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What should I do??

doubleeagleddoubleeagle Posts: 9
edited 06/11/2012 - 7:25 AM in Degenerative Disc Disease
Hi Everyone--After reviewing my discogram results with my orthopedic surgeon today, my only surgical treatments are a 3-Level Fusion (L3/4-L5/S1), from an anterior approach only w/instrumentation. I was positive for pain on L3-4 and L4-5, but L5-S1 is bulged and degenerated badly also, so he said I would have to have all 3 of them fused.

I'm a 41 yr old male, I had a 1989 laminectomy L4-5 by the same surgeon. He is highly regarded and handles the treatment of all 4 of the Major Professional Sports Organizations in Detroit. I have tremendous faith in him and trust his analysis of my condition. However, I am somewhat disappointed by our discussion today. He said this is not a so called "slam-dunk" surgery like I had in 1989 for one severely ruptured disc. He said this is a "whole new ball game", and that were dealing w/ something completely different. He said I have a 60% chance of being better, and a 40% chance of staying the same. He emphatically stated that I would not be worse. He said that I could have additional problems down the road with arthritis and it is hard to predict how severe it could get.

He truthfully admitted that w/3 level fusions, the success rates go down. Overall he was not very eager to do the surgery, mostly because I am fairly young. He said if it was him, he would wait another year and keep working on the p.t. and core strengthening. I don't have any numbness/tingling or weakness in my legs, and very little leg pain. My problem w/any motion of my spine created by activities, my muscles spasm up horribly to protect my spine by forming a splint.

Have anybody out there been told, or no of anyone who was given the same type of odds from their doc's and went ahead and had the fusion??

I don't know what to do? I know if I don't do it, I'll never be able to have a normal activity level on a day to day basis, no matter how much conservative treatment I do. I've already done it all the past 4 yrs, it's too much to even list.

Thanks for any help/advice.



  • listen to the doctor.....or get a second opinion.
  • If you can afford a year off work is that what he meant? Or would it be okay to wait and there would be no damage I would ask that of him. If unsure I too would get a second opinion perhaps from your Neurologist? I'm sure you'd be able to keep him as a surgeon just to get someone else's point of view. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
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  • Thanks for the response. My doc has me on permanent restrictions, so I am on long term disability which doesn't pay much. He said that waiting will not necessarily make things worse, but I would not suffer any permanent damage by not doing anything at this time.

    You are right bigcat90, I am going to take his advice and I am going to make an appt with a neurosurgeon just to get a 2nd opinion.

    Have you or anyone else out there know of anybody that has had a successful 3 level fusion? I am afraid of any fusion because it's irreversible and if it makes things worse, you are just gonna be on more pain meds for life.

    Also, has anyone out there with DDD had significant improvement from non-surgical treatments?
  • I had a discogram done and found out that L3 L4 and L5 S1 are causing severe pain (discogram was hell). In meeting with my surgeon he said that because of the location of these discs L4 L5 would have to be done also, or it would just be a matter of time before it would go. My surgeon said he would not do a three level fusion on me unless I was in too much pain to move, so he put me on PT and got me a back brace.

    The back brace causes pain when put on, so that is out and the PT I can do is minimal to say the least (mostly isometric stomach exercises, a few stretches and walking). I am working on my PT every day and feel like I have been making progress and have been told in six months to a year I could be mostly out of pain. Not the best thing to strive for, but to me it beats the fusion option (which is guranteed pain and chance it could make it worse).

    I have severe DDD in L3 L4 and L5 S1 and multiple bulging discs. I feel strong about my decission, but it may change if I am in the same amout of pain a year or two from now. Take care and keep us posted. Mitch
  • :jawdrop: I hear ya on the pain of the discogram. Had mine done last week - good thing the docs and nurses stand behind you otherwise I might have hit someone! My DDD has progressed over the past 7 years as a result of a fall I had from 20+ feet in 2001. I'm now scheduled for an Anterior Lumbar Interbody Fusion (ALIF) on 17 Dec.... really not looking forward to it, but I'm hoping it remidates the daily pain.
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  • I just got the results of my MRI, L5 pars defect, disk bulge some L6 and SI involvement too. I was fitted for a bi-valve brace which look torutous but should arrive in 2 weeks. My neuro-surgeon says to prolong surgery till the pain is unbearable, this confuses me because my right leg will seize up if I walk for more than 10 minutes. I have some numbing on my right side, and I would hate to lose more feeling by waiting. Any ideas or feedback is greatly appreciated.
  • :) hi! you asked if anyone was having good pain control with DDD using conservative measures. i have a good program right now that is making me feel better than i have in many years. i am 52 so i know of the problems you speak of with age. i use pain meds, i feel i am highly functioning on them. also nerve pain meds, exercise(walking or swimming), rest, Yoga,and if i could, i would have a massage at least once a week to loosen the back and neck muscles. i also do volunteer work which i feel is so important to my mental well being. there is many more than these and you have to find your combination, ones that works just for you. over 50 our discs loose the moisture inside and DDD does not progress as quickly. it would certainly be of benefit to you to start to check out some of these measures. a good pain management doctor is a good start. the sooner you start the better you will feel. Jenny :)
  • L6? There is no such thing as L6... where is your L6 disc bulge? :/ The lumbar spine is L1-L5.
  • Maybe it's congenital and there's an extra disc.

    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
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