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At a fork in the road, DDD contemplating L4-S1 fusion W/MRI summary

edited 01/02/2016 - 8:07 AM in Degenerative Disc Disease
Hello-Any feedback would be super!

I am: Male , age 47, non smoker.

DDD going on 12+ yrs, just sort of lived with it, did the best I could. Really had a dim view of a fusion, as I thought it was giving up. I saw a new Dr lately that said nope, a fusion, I should look at as increased function and lower pain, well heck then lets go I thought ! Then looking into how invasive and the down time, wow-this will take some planning. Like I've printed off the entire calendar for 2016 and now am trying to plan.

Pain level, 4-5-6-7 daily, the best days are worse in last ~24 months. Pain in getting in the way of living for sure. Very active golfer since pre-teen, had flare ups in high school and college (lower back) , really I've played a ton of golf, but my dad had a bad lower back and probably genetics but really that doesn't matter.

MRI "Impression" : Multilevel dengerative disc disease and spondylosis without high-grade canal or foramina narrowing.

L3 and above looked normal, so left them out. The actual L4-L5 and L5-S1 on the film do look pretty narrow and was told their basically "SHOT"

The L4-L5: Moderate loss of disc height and disc hydration with small anterior and lateral vertebral marginal osteophytes and Schmorl's nodes, with a 3mm AP generalized posterior margin disc budge, superimposed postercentraol 10mm transverse x 3 mm AP disc protrusion which protrudes 2 mm caudally, and mild right and left posterior lateral disc osteophyte hypertrophy, mildly to moderately narrowing the subarticular recesses, left greater then right, and mildly narrowing the AP dimension of the central canal to 10mm. Mild narrowing of the right neural foramina entry zone. Patent left neural foramen.

L5-S1: Moderate loss of disc height and disc hydration with vacuum disc phenomenon right anterolateral 5mm disc protrusion and mild associated osteophyte. 4mm left anterolateral disc bulge and osteophyte with Modic 2 fatty infiltrated marrow. 4mm AP broad based postecentral disc protrusion with associated high T2 and STIR signal in keeping with annual tear. minimally indenting the ventral thecae sac. Thecae sac measures 13mm AP, without narrowing. Mild Bi-lateral subarticular recess narrowing. Mild to moderate right neural foramina narrowing and mild left neural foramina narrowing.

In last 60 days had two ESI shots, no help. One facet joint shot 3 days ago, too early to tell but maybe 20-30% help so far.

Had ESI shots over the yrs, didn't really do much to help. Tried several PT efforts, even tried acupuncture. Pretty much tried all the conservative treatment, at best it was a band aid.

I can still do a lot but its the more I do the more pain I'll have. In addition, my golf has curtailed big time, just hurts too much. I can still play well but I will pay for it.

I've seen two new Orthos, and the Ortho I've been seeing for yrs, (over the last 30 days) two said L4-S1 fusion, the other said what I think was a laminectomy.

I've pretty much decided to go with the fusion, I hear its important to have a positive attitude to get thru it. Whats tough is, I've tried everything but surgery and that hasn't worked, which is frustrating. So I need to believe the fusion will work knowing everything else hasn't <not easy.



  • Your story is like mine. Been kicking the can down the roads for 12+ years. Getting worse. Still active but pay for it. Don't want to lay down and ice every day for the rest of my life. Surgery on 1/26.
  • kkuylenkkkuylen Posts: 86
    edited 01/22/2016 - 5:47 AM
    Same here guys. I just scheduled L5-S1 ALIF fusion for Feb 16. Back pain been on and off for 10 + years but last year and half has been constant discomfort and severe limitation of my activities. How are you guys making out?

  • I am ahead of you by almost three weeks. Hopefully, my report back will be encouraging. :)
  • I was not as long suffering as you gents. 3-4 years of trying PT, epidurals, chiropractic and loads of ibuprofen & scotch without progress. MRI. Showed DDD, doc says it won't get better on its own. I jumped at the chance for ALIF surgery. I have been athletic all my life, want to get back to being active again.

    The first week want as expected; pain from surgery but previous leg pain gone...or mostly so. Weeks 2-3 I had the most horrific leg nerve pain in both legs. Before surgery only pain in left leg. I'm telling you, I slept 1-2 hr stretches in the recliner, roamed around the house all night just trying to keep moving. My pain meds did nothing to alleviate.

    But I kept walking 3-4 tines per day. Started out just around the block, then around the neighborhood. By week 4 nerve pain subsiding, and I stopped all meds. I'm still not 100%, but the pain I went in to fix is totally gone. Now it's just recovery: nerve decompression, strengthen muscles, etc.

    It's worked out for me.
    57 Years old Male
    L4-S1 ALIF 12-16-2015
  • Felling great. Pain is very manageable, not even using anywhere near what they are offering me. Sat in a chair for 90 minutes yesterday and taken multiple walks around the ward.
  • SavageSavage United StatesPosts: 5,427
    Welcome to Spine-Health
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    Please read my medical history at: Medical History

  • I have had DDD since 2003. I just turned 54 last week. I worked as a surgical nurse for 24 years and have handed the scalpel on about a 1000 spine surgeries. Years of lifting patients and heavy trays of surgical instruments demolished my back. Lower back being the worst. Years of pain management with injections, Rhizotomies, more blocks, even did Stem Cell injections taken from my bone marrow in hip. This was not a success for me either. L4 L5, L5 S1 were collapsed so badly I called myself a half a day person. That's all I was good for. Unable to function in my very active life, I went for a second opinion after 12 years. The opinion was strongly recommending 2 level fusion. Keep in mind that I was a surgical nurse and know the best doctors in my area. I chose to have the surgery November 3,2015. I am 3 months out and doing much better. NO LEG PAIN! NO BACK PAIN! If I'm up to long it starts to hurt but I feel it was the right decision for me. I know that this is a step in managing my back issues not a cure. I will take care of it and I have had to give up scuba diving but I do not like being in pain ALL the time so I will not risk hurting it if I can help it. Good luck with your decision and do what is right for you. My recovery time has been described to be 6 to 8 months, even a year for complete fusion.
    Renee Roth
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