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Surgery outcome data

Can anyone point me toward some research on outcomes for lumbar fusion surgery? I am new to these forums and have been frightened by some of the stories here of people who have had bad outcomes and ended up confined to bed, in terrible pain, etc.

My story: I'm 57 and I've had back pain for about a year. Most of the time it's not very bad, but it gets worse when standing/walking for an hour or so, and I get stabbing pain whenever my back is jolted (like even stepping down off a curb). The stabbing pain has limited my activities a lot - have had to miss family vacations, stop athletic activities, etc. MRI/CT shows herniation, degeneration, and lysthesis at L5/S1. Have had facet injections and SI injections (my doc was working on the hypothesis that it was arthritis in the facet joints causing the pain) with little success. Now the doc is thinking I might need fusion surgery. If it can rid me of those stabbing pains, great, but if there's a significant chance I'll end up much worse than I am now, maybe it's not worth the risk.

Thanks for any help!

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Comments

  • mdbob

    welcome to spine-health

    learn how to use spine-health - take the system tutorial 


    Research on outcomes is hard to come by because of so many variables, I have had 2 lumbar fusion surgeries L3-L5, I consider both a success, but I also have several other spinal issues which still cause me pain, the fusion surgeries did however reduce my major pain and at least let me walk again without major pain, most patients that have surgery and do well end up going on with their lives and do not really talk about it very much, so when you come here, you do not see many success stories.
    I will tell you that fusion surgery is a very serious surgery with a fairly long recovery time, after my first I was able to go back to work after 4 weeks part time, I owned a auto repair shop, so I was on my feet a lot, after the second it was 9 weeks, again part time, it was at least a year before I felt like I was fully healed, so it is not a sprint, more like a marathon..
    I hope this was somewhat helpful, and if I can answer any other questions, please do not hesitate to ask.

    Chip

    challenger
    Veritas-Health Moderator


  • Mdbob, Chip was spot on with his post. There are as many success stories as well as not so good stories. The problem is, once the member has recovered , and it was successful, Then they stop coming to any spinal site and not just this one and get on with their lives.  I would definitely though be pro active with your spinal care! The longer you wait for any treatment, the more the damage increases. Please keep us posted...David

    DavidG

    Veritas-Health Forum Moderator

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  • Mdbob, another thing I should have mentioned in my previous post was that surgery success rates are truly misleading. To a surgeon, a successful spinal surgery means stabilization. Has no mention of nerve pain, radiculapathy, which is not looked at as part of a success rate.......David

    DavidG

    Veritas-Health Forum Moderator

  • Thanks for your responses. I'm aware that folks on this site are more likely those who have had less-than-successful outcomes - that's why I was hoping to find some real data on the subject. The data I've been able to find only talk about patient satisfaction - not about serious negative outcomes. I think that's what DavidG is saying. I'm also aware that back problems vary wildly, and so outcomes must, too. Maybe what I'm looking for just doesn't exist? 

  • Mdbob, you can take 2 patients of the same age, same problem and even then the outcomes will be different. There is so much data that has to be put in to the equation and unfortunately you will still have questions. The same goes with asking the surgeons! You will be given so many different answers. I really believe we all walk into our first spinal surgery and think we will come out of it feeling brand new! Some do and a few years later their back with additional problems. Some come out with the same issues and pain and even are given new symptoms and new pain as a bonus! The one thing I am positive about though, is the longer you wait, the more damage you will have. That’s one common denominator! Please keep us posted and let us know how things are going...David

    DavidG

    Veritas-Health Forum Moderator

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  • Mdbob

      What chip and David are saying is spot on. Alot depends on what problems also that are involved.  Now with me  my first surgery was more a emergency surgery so I really didnt have the option to explore data. I deem it a success because I'm not wheel chair bond..but in terms of pain relief no..so alot also has to do with your initial problems. 

      Now 14 years later since my last surgery I am again having increasing issues...this time though yes I can explore option as it not as urgent.  I keep tossing back and forth the pros and cons..and what in the long term the affects will be. Should I allow them to extend my fusion or just seek out palliative pain care..I'm also older now..my first 3 surgery were done in my very early 40s..now I'm 58..so theres alot that figures in..

      I do feel and this is only my opinion I have seen threw reading and listening to others that the less levels done they seem to be the ones left with the least post OP issues with chronic pain ect..and go on with their lives and that were you are at with the one level..do you continue with the pain or more or less shoot for the stars and have that level fix..chances are you will do well..cant promise but most do.

  • Mdbob I had a lumbar fusion of L3,4,5 and S1 on Feb 20 2019. I had been having some pain upon standing and walking and I also have scoliosis which was getting worse. I think the surgeon was correct about it getting worse over time and those vertebrae getting more squeezed down. However, the surgeon, who touted his experience with minimally invasive surgery was probably not the best one to go to. I should have gone to Seattle to a well know spine surgeon to have this done. When I woke up I had the worst, most intense burning pain down my lower leg to the top of my foot and arch. It has been 3 month after surgery. The pain has lessened as far as the burning, but my foot is still really bad. I can barely wear a shoe or sock. I still have to take hydrocodone. I am told that it might heal or it might be this way forever. The doctor never mentioned this to me as a possible outcome. If this doesn’t get better I can say that life as I knew it is over. If you decide to go ahead with this surgery be sure to get a couple of opinions from well established doctors with good track records. I didn’t do this and am now paying dearly for it. This was my experience so far....if it my nerve ever heals or there is a procedure than can manage the pain, I will come back to this forum and report it so as not to scare people off of doing it. Some have great success. I think it depends on the surgeon. Good luck!

  • Went to another surgeon today (actually the one I originally went to last year) and he convinced me to wait on the surgery. He wants me to have an ablation first - to "get all the data". I asked him about the worst-case outcomes and he said that usually happens only with more complicated back surgeries/problems. He admitted that even with a single-level fusion, about 10-15% either see no improvement or are slightly worse afterward (in his practice). 

    newtopain, sorry to hear your experience, that really sucks. Thanks for sharing the cautionary tale. I feel like this surgeon I'm seeing is very cautious, so I trust him to tell me what are the likely problems up front.

  • nutcase007nnutcase007 United StatesPosts: 918

    Your surgeon wanting you to get a nerve ablation first appears to have become a standard protocol these days.  I don't have lumbar issues, but have complex cervical issues.  I was also but through the nerve injection process and then multiple nerve ablations.  Yes, from my experience, nerve ablations can often be diagnostic or as you said, "get all the data".  I know several friends that have had single level lumbar fusion and have had very good success.  As you know, there is no guarantee of success.

    I've often used this borrowed quote: "Do your due diligence, trust you know your body
    and question everything if it does not fit. Advocate for yourself and you will
    be surprised what will be revealed trusting your body and instinct
    ".

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