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Having surgery soon...Terrified!!!! Fusion or Disc Replace??

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:22 AM in Back Surgery and Neck Surgery
Hello,
I'm a 38 yr old female. I'm having surgery on L5-S1. I need help making up mind about which surgery to do. I've been offered one of these by my Dr. (I'm not sure my insurance covers ADR.) I can't live with the pain any longer. But am terrified of being cut open through the front & having my insides moved around including major veins. I guess the parts that scare me the most are bleeding, death, having major problems after the surgery, because of the veins. I have 2 kids that I don't want to leave them mother-less.

So, please give me your insight of which surgery you had. How long it took to recover, back brace, are you still in pain, have any new pain and anything else I forgot.

Thanks a bunch!!!!!!!!!!!



DDD L5-S1, x-rays, MRI, Melyogram, 2 CT Scans, Discogram
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134

Comments

  • Hello Charmed.

    A serious choice. Do you have a supportive partner?

    I have had 2 surgeries now, Dyneyses and PLIF S1/L5 and removal of dynesis to pedicle screws and fusion of L4/5. I am 6 months post 2nd op and still in pain - but I am unlucky. I am an unstable spondy and ddd so have numerous problems to sort out.

    I was at the end of my rope and felt the risk was worth taking. It is a long recovery and varies for all of us. With a suppostive family around it will be easier for you.

    The results are not guarenteed and you kinda have to be in a place where you have nothing to loose. What is the quality of your life now? Can it get worse - I mean is there room for you to suffer a bit more? (hope not but you need to think).

    Ask your surgeon what results he hopes and what your expected problems may be...for example if you smoke your at higher risk of non union, DVT if you are overweight you may have problems with wound care. Its not an exact science, sadly!

    When I went in the nurses did a risk score on me. As I am young non smoker no health probs my score was low. But on my second operation, my score was high risk just because my previous surgery. This will make me think very hard next time (hopefully not) but i would want to know the expected gain versus the risk of problems.

    I lost 1500mls blood last time and felt quite weak afterwards. But i ate a good diet, pleanty of steaks and green leaves (vit c helps iron bind to red blood cells)and I felt ok after a few weeks.

    Its a tough one. Good Luck and keep us posted. :H
  • I too had to consider all my options. Surgery was a last resort. I tell you, I was almost surprised when I actually woke up after surgery - my first thought was. 'I'm still alive, thank you.'

    I also had complications post surgery and had to have a second surgery 2 days later. I had not lost a lot of blood in the first surgery, but needed 2 units in the second. I am left with a new symptom - a numb right leg. But my left leg shooting pain and bladder issues are gone. I'm happy with my outcome so far. I know numbness is lower on the healing scale than pain (pain means you at least have feeling), but I'll take it.

    It's a big decision and only you can make it for yourself. But I also have a dear friend who has been suffering severe back pain for many years. It would be the greatest thing in the world for me to see her able to feel better. Sometimes surgery really is the only option.
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  • I had PLIF 2 weeks ago, am doing well so far. My surgeon prefers ALIF, but I was not a candidate due to my unstable spondylolisthesis. With an anterior surgery they will have a general/vascular surgeon there just to be in charge of/protect your great vessels during the operation. I have been told the recovery from ALIF is much easier than PLIF. Those posterior muscles have a harder time healing than our abs apparently. So it is actually a plus that you are a candidate for an anterior approach, scarey as it is. Any surgery has risks, and these must be weighed with the benefits of possibly being pain free again. I know I struggled up to the minute I went into the OR with my decision, and so far I am happy I went through with it. Best of luck, Sue
  • I have just had to make this exact same decision myself. I'm 35 years old and I have decided to go ahead with the fusion. The ADR hasn't been around long enough for me, and as my last surgery was still "experimental" and has now failed on me, I need to do something that has more of a guaranteed result.

    Due to my old hardware having to come out, I'm having a PLIF. My surgeon told me that he prefers to go in from the front, because there is less chance of bleeding that way and also there are less muscles to actually cut through in order to get to the spine. They literally just move the intestines and stuff aside out of the way! Sounds horrible but apparently it's less risky. So I hope that eases your mind a little bit!

    Good luck with your decision, I know how tough it is to make it. Let us know what you decide to do. Hugs, Spicey :)
  • I just had a talk with my Neurosurgeon today about ADR vs fusion. She told me that the doctors in this area don't do them anymore because they are not secured to the vertebrae, and can slip back and forth. She said if they slip out, you need a major, major surgery to fix it. I was told that they have no proof that ADR puts any less stress on the surrounding discs than fusion does, but ADR carries more risks and is too new for them to have any long term studies. She also said most insurances won't cover ADR.. I think partially because it's so new.

