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Time for a lumbar fusion? ?

nreidnnreid Posts: 8
edited 01/30/2015 - 7:47 AM in Back Surgery and Neck Surgery
Hi Folks,

First post here. I have an awful dilemma. I underwent a microdiscetomy 11 months ago to repair a herniated L5/S1disc and my recovery went fantastic. I went back to work in my job as a Paramedic in the Ambulance Service after my recovery was finished and had 8 months of being completely pain free until the second week of December 2014 when I then started developed widespread Lumbar pain once again. I thought little of it and presumed I may have strained some muscles. The pain grew stronger over the space of 3 days until the point it became sore to walk in my heavy work boots which then led to me taking off work sick and have been on sick leave until now.

For the first two weeks, I was still confident that it was just strained muscles as the pain was widespread over the Lumber area of my back as opposed to being central over the spine. After two weeks, I started to experience mild intermittent numbness and sciatica down the back of my right leg with no symptoms down my left leg. This then dissipated and the widespread Lumber pain turned into focal pain over the site of my previous surgery only. I was also experiencing a lot of what I call "weakness", meaning any forward bending or leaning over was causing a pain sensation that I would describe as "my back giving out", or basically not being able to support the weight of my bent over torso. I then went for a MRI scan and made an app with my consultant. He reviewed the scan and said it was consistent with what he would expect to see post discectomy surgery with the exception with a slightly enlarged nerve route (not sure which nerve) and advised physio and rest to repair the strain. He did mention that if I was to deteriorate any further, that he would like to do a spinal fusion and had mentioned before my discetomy last year that this was his preferred choice but avoided it in favor of the disctemy as I would be unable to continue in my line of work if I had a fusion done, as the heavy lifting would put too much pressure of the bone graft included in the procedure of the fusion on the long term.

I spent the following two weeks after this, I tried to repair myself with said advice from my surgeon but it has only gotten worse, particularly so over the last five days. Today was the first day that I woke up that i felt a large period of the back of my left leg was numb and had loss of sensation. Bare in mind this is the opposite leg as to where I had the intermittent numbness two weeks ago. Admittedly I had been a bit too confident in my recovery over the last two weeks and pushed myself a little to hard (in my own opinion) by cycling in the gym and doing core strengthening exercises.

My lumber spine is now soo tender over the last few days that any movement what so ever is causing a feeling of extreme weakness / pain in my lower back. I`m also very concerned with this return of numbness down my left leg as it obviously means a nerve route is impinged again.

The main reason for the post here is I feel I may be getting near the point of having to opt to have a fusion done and I am concerned as it it obviously a much bigger operation than the discetemy surgery. I am looking for to hear from people who have had a lumber fusion done and how their recovery went?? Also, if they needed a bone graft taken from another part of their body or if a cadaver bone was used. How long did your recovery take?? I have been told it can take anything from six months to a year for the graft to take and become active again?? Also, one of my biggest concerns is, I have been told that you can loose up to 20% of the rotation of the trunk of your body due to the screw fixtures.

I am in no way concerned about having to change my line of career if necessary and this has no bearing on my decision on whether to get a fusion done or not. Health before wealth is how I feel.

I would be glad to hear from others and thank you for taking the time to read the post....if you have.

Kind Regards,


  • LizLiz Posts: 7,832
    Welcome to Spine-Health

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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
  • As I have a very large herniation right now, scheduled for surgery and just discovered a pars defect which may mean I need a fusion. I'm quite terrified and tearful. My career wouldn't change (Thankfully I moved from Emergency Medicine to Infection Prevention a few years ago) but my entire life will if I am fused. I am terrified. Good Luck to you.
  • I know what a difficult decision this is. In my case, there really wasn't another option, as I had undergone two prior microdiscs and still ruptured within a 4 month period. A lumbar fusion was the only thing that stopped the terrible nerve compression and allowed me to get my life back.

