I had similar concerns about my neck. I had 3 opinions, and 2 recommended 1 level, and 1 recommended 4 levels. I decided to go with the 4 level because with my history of things getting progressively worse over time I really thought if I did 1 level I'd be back for more surgery later.

I was straightforward with the surgeons; asked them what was wrong, what they recommended and why. I told them about my concern about my other levels, and why should or shouldn't multiple levels be addressed.

I had the same concern when addressing my low back, but I was comfortable with my surgeon's explanation of why a laminectomy and discectomy at one level was appropriate.

It is tough being a "spiney" with multiple areas of issues.

Good luck with your appointments.

KarenD

When I had my spinal fusion (L5-S1) L4-L5 had spinal cysts. The doctor decided not to fuse that level too because that's where the most movement in the spine is, so if that's fused then all that movement carries over to the next disc in line and causes it to deteriorate.

His view is that you should fuse what you absolutely must but work on strengthening core muscles to support the rest of the back, otherwise you just end up having one fusion after the other. Apparently, this does not happen with L5-S1 as much because it doesn't move much anyway.

Obviously I am not a doctor, but as I understand it, a surgeon will only perform an operation if it's necessary. And although you may have a few herniated discs, it doesn't follow that they are ALL pain generators.

Some herniated discs can heal by themselves if left alone and given sufficient time, a degree of protective care and can go on to give years without further problems. Of course, this doesn't apply to everyone.

If the surgeon fused all the discs, then not only would your flexibility be compromised, but you would have endured a far more invasive surgery with far longer recovery time. On the other hand, if you had 1 or 2 levels done, it could be that the remaining discs might settle down with the right conservative treatment and good pain management etc.

Out of interest, have you had a 'discogram' or similar diagnostic tests to find out exactly how many discs are involved and if they are all pain generators or not?

When I first saw a surgeon 7 years ago about my back pain he said that a one level fusion might be suitable at that time, but I did not have the surgery then. However, after continuous chronic back pain and loads of conservative treatment, by the time I saw my last surgeon in 2009 and having a discogram to confirm which discs were pain generators, he recommended a two level fusion, which I had in 2010. My point here is that if I'd had the one level fusion many years ago, I would have automatically blamed that on my need for having a further fusion in 2010 - when in fact the degeneration happened anyway. Do you see what I mean?

There's no evidence, in my opinion and from my own personal experience, that having a fusion will automatically mean that you will need to have further levels fused later on.

As the previous post said, good core stability to protect your back and offer more improved muscular support to your back is the best defense you can give yourself, as well as adjusting your lifestyle to avoid excessive bending, twisting and lifting etc. and receiving good pain management if required.

If you've already had the diagnostic tests and the surgeon has recommended a multi level fusion, then I'm sure he only has your best interests at heart.
Keep asking questions, and research well and get lots of information. Your surgeon should be reassuring you of what procedure you need and why.

NB: Sorry, I should have done this first, but I've only just read your signature details and noticed you've already had a 3 level cervical fusion, plus your surgeon is saying 3 further cervical levels are herniated and now the herniations in your lumbar spine. Have you actually been given a definitive reason why your discs keep herniating or do you perhaps have a very physical job that may be causing it? Is it DDD? Just wondering because whatever your diagnosis is may indeed indicate that fusion of more levels is recommended to avoid further disease/damage and to ensure future spinal stability.

As I said, I'm not a doctor, and I'm sorry you've had so many discs that have caused you problems. I'd be interested to understand why if you are happy to comment further.

The first thing i would do is get another one or even two more opinions. I made the big mistake of going with the one and only opinion i got. L2-L5 were bad and the surgeon told me that S1 is fractured and to do only a 3 level fusion on the discs above the fractured disc is llke building a new house on a bad foundation. To me this made sense and decided to fuse all four levels at one time. Since your bad discs are above the bad one and are not as weight bearing may make a difference if they really need to be fused. I don't know, i'm not a doctor, but I would sure get another opinion. Let us know what you decide. I hope the best for you. fusing all four at one time is a HUGE surgery. Kevin