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L4-L5-S1 Fusion...Posterior, or 360?

skeegansskeegan Posts: 1
edited 09/01/2015 - 9:06 PM in Back Surgery and Neck Surgery
It's imminent that I'll be having surgery for L4-L5-S1 fusion with decompression. I have L4-L5 spondylolisthesis and severe disc degeneration among a slew of other issues. I'm in fantastic physical shape, although in the past year have gained 10 pounds (about 10% of my body weight) due to the limiting pain. I've seen two great surgeons. One is adament that a 360 surgery is necessary. The other is adament that just a posterior surgery is necessary. Common sense would say to get a third opinion. However, two things: 1. The process to get in with another reputable surgeon for an opinion, then subsequently get approved and schedule for a surgery is multiple lengths long (which I've already gone through twice). 2. It seems that each surgeon has their own preferred methods of surgery, and that no matter what your specific situation is, the surgeon is going to still "sell" you on his/her preferred method. I'm at the point of throwing in the towel, and flipping a coin to decide on the surgeon and procedure. Any insight (or frankly, hindsight) is greatly appreciated.



  • LizLiz Posts: 7,832
    Please take the time to read this post and refer to it when you have questions

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    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • hvillshhvills Suzhou, ChinaPosts: 719
    Dear Seegan

    I've had 2 PLIF surgeries by the same surgeon... the first was a L4-L5-S1 fusion just like you and the second was a L5-S1 fusion due to the fact that the fusion on this segment from the first surgery failed after 18 months. If I had to do it again... I think I would opt for the 360 as this gives the fusion the best chance and still maintains the good stabilizing screws and rods like a PLIF procedure. You are doing a double level fusion and the chances of one of the levels not fusing is high so you want to do everything you can to make it work. Also although my surgeon says they are nonsense... I would get a bone growth stimulator installed as part of the surgery. Just my personal opinion as somebody who has been there...
    Harry - 62 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
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