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Upcoming L4/L5 fusion

mel v.mmel v. Posts: 59
edited 06/11/2012 - 8:43 AM in Lower Back Pain

Scared!!! Dealt with pain for the past 4 years. Go to the gym 5 days a week, doing core exercises, chiro, accupuncture, swimming, :< lumbar traction, many rounds of PT, epidurals that once lasted 3 months are only lasting 4 weeks. All non-invasive modalities tried and 4 ortho-spine specialist later... say L4/5 fusion needed. In this last month, I will be building my thigh muscles and my arm muscles to help with movement. Eating super healthy and trying to lose a little weight before surgery. I am not overweight, I do not smoke, I exercise regularly, eat well and generally a happy person. Trying to keep positive. Scared I'll be in pain the rest of my life if I don't do the surgery, and scared I'll be in pain for a very very long time if I DO DO THE SURGERY. I debate the question...how long should I wait to do the surgery if it is inevitable? Doing it next month gives me (3) months over the summer to have a slower pace of life and be selfish with rest and have people help me because school is not in session. I already feel that our life here with my two boys (16) & (12) and husband of 18 years have been compromised by my back pain. All vacations and leisure activities are dictated by my pain level. I am either in pain or don't participate. So.....how long do I wait ?


  • Mel,
    Welcome to SH. Sorry you had to find your way here. Glad you did. You will undoubtably get a host of answers here. Most will tell you the same thing in the end. "it's up to you!" Only you can decide if and when surgery is the right thing for you.

    Reading your post I think you have pretty much made that decision. (And done a fine job thinking it through too I might add.) Now you just need to convince yourself. LOL!

    Many will tell you how they made their decisions and hopefully it will all help sooth the bundle of nerves. Bottom line, it's a personal decision. You know when you are ready and when your family can best handle it. Honestly, when is there ever a good time for surgery though? Right?

    As for me, after 5 years of exhausting all conservative routes I was bone on bone. It was time.
  • If you could provide a bit more information, it would be helpful. Why is surgery recommended? When I first read your post, I was surprised how much you are able to do...going to the gym five days per week, swimming, etc. But if you have been assured that there are no options other than surgery, only you can decide when the time is right.

    It sounds like you have done your homework and it is more convenient to do it when it is good for you and your family than waiting and possibly ending up in a situation where emergency surgery is needed.

    It is perfectly normal to wonder IF it is time to have surgery, and to be frightened. We can help with the being scared, but you'll have to decide if the time is now.

    Good luck with your decision.

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  • I believe Frog really put it best that in the end it is up to you but Gwennie also made a point that really screamed out to me when reading your post.

    You have been able to do quite a bit and most people look to surgery as the last option after they usually have pretty much reached the point that the quality of life has reached a very low point.

    The only reason I bring this up is that a fusion is pretty much one of the last steps people do to deal with the pain and low quality of life issue. As many can tell you once you do a fusion there is no turning back. Also you can read through the many threads here of people who had no success or some success and than failure with a fusion.

    I have not had a fusion myself but going on 1 1/2 years of fairly chronic pain. I personally would not do surgery until a 5 year period similar to Frog has passed and the quality of life has reached a very low point. Ofcourse you and I would listen to my doctor closely but may get multiple opinions.

    Please understand this is just my opinion but if you do the fusion I really hope you can finally attain a pain free life.

  • Welcome to Spine-Health. You'll find a lot of information on this site and might want to check out the articles and videos concerning lumbar spine surgery.

    Like the others have said, the choice to have surgery is a very personal one and only you can decide when and if it's time.

    My choice came when all conservative measures were exhausted and I simply couldn't function on a reasonable level in my life. The time was right for me as well, so I went ahead with it. At four months post-op, I'm glad I had it done as the pre-op problems are gone, but I'm not going to lie - it's a painful surgery with a long recovery. And every surgery will forever alter your spine, many time for the better if you're having severe pain or your spine is unstable. Another thing to consider is if you'll have permanent nerve damage if you wait.

    Nobody can tell you what's right for you, but I've shared my story with you as others have.

    Good luck on making your decision. We'll be here to support you whatever you choose to do.
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  • Welcome to Spine Health. As has been stated, whether or not to have surgery is a personal decision between you and your doc. Only you and your doc can know the long term prognosis of having or not having the surgery.

