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Contiplating TLIF



  • Whyme said:
    Thanks for asking! I have results, but all I can do is guess to the meaning of some of it: "resorptive and sclerotic reactive changes..." I think (hope) it means I'm fusing, although I still have bulging discs in the level above and 3 levels of my neck, but not sure of the other stuff on there :p I'll know more if any of it is problematic on Wed. :W
    I wonder if the "resorptive changes" refers to one side effect of BMP. Sometimes it causes bone to grow then reabsorbs the bone then maybe grows it back again. If you have new nerve pain, the BMP could have caused bone to grow on your nerve roots, not sure where your pain is, tho. Hope you have good news on Wed.
  • GYnot said:
    I'm new, so please be gentle. In '89 I had my first fusion L4/L5, no hardware. It was so successful that I was on top of the world. No more leg pain (Sciatica), I felt great. About 14 years later I must have done something wrong, probably lifting, and the leg pain came back. I also have DDD, so I'm sure that that played a part. The odd thing about the pain is that it's only there in the morning, but it's excruciating. If I take a 20 minute drive it's usually gone for the remainder of the day and again I feel great. Arthritis? Swelling?

    I recently had a CT, MRI and Milogram (talk about barbaric on the last one). These showed lytic spondylolisthesis at L5 upon S1 (bone on bone) and mild spondylosis at L4/L5. I saw a specialist yesterday and he recommended a TLIF. He also said that if I it done that I could also have complications in a few years and have another disc go. This is my biggest worry.

    If I stay like I am now, what's the worst that could happen? Would losing weight and physical therapy help that much? He also mentioned injections (not sure what kind), could those help?

    I take nothing for the pain except MSM and Glucosamine Sulfate 3 times daily.

    I'm on COBRA as far as insurance which runs out at the end of September, so I have to make a decision soon whether to have the surgery or not.

    Thanks for any help.
    Many surgeons believe that after a fusion you have a "golden window" of 10-15 years before another disc goes bad from the stress of the fusion, so I wouldn't worry about whether you've done something wrong.

    Bone on bone? Normally I agree delay surgery, but how are you going to non-surgically fix bone on bone?

    Is the Glucosamine for your back? I know it works for knee joints, but don't believe there is any peer reviewed credible research that proves it can do anything for your back, it just doesn't work the same. But maybe you take it for joints???

    Another opinion might be good to ease your mind. TLIF results I have heard have the same 2 year outcomes as traditional midline open fusions. Some would say that in a TLIF, less muscle is cut, but if the muscle retractors have to be left in place for a long period, it can deprive the muscle of oxygen so why not just cut it? Most of the TLIF people I've talked to haven't had shorter hospital stays. In fact, considering you've had previous surgery, it might be better to have a more traditional approach so that the doctor could better visualize everything. I wish my original surgery would have been on open, midline, fusion rather than a TLIF. But, my point is, get more than one qualified surgical opinion so you can make a better informed decision.

    It is unfortunate that you are on an insurance timeline. I really think you need to act on getting a second opinion so you can make a decision. Please keep us updated.
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