I'm seeing a lot of discussions about the L5/S1 fusion but nothing much relating to the L4, L5, and S1 so I just wanted to bring this up and possibly have some good discussions about it.
I've been going to pain management for almost 3 years that started due to residual neck pain after a C6/C7 fusion. About a year into it, I began complaining to my pain management doctor that my back was causing me unmanageable problems again. Needless to say, I had my pain management doctor scratching his head on how to help both conditions. I've tried almost every single injection known to man including a caudal epidural. Only minimal relief for my lower back problem. The longest relief I had only lasted six days. It was on the fourth day that I could feel the effects wearing off and on day six was when I was right back to the way I was prior to the epidural.
We were at the point of discussions to have a spinal cord stimulator installed but it couldn't be done if there was something surgical that needed to be done. We decided to get another MRI done on my lower back since it was just over a year since the last one. That MRI has placed me in the hands of a neurosurgeon again. I have a herniated disc at L4/L5 that I already had a micro-discectomy for, 5 1/2 years ago. To top that off, now the L5/S1 disk is almost completely collapsed.
I had the meeting with the neurosurgeon on 4/30 and a fusion is the only option I have at this time because of the condition of the discs at L4/L5 and L5/S1 which need to be removed. He is planning on doing the surgery with an anterior and posterior approach. There will be one incision in the abdomen and one incision on each side of my spine in the back. I am meeting with a vascular surgeon next Monday as he is the one that will open the anterior access for the neurosurgeon. After that meeting I will complete my paperwork with the neurosurgeon and then go to the hospital to do the pre-admitting. I have already committed to having this surgery done as I am tired of my current living conditions.
I asked the neurosurgeon what the pain level difference is between the micro-discectomy I had and the fusion I will be having and he said that it is a considerable difference and especially with this surgery incorporating 2 levels. I was only in the hospital overnight for the micro-discectomy and he said that I will be in the hospital for 3, possibly 4 days, for this surgery. That is not something I am looking forward to but it is what it is I guess.
I'm a very strong willed person and when I set my mind on something, I give it everything to make it happen. I have every intention of pulling through this with a very positive attitude. I understand that it will be very painful and there will probably be some loss in the ROM.
Would anyone be willing to share their recovery pointers for this type of a fusion surgery? Has anyone had this type of surgery with the three incisions? It is my understanding that it is a fairly new process. What should I expect, not expect? What are the do's and the don'ts that you've experienced while recovering? Please include how long it has been since fusion surgery.
Sept 11, 2009 L4/L5 Microdiscectomy
April 12, 2013 C6/C7 ACDF
May 27, 2015 L4/L5 ALIF with PLIF
Too many cervical and lumbar injections to list, including RF Ablation C3-C6 on the right and left.