    I commend you for working to make certain you are in good health and good condition in order to make your recovery go better. I too am one of those who did everything possible to get into as good of shape prior to surgery as possible. My husband would cringe watching me force myself to work out knowing how painful it was and would always be there with ice and a helping hand afterward. I also found that the endorphin release from the exercise was some of the best pain relief I could get and I hated knowing that it would only last through the exercise and a short time after. It was enough though to help make that difference. It all depends on the specific injury though as to whether we can do any kind of exercise. As you can see, many feel they are unable to do so. Being an exercise junkie, I find it is one of my only "comfort" places to be.

    Of course key to this, is ensuring my surgeon gave the okay prior to. I was told I could do whatever I could tolerate. I hope you have checked with your surgeon as to whether or not pre-surgery exercise is okay for you.

    You will see that there are many people here who have had mixed results from fusion surgery. The statistics are swayed by the fact that many who have successful recovery from surgery no longer feel the need of the support from this group of people. So they move on and many that remain, are those who are still struggling. It is something to consider, but please keep in mind that what you see and hear here might paint a gloomier picture than normal.

    Once again welcome to Spine Health.

  • Hi Gwennie17,
    I've had (4) years of pain. Tried chiro,, lumbar traction, accupuncture, accupressure, message therapy, numberous rounds of P/T at local hospital, swimming, and now (5) epidurals over 16 months, yoga and pilates. My last epidural was March 22nd and is wearing off quickly. My problems are thus: Grade 2 spondlyo., herniated disc btw. L4/L5 and spinal stenosis. I've been working diligently for 4 years of avoid surgery. But as the the epidurals wear off, saiatica kicks in, sleeping is worse, walking around the block with my small dog kills me, standing in the kitchen cooking for my family is painful, walking any distance hurts. I've been to (1) neurosurgeon, & (3) ortho-spine specialist for opinions. I've had (2) sets of MRIs and countless x-rays....I should be glowing. They all say "L4/L5 fusion via PLIF method.
  • Mel,
    Each surgery is a separate entity and although my fusion failed it should not be used as a reflection for others, our medical status all differ and as said, only with evidence from a doctor should we decide when the opportune point is, it is a leap of faith and you are entitled to that chance without is being tainted from the minority. It is natural to have some trepidation of the future and if this is your last option then you can do not more than that, you have worked with your condition and maximised the chances of success, through your endeavour and positive strategy.

    All pain impacts on family life and this is a team event, we need that close support and encouragement, all those helping wished you had no pain and that is something they cannot provided it is not easy for them, watching someone they love in pain.

    Doing nothing is only an alternative when you are evaluating change or that has been a medical recommendation. You have to feel confident in the decision you make and delaying the inevitable surgery when this is the appropriate action, does you and your condition no favours. You wait as long as you have too, only you know when the time is right, at times our condition itself determines the time scale, my time came when I could not walk well or stand up straight, what alternative option did I have.

    Quantifying improvement cannot be projected and if the chance of improvement is greater than staying where you are now and doing nothing, then the decision is made your ortho has suggested this on the basis that it will improve your quality of life and many here wish you well in the months ahead.

    Take care and good luck.

  • Your symptoms are similiar to what I had before my surgery, though I also had gotten to the point of incontinence, spasms that kept me awake for days, and almost complete inability to walk. Fusion is the treatment of choice for spondylolisthesis. What impresses me the most about you is your level of fitness. This will be a big plus in your favor for recovery. I still have pain after my fusion, but the worst of the symptoms I had are gone. I am glad I made the decision to have the surgery.

    Best wishes,

  • Hi guys, I'm new to this (first posting and all). Can relate to 'Mel v'and am very sad to hear all your experiences. I had the same dilemna, sort of,pain was unbearable, my wife in tears watching me struggle to take even the smallest of steps,etc (won't go into it all).
    My doctor referred me to a specialist who explained to me an alternative to fusion and that was having an implant. He gave me a choice between a 'Wallace' implant and a 'DIAM' implant as they would do the same job as fusion in regards to pain relief but allow full movement of the spine. This option sounded good to me and I chose to go with the DIAM implant in the L4/L5.
    That was March 2006, now over 4 yrs later. Relatively pain free, still take 'brufen' and I don't do much with regards to activities, but my quality of life is vastly improved. I say all this because nobody seems to say much about these implants or offer them to people as an alternative in your posts. Hasn't anybody heard of them. Any way surgery worked for me so, I say go for it. 'But of course' it is up to yourself to decide.
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