i have multilevel DJD L1-S1.mild low back pain for years.now 2 months of radicular pains down both legs to buttocks and into lateral calves aftre attemping to lift large metal storage door.also at times very sharp pain into front of thighs.now mild weakness of dorsi flexors of ankles-i cant walk on my heels without failing to side. physical theray for 3 weeks did not help. interforaminal epidural steroid[x1]did not help.Stretching, squatting, sitting, and oral corticosteroids help temporarily. Surgeon reccommends major surgery involving transforminal lumbar interbody fusion, posterior lumbar fusion and use of bone morphogenetic material possibly for all joints L1-S1. Says I will get 90% leg pain relief but be stiff in lumbar spine.Surgeons experience-spine specialist only for 18 years, university faculty and author of med books and articles.I may try to convince to do only L3-S1. Anybody experience with multiple fusions in lumbar area. Im 61 years old and in good health- parentsd still living at 87 and 89.
I gather you have not had back surgery previously, right?
If I understand you correctly, your surgeon is recommending fusion from L1 to S1? There are probably a couple people on the board that have that many levels fused, but, it is not common.
If I were in your position, I would get at least another opinion, perhaps several more depending on what the second doc says. You would not want to contemplate such a HUGE surgery without knowing for sure there are no other options. Your surgeon sounds well-qualified, but every specialist has a slightly different way of proceeding and of evaluating what will help and what may not...so it is always a good idea to find several well-qualified spinal specialists and see what each recommends.
spondylolisthesis at L4-5; stenosis at L3-4 and L4-5
radiculopathy for about 3 years
PLIF (L4-L5)in Jan '08 (PEEK cage, rods & Screws, BMP); continued radiculopathy....
Lami-foraminotomy L5-S1 Jan '09; continued radiculopathy;
Bulging discs L3-4 & L5-S1; crazy screwed-up S1 nerve
***** I have no medical training and am in no way connected with the medical profession, other than doing my part to keep them at full employment. My posts are based on personal experience and knowledge gained through the adventures of living. Take them for what they are worth....
Thank you gwennie17.Weakness in legs and reflex changes involve L4-S1. cant work without a small amount of cortisone [dexamethasone 1 mg-1.5mg on day of work].i am bent forward an cant stand all the way up until the steroid hits. i just suffer on the days i dont work and dont take any steroid on those days.going for another epidural at right L4-5 in 4 days.i will seek another opinion soon also.my primary care has been Physiatrist but he has not helped so far.I think L4-S1 fusion might resolve symtoms as traction does a good job of alleviating all leg pains.
When you start having loss of reflexes and muscle weakness, it is probably time to think about doing something.
The probable 90% improvement in leg pain is based on statistics. It is important to be realistic going into a fusion and to realize that the surgery will not restore you to the way you were prior to injury or onset of pain. You MAY come close, but you will never be "good as new."
Back surgery is very different from every other type of surgery and it is hard for others to grasp this concept. We all have problems in recovery with people who assume we should "be better by now." They are familiar with surgery, like an appendectomy, where once you recover from the surgical procedure, you are well...and can function just as you did before. This is not the case with back surgery...as there are no guarantees to the outcome...and the road to recovery is a long one.
That being said, I don't think you will find a great deal of difference in the movement of your back after you heal...if you just have one or two levels fused. With more levels fused, you would...but, with what you are having done, I don't think you will find it too different. (assuming they do L4-S1 as you mentioned -- L1-S1 would be an entirely different story. I would definitely get more opinions if you are thinking of having that many segments fused.
They always say that the surgery is much better at resolving leg pain than that of the back. I have no personal experience with this since I never had any back pain. Mine was almost entirely in my legs.
On another note, you might want to go back and change the subject of your post. I think people scanning through think the thread pertains to message boards in general, rather than to a specific comment you have. It is unusual not to have more comments for others, so you might want to try that.
spondylolisthesis at L4-5; stenosis at L3-4 and L4-5
radiculopathy for about 3 years
PLIF (L4-L5)in Jan '08 (PEEK cage, rods & Screws, BMP); continued radiculopathy....
Lami-foraminotomy L5-S1 Jan '09; continued radiculopathy;
Bulging discs L3-4 & L5-S1; crazy screwed-up S1 nerve
***** I have no medical training and am in no way connected with the medical profession, other than doing my part to keep them at full employment. My posts are based on personal experience and knowledge gained through the adventures of living. Take them for what they are worth....