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3 level lumbar fusion for ddd

Hey guys. I'm in the process of seeing a whole plethora of surgeons for my low back pain. I have 3 herniated discs from L3 to S1 with DDD and congenital stenosis. My surgeon is hesitant to do a two level fusion because L3L4 and L4L5 are my worst discs. I also know that 3 level fusions for DDD are very rare and not exactly successful all the time. As a 21 y/o I can't continue in this pain and I need to do something as all conservative treatments have failed. If anyone has had a 3 level fusion with DDD the chief complaint, please post a message on how your levels done, if the actual fusion was successful and, of course, if you are now out of most of your pain. I know any fusion is a MAJOR surgery (let alone a 3 level fusion) so I don't want to jump right in just because I'm in pain; I've read too much literature on how people make rash decisons to regret it later. Please get back to me soon. Thanks :)


  • MagistraMarlaMMagistraMarla San Antonio, TexasPosts: 180
    Hi Rocco,
    Your diagnosis sounds a lot like mine. I'm 57F and I have three degenerating discs - L3, L4 & L5. I must admit that I was so traumatized listening to the surgeon that I'm not sure how many fusions he plans on doing, but I know that he mentioned possibly using pins. I'll find out more at my pre-op appointment on March 31. My surgery is scheduled for April 13.
    I've had pain, falls and lots of different symptoms since 2003. Every specialist that I've seen has had a different theory, but most of them have been ruled out. I've been told that I have MS, Parkinson's, Lupus, Spastic Paraplegia, RA and even that it's all in my head and that I'm just a hypochondriac. Finally, a doctor thought to send me to a spine specialist last summer, who ordered a full body MRI and then showed me how disintegrated those discs are.
    If I were your age, I wouldn't want to put it off for a long time. I've gone from falling occasionally to not being able to drive or to walk without help. I'm really hoping that I can recover well enough to be able to drive again. I really miss my independence.
    I'll try to keep you informed about how my surgery goes if that will help you in making your decisions.
  • I used this site to do a lot of reading while trying to make my decision about fusion surgery, so I figured I'll pass on my experience. 2/3/14 I had a TLIF surgery and I am now fused from my L3 to S1, including 2 rods, 8 screws, and 3 cages keeping me intact. I was 30 when I got the surgery and my main complaint was debilitating mobility issues in my right leg due to compressed nerves and moderate back pain Due to severe DDD, Mild scoliosis, and severe arthritis.

    Before even considering surgery, I maxed out 2 years worth of physical therapy, 4 sessions of steroid injections, and a discography that may have been the worst thing ever, but super helpful. I had 3 MRIs and one CT scan. And then to juuuuust be absolutely sure, I went through one more round of physical therapy with a very aggressive man who kicked my butt. Obviously, it didn't do much good, and after a lon discussion with my surgeon, I went ahead and did it.

    I give you the list of things I did to try to avoid surgery because you should exhaust ALL resources before considering such a huge fusion. I've heard and read SO SO SO many horror stories of failed fusion, worse pain, and having to get multiple surgeries for the rest of life.

    That being said, I am a huge success story. BUT, that is because I went into this surgery with realistic expectations. I knew my pain wasn't going to disappear completely and that I may never recover full mobility in my right leg. I made the best decision I could, and decided that if I came out of surgery being able to walk normally and not have to take pain killers for the rest of my life, I'd be satisfied.

    My surgery was 6 hours long and I spent 3.5 days in the hospital. I drove my nurses insane by getting out of bed as often as i could and MOVED MY BUTT within 8 hours of being conscious enough to walk without falling. The only reason I was in the hospital that long was I managed to get a 102 degree fever, but I'm convinced it was from the gross drain still sticking out of my back. Once they removed that, it was down almost immediately and I went home.

    I lived alone and had people visit. Showering was nearly impossible for a week and I had to have someone change my dressings for me for 2 weeks. I was taking a muscle relaxers and the lowest dose of Norco 3 times a day, plus stool softeners, because those things will clog you up. Gross, right? After surgery is gross until about a month. Thats when I felt fully capable of wiping my own butt and showering thoroughly. Up until then, you just kinda wing it.