    I asked about the loss of mobility, and she said it was about 10 degrees for l4-l5. l5-s1 is less than that, so you'd most likely not notice much difference, and should be fine playing with the kids :)

    I'm also going in for a fusion soon, and I wish you the best of luck! :)
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  • Hello Charmed -

    I understand the position that you are in. I had to make the same decision two years ago. I am 36 and chose to have a two level Chartie artificial disc replacement as my surgeon said that he would not perform a fusion due to my young age. I had the first surgery on 09/08/2006. Unfortunately for me, almost immeditately my pain got worse instead of better. My doctor kept telling me that everything looked great on the x-rays. I finally asked for a second opinion and was told by a world renown back surgeon in Baltimore, MD that both of my disc L3/L4, L4/L5 had migrated one by 5 cm and that if I did not want to die, that both devices would need to come out. The devices were actually causing my spine to develop scoliosis. Both my surgeon and Vascular surgeon in Baltimore explained that this removal and revision surgery was life threating. I really felt like I had no option. I am married and have two young children at home. The second surgery was in May 2007.
    After 7 hours they removed my two artificial disc, almost aborting the procedure on several occasions.Because of the scar tissue from the first surgery 8 months prior, it was
    like my surgeons were operating in the dark. My Inferior Vena Cava was cut causing me to require a blood transfusion of six pints of blood. My left ureter had affixed itself to
    one of my artificial disc and when they tried to remove it, it broke in half. After they opened me up in the front and finally finished the removal and anterior fusion with cages, they opened me up in the back where I had two rods and 9 pedicle screws put in to help stabilize my spine.
    I ended up with a 360 degree fusion and two additional surgeries to correct the problems from the removal of the devices. It is a bit ironic that my surgeon had me wait for 8 years on this new technology in lieu of the fusion procedure in which he refused to perform and in the end I ended up with a 360 degree fusion. I am still in a lot of pain and on morphine for almost two years, although thankfully on a low dose now. I just underwent a bone scan today as my docs are still trying to figure out why I am still having so much pain.

    My advice and I must stress this is my advice, If you must have surgery, I would stay clear of the disc replacement option for the low back. Also, get at least two opinions from doctors in different practices that have lots and lots of experience. I made the mistake and trusted my first doctor because he had a great reputation. Unfortunately, little did I know that at the time his reputation was based on the tried and true procedures of fusion. I wish I had chosen fusion as my first alternative. If you only knew what my family has gone through from all of this mess.

    Please feel free to send a PM anytime. I would be glad to
    answer any questions. I wish you the best of luck.




  • Before worrying about which surgery to have, chat with your insurer to see which they will cover you for as that may make the decision for you.
    I had a lot of problems and a big op- several level.

    But I ended up having 2 units of blood post op which was fine as i needed it and have continued on Iron tablets & C since as my HB is still a bit low. This has make me more tired then usual but that is not a bad thing as I have rested more- see a silver lining.
    Now remember that these Drs do these surgeries all the time and they constantly cut people open and move organs around so it is not like you are going to be an eaperiment. If they weren't practiced in this they would not be allowed to practice.
    Maybe your Dr could do a PLIF which is entry from the back?

    Also if you do decide to go ahead and have either surgery- you really have to get your head straightened out first. If you go in really scared it will be much harder for you so start thinking of the wonderful life you will be able to have after the surgery.
    Sure, it is hard and the recovery is long but I for 1 am so glad I had it done. I feel like I have a life again >:D<
    Blessings Sara
  • Well, up until now..I've made my decison on disc replacement. After reading your story, Timothy, I'm horrified!!!!

    First, I just want to say I'm so sorry, you had to through all that h*ll!!!

    At first before, I even went to the dr about my back...I was already checking out stuff on the web...and thought I had to have ADR. It sounds so much better than fusion.

    I have spoken to my Dr about both. I asked if he were me which one he would do & he told me due to his age (50's) and size (very tall & big, but not fat) that he would have fusion. I asked if he were me and my age & not over weight (134 lbs) & 5' 7" what he would do & he wouldn't tell me. He did say that there was success in 85% in ADR & 90-95% success in fusion.

    My part that worries me for fusuion is that it puts wear and tear on your other discs causing more surgeries in the future.

    Kristie



  • Hi Charmed!

    Well as you know this is a major decision. As for which one is best. Personally a fusion at L5/S1 is going to last a long time. If you get the ADR approved and installed and it fails the revision is for fusion. I have been told although I have my doubts that at that level by the time you are in your 50's there is limited movement of the L5/S1 joint. Get several opinions and then decide what works best in your world. Also when you make an informed decision with plenty of knowledge your apprehension regarding surgery may ease.

    Paul
  • Thanks everyone for you comments. My fears are starting to ease.

    I still haven't fully decided which one to go for, but I'm calling my Dr today to ask more questions.

    Good luck to all!!!!
    Kristie
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