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How many levels of fusion?

I am scheduled for spinal lumbar fusion on December 2nd. I will admit I walked out of the office thinking, "crap, I have to have this done" and when someone asked how many levels of fusion I was going to need I didn't quite know the answer. I will definitely know more when I see him for my pre-op visit, but was wondering if anyone had a guess as to how many levels could potentially be involved.

L3 has slipped over L4 with 50% slippage. The disc between L3 and L4 is herniated into the spinal canal (severe disc desiccation). So to repair the spondylolesthesis and do the laminectomy would that probably mean a fusion from L3-L5? So would that be 2 level? How different is the recovery for something like that? He said the cage would be anterior for more stability but all of the paper work and his nurse said the incision would be in the back. Thanks


  • kinpainkkinpain Posts: 958
    edited 10/21/2014 - 11:40 AM
    from L3-L4, and L4-L5, providing this is all your your surgeon would do.
  • I called his office (had another question) and asked his assistant. She said it was listed as L3-L4. But if L3 and L4 are unstable, wouldn't they need to at some point be fused to a more stable point (like you said, L4-L5)? I have a meeting with my doctor on 11/7 and know whatever is said here is not medical advice per say, but the more information I have the better prepared I will be with questions for my doctor, so thanks.
  • sandisandi Posts: 6,343
    edited 10/22/2014 - 7:30 AM
    It depends on the extent of the spondylolysthesis and the conditions of the discs /vertebra surrounding it.........they may opt to do a one level L3-4.
  • 50% with the spondylolysthesis. L3 is collapsed on L4. There is severe disc desiccation between L3 and L4, the disc is pushing into the spinal canal. He will perform a laminectomy there as well. That's why I was wondering, with all of that, if more would be needed. Again, just trying to go in as informed as possible.
  • I ended up with a one level fusion L4L5 for similar issues at that level.
  • sandisandi Posts: 6,343
    edited 10/22/2014 - 4:21 PM
    The laminectomy will widen the canal where the thecal sac passes through.....and pulling the vertebra back into alignment should relieve the compression that the disc is causing , as well as the discectomy/fusion....so it sounds like one level, unless of course, he finds more damage in there than what is shown on the imaging.
  • have you already had your operation or was that another member ?to the author of this post it sounds like your due [or had } and ALIF the recovery time can be long if it was not your first surgery , some can be lucky but many go on to have on going pain and a long recovery and reduced mobility ,wishing you well anyway
  • My surgery date is set for 12/2 and this will be my first surgery. I had always had back twinges but figured they were from a car accident 24 years ago and would take motrin and move on. I slipped over the summer (down 2 steps) and slipped a disc, revealing a previously slipped disc, severe arthritis (I'm 46 but was told the X-Ray looked like that of a 70+ year old) and spondylolesthesis of 50%, I've been told recovery will be long and not very pleasant, but I am in chronic pain now and it has affected my ability to do things with my kids, my job, even shopping for groceries is painful now and can take me out for the count at times. All of the paperwork says he will be going in through my back, but he told me he will be placing the cage anterior (his nurse said he can do that from the incision in the back). I see him next Friday for my pre-op appointment and will get more specifics then. Now you are making me nervous though, are you saying this surgery mostly doesn't help? I feel like I am between a rock and a hard place. :(

    To the others that have responded, thanks for your input and help clarifying things. :)
  • sandisandi Posts: 6,343
    edited 11/02/2014 - 3:03 AM
    I know that you are scared.........the poster you are referring to is no longer here. Don't make decisions based on someone else's experiences.
    There is more to the story about why that individual had issues going into the surgeries he had than he alluded to in his post...so, talk to your surgeon, discuss your fears and concerns, and listen to what he tells you regarding your specific case, and don't base your decision about surgery on someone's else's comments.......there is usually far more to the story than is presented in a post regarding why someone's outcome is not as they would have preferred.
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