine for the 10 days prior to surgery. Afterwards it was a relief just to be able to sit upright and walk to the bathroom.

    2.5 years later I still cannot walk far without disabling pain in both legs. I am not really employable and I've resorted to using a wheelchair for any trips to the store etc. I'm still THRILLED to be able to sit upright and walk to the bathroom. Spine problems definitely can make us grateful for the small details in life.

    On the upside, as well as being able to stay upright now, I am back to being able to bend, lift, twist, although I try to stay aware of my form if I do these actions. Most fusion patients do not have the long term leg/walking pain that I have experienced.

    As most people on this forum would also suggest, I recommend you exhaust everything else before resorting to a fusion, just because it is such a gamble. I was super-fit and underweight at the time of my fusion, but this doesn't seem to be a factor in whether the surgery cures all pain.
  • The statement by livingforwards, "2.5 years later I still cannot walk far without disabling pain in both legs," is an example of the kind of statements that terrify me. The pain in my left leg is often so bad that I want to pull my hair out. Almost every morning when I get out of bed now & often when I stand up from sitting position, or get out of a car, I have episodes of pain so excruciating that I can't do anything except lean heavily on cane & slide my left foot across the floor to move. I am scared to death that this will be my life now, this pain. I'm waiting, as I write this, for a call from an old high school friend, who is a neurosurgeon (in another state) to give me his opinion after reviewing my MRI & extension/flexion images. I want to get his opinion of my condition, options, & prognosis before my consult with local neurosurgeon on Tuesday (8/19).
    Livingforwards- where was your fusion located? What was your diagnosis or what did your MRI before surgery show (if you don't mind sharing that information)? Thanks so much for sharing your experience & I wish you relief from your pain very soon.
    8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
    9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
    10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE
  • are done for spinal stability not pain relief and fusion take a lot of time to heal .if you can avoid it I would there are many posts on here about all the various fusion they make good reading
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