    Anyone carefully considering this surgery is wise. It's a big deal with a long recovery period and some life-long changes, but let me reassure you, it's not as bad as some of what you read here. You can still go back to most, if not all, of your activities. Something to consider carefully is the question, "What will happen if I DON'T have this surgery?" IN my case, a lot of nerve root damage was happening, and in the quest to get insurance and doctors to cooperate with me, it likely took too long to have the fusion done and I most likely have permanent nerve damage. That isn't a fun thing, as I'm 36 and now walk with a cane. There are definitely worse things than the surgery, although I completely understand the overwhelming fear. I was terrified of the idea of screws and rods and removing things, etc...but I survived. I had a TLIF and spent one night in the hospital afterwards. The first month to 6 weeks was the worst. There wasn't uncontrollable pain, just discomfort and difficulty sleeping. A turning point hit after that and I have slowly been getting back to my "new normal". I did have another surgery almost 5 weeks ago, so that has slowed me down a little, but 4 plus months out from my fusion, life is mostly normal again.
    Left leg radiculopathy/sciatic pain
    L5/S1 microdiscectomy - May 30, 2014
    L5/S1 microdiscectomy - Aug 14, 2014
    L5/S1 TLIF - Sept. 24, 2014
    Left-side screws/rod removed along with bone fragment Dec. 29, 2014
  • Coltsfan78CColtsfan78 Posts: 182
    edited 01/31/2015 - 12:36 PM
    I forgot to answer a question....I did not have a bone graft or cadaver bone. My surgeon just used bone material that he took out of my spine during the course of the disc removal. I don't completely understand exactly where it came from, I just know that he told me it was a really good graft and it was my own and I didn't have any other surgical sites.

    Also, as a point of reference because I had no idea what to expect, I have two, inch and a half to two inch scars on either side of my spine (I also have one down the middle from the two previous surgeries). They used superglue instead of stitches and I can't believe they were able to do everything they did through such small incisions.
    Left leg radiculopathy/sciatic pain
    L5/S1 microdiscectomy - May 30, 2014
    L5/S1 microdiscectomy - Aug 14, 2014
    L5/S1 TLIF - Sept. 24, 2014
    Left-side screws/rod removed along with bone fragment Dec. 29, 2014
  • In my case, my discs at L4 L5 and S1 were so deteriorated that I had already lost any movement at those levels a long time ago. So for me, the removal of the discs and addition of titanium did not cause me to lose any additional movement.
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • I'm sorry to hear of the worsening pain. Unfortunately, our line of work is not easy on the back. I would caution you to search out all conservative options before having a fusion. Given how much lifting and America's weight obsession :) going back to the streets after fusion is tough. Two person lifting is tough after a fusion. I had 2 level (L4S1 360 ALIF) fusion in 2007. After a good long while (almost a year) I felt comfortable enough to go back onto the streets. I was response/management, so I rode a desk for the year. I was able to do both aspects of EMS until 2012 (albeit with pain) when the pain had come back to the point I was on narcotics 24/7. My medical director said no way to the streets anymore due to liability. I fully understand why he won't allow it. I am fortunate that I still can work as management and don't have to find a new job...yet.

    I would suggest that you look at any potential positions within your employment that will limit street work. I lost some ROM but it wasn't 20%...more like 10 to 12. I have PEEK cages at both levels and the surgeon used BMP-2 for bone growth. After surgery, I went through a lot of rehab! Aqua therapy was the best, hands down! I still like getting in a pool and hanging on swim noodles.

    If you have any other questions, feel free to PM me.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Hello again everyone,

    Been a while since i posted. So since my last post, I have completely stopped all physiotherapy recovery and given my back complete rest with no more than some brisk walking each day as the physiotherapy was causing me too much pain. What i have found from doing this is that my pain levels have significantly decreased and I now only experience pain whilst bending / stooping / lifting as opposed to the constant pain i was experiencing.

    Although I am now in a position of less pain now in comparison to what I was when i last posted 12 days ago, i am still very worried as i am lost for direction as to what exercises to do to strengthen my back up again. The physiotherapy exercises I was doing were obviously not suited to me. Either that, or I was pushing myself too much whilst doing them. Either way, they are the ones that the physio`s recommend for people with DDD and they are not helping me!! Just to mention they are the McKenzie exercises. They are even recommended on this very website / forum.

    So where do i turn for advice now? My surgeon has already given me the ultimatum: Get better with physio or have a fusion; so i don`t see the sense of having another consultation with him to the cost of 250 euros when he will only be repeating his advice. The physiotherapy exercises are not working......and i desperately want to avoid a fusion if at all possible.....so I am now lost as to where to go from here..... Felling lost, stressed, and getting very sick and tired of being out of work.
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