    I stopped taking pain killers and muscle relaxers somewhere in week 3 post op because I was hell bent on being mobile (driving) again. I used ice, heat, my tens unit, and diclofenac (an NSAID) to get me through. I had a bone stimulator given to me around a month and I used that daily.

    I had ex rays taken 4 times post opp, and my doctor decided I had sufficient bone growth at 13 weeks post opp and released me from his care. I am now a year out of surgery and I have maybe 10% of the pain I used to have and 95% mobility in my right side. This is MUCH better than I expected. Much better than my surgeon expected.

    Why do I consider my surgery a success? I can walk. I don't limp any longer. I don't feel like my leg is dead weight being dragged behind me. I still do not take narcotics (they're nasty) and I manage just fine With daily doses of aleve.

    A few things to consider: your mobility in your back will be pretty restricted in strange ways. I can twist and turn now, but cutting my toenails and putting on socks is a task in itself. I just cannot bend the way I used to. I didn't think this would bother me as much as it does, but it can be downright annoying at times. Tying my shoes? Pffft. I tie them first and then slip them on. Another thing? I have weird numb spots of the outsides of my thighs. Maybe they were always this way and I just didn't notice Because I was in so much discomfort before. Who knows? Also, I will more than likely need another fusion for the upper levels as I get older. Ive got a nice curve in my spine right at the good disc above my fusion. Doc says I've probably got a good 10 years until it's needed, but it will more than likely start causing problems

    I decided this was ok. I did not want to spend my 30s unable to walk right. I would do this all over again. If I had to.

    Think hard, round up a good support team, and be realistic about the outcome. Also, come to terms with what may happen if your surgery is not successful. How will you cope? I'm the Minority success story when it comes to long fusions of the lumbar spine. It can happenlike it did for me, but the odds are against you.

    If you decide to do it- commit. MOVE even though you won't feel like it, listen to your restrictions ALWAYS, and get off the hard drugs as soon as you're able.

    Hope this helps. Sorry it's long and rambly and badly typed. I'm using a cellphone.
  • SpineAZSpineAZ WiscPosts: 1,084
    Personally I look for the most comprehensive surgery.

    My lumbar problems stem from spondylolisthesis (vertebrae shifts over vertebrae below) . I've had 3 fusions, most recently L3-S1 in 2010. The surgeon took out the old L4-S1 hardware. In my back is had additional levels move forward over the years, this ending up now L3-S1.

    My neck was a little different and where I really learned what to ask surgeons. In 2006 C5-C6 and C6-C7 were clearly in bad shape. C4 was "iffy". I really wanted to have the surgeon fuse C4-C7 but he said only C5-C7 needed fusing. A few years later it was clear C4 needed to he added. Had I insisted on C4-C7 instead of C5-C7 in 2006 I might not have had to add C4-C5 in Dec 2013.

    So, I now will tell any surgeon who operates on my spine to fix anything that needs to be addressed one he gets in there. Especially since MRI may not show the severity that can be seen during surgery when the surgeon is viewing the spine directly!
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • BpainFree39BBpainFree39 Posts: 127
    edited 02/18/2015 - 3:58 PM
    Hi... I am fused from L2 - S1. I had 2 surgeries and the first one did not work. The first doctor fused L4-S1, but the screws did not take. A year later I had my second operation. This time the doctor removed all the hardware, and fused me again from L2-S1. After a year I was feeling better, but not great. I am in pain still, and get numb a lot. I am starting treatment again, and need a new MRI. I'm not sure what's going on in there this time, but I am in pain all the time and it could be anything.
    Left foramina stenosis of L3/L4 (retrolisthesis)
    L2-ilaic revision fusion ( loose screws) with a laminectomy at L3 (cage at L3-L4)
    (PLIF) -@ L4/ L/5 - S1 (cage at L4/L5)
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