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ALIF L4/L5 & L5/S1 - Should I bite the bullet and do it?

BorderlessBBorderless Posts: 14
edited 06/11/2012 - 7:46 AM in Back Surgery and Neck Surgery
I know no one can answer this for me but I'm really grappling with the decision to do the surgery now. My story is here:


Every surgeon I've consulted agrees that at some point I'm going to require surgery to fix my pain.

Is now the time to just get it done? Just about every year I have some "episode" where I am out of work for 2-3 weeks and can't exercise for 6-8 weeks. Then with steroids, pain killers and rest it usually goes away. This time feels different and feels like after 8 years since my last discectomy, maybe it's time to have a more comprehensive surgery.

I have numbness in my leg that isn't getting any better. Every day that goes by I worry that the nerve damage is permanent. Life continues and I sit here waiting. I work from home when I want to be in the office.

I know pain is certainly one indicator but what about numbness? My pain is tolerable in my leg and sucks (as it has for the last 10 years) in my back. Would you have the surgery if all you were suffering from was numbness and some weakness in your toes?

I hate being in limbo.. I want this episode to pass or just get the surgery over with... the waiting is hard to take.


  • Borderless,

    You are correct, we can only of course go on what *we* know from our travels down the spine trail of life! :)

    My first fusion was needed to prevent paralysis, so that isn't a good one to use. When my C6/7 went, the disk slammed into the right exit nerve root. The concerns I had initially was (aside from the pain okay?) was the numbness down my arm, and the marked weakness - I couldn't pull my towel up to dry my back, or wrap a pony tail, brush my teeth with my right arm. My surgeon was most concerned with the loss of strength as the pain and numbness could be the nerve regenerating again.

    By the time my MRI was done and report back (a week and a half), I lost further strength. His fear was permanent damage (which happened by the way). If I mix the two - Pain - how much is it effecting your day to day life & quality? Numbness was never addressed as we can work with numb. Strength shows that the nerve information is not getting to the motor nerves, and thus the muscles start getting affected as well. Except for emergent surgery, it is a very personal decision between you and your surgeon.

    Have they done a recent MRI or CT to 'see' what is going on? Have you had a complete Neuro test to see your functionality and pain producers? Have they conducted an EMG/NVC to see if there is issues were the nerve activity is being affected or damage has started? All of these give your surgeon and you a better picture, and thus a better decision can be made.

    My lower back has been 'off and on again' since 1984, but about 10 months ago I felt 2 pops and its been "on" since! MRI showed the disc material spread out in 3 different directions, and all on nerves and the thecal sac. Mine developed into Neuropathy and Radiculopathy - stinks! Because of the Neuropathy, surgery is on hold for me presently. There is a big part of me hoping the discs will heal on their own - after almost a year I doubt it, but still working PT in the pool and so forth.

    Lots to think about eh? I hope you find enough answers to make a decision one way or another soon as day to day pain stinks, and numb stinks, weak toes...that could be something, but dunno, not my area. Please keep us posted on how it goes!!! *hug*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I made my decision because of the pain and insomnia, and I used to get very upset seeing people walking and enjoying life and I couldn't. I didn't want to live the rest of my life as a recluse, and so I made plans for the fusion. It took 10 months from making an appointment with a neurosurgeon, and then I had to see two others, and that took time.

    I still have some left leg weakness and numbness down the front of it, but that's easy to live with. Sitting for longer periods is a problem, but I just get up and walk around or do something else, and then go back to sitting.

    My fusion is successful and I'm out enjoying life again.

    Please let us know what decision you make, and if we can give you further support, we will.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
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  • My answer to your question is no i would not have surgery if all you were suffering from was numbness and some weakness in your toes. I had failed back surgery and i am much worse after surgery then i ever was. Surgery is very risky when it comes to the spine and there is always a risk of nerve damage and as doctors will usualy tell ya it can make condition worse in some cases. If there is no risk with further damage developing by not having surgery then i would try every other posible option for the numbness before considering surgery. Trust me they are not kiding when they tell you surgery should be last option. If your pain is not so bad as you said, and its just numbness in toes, you might be trading that in for posible pain after surgery in my opinion. Good luck in what ever you decide to do. Best wishes' Alexhurting
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • if you can still work and get by on pain killers then keep away from operating theatres .but if you get to the stage where pain disturbeds your sleep/sex life/work etc then go for it ..i am at that stage and have been since my last failed operation some 4 years ago.i have given it lost of thought and a multi level fusion is my only option .if you need surgery then make sure you get at least three opinions and get a surgeon that's been recommended by other previous patients .don't settle for any old surgeon .fusion are a major operation and it will take you many months to fully recover so do your home work .if you live in the UK i can give you my surgeon's name
  • Borderless,

    As you can see by Alexhurting's post, no surgery is a guarantee. He is in pain 24/7 due to failed surgery, and myself for failed and a bit complicated fusion. It isn't fun, not at all. Yes many do well, but you must keep in the front of your mind that we are the other side of the possibilities of surgery on the spine!

    Like he said, and I pretty well said too, numb, and only minor weakness, most can live with. The pain associated with it (for most of us) has to get to the level that we don't have a life if you will! Too there is no magic pain be gone pills as you know.

    Once you enter 'fusion' territory, there is no turning back. In some instances too, the fusion changes the dynamics of your spine, and other issues can come up later down the road. I'm on that good ship lolly pop myself right now. To echo Alex do everything you can to see if you can avoid it. Please let us know what you decide to do. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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  • I can't stop thinking that I just want to get this done.

    Let me elaborate more. Again I understand I'll hear opinions from both sides (do it vs avoid it all costs) but it definitely helps to "talk" and here from you all.. so thank you.

    The piece of my story that I'm sure is not unlike all of yours is this.

    Since I had my last laminectomy/discectomy in 2002.. just about every year I have an episode... which is basically I'm playing tennis or with my kids and I hurt my back. That's generally followed by weeks of lower left back pain (annular tear) and left leg pain (herniation at L5/S1). I take a medrol dose pack. I take pain killers. I miss work and then I have to wean myself of pain killers.

    I literally have one of these episodes every year. After my episode in 2009 I considered the double fusion but decided to put it off one more time. I lost 20 pounds (6'3" - went from 205 to 185) and started doing Pilates twice a week. I instantly noticed the difference in my core. I felt great!!

    Then 3-4 weeks ago I was playing tennis and had the worst "episode" in the last 8 years. As I described in the post I linked to in the original message, I've been through a cortisone injection and 2 medrol dose packs. I started on Percocet and am now back to Vicodin. I have numbness and weakness which I've never had either.

    Here's the dilemma.. I know in my mind (and from the consultation of 2 neurosurgeons and 1 orthopedic surgeon) that at some point I'm going to have an "episode" where I'll be forced to have the surgery.

    So here I am... am I recovering from this episode? Kind of. I've been in pain killers for weeks now. I have numb ness and weakness still. Is it a medical emergency to do the surgery this time? Probably not.

    But I'm an executive at a public software company. I can't live on pain killers and I can't continue to miss work like this. I now it sounds superficial but I'm so excited about the prospect of being mostly pain free with a successful fusion surgery which my surgeon is confident will happen (I know there are no guarantees). I guess what I'm saying is that it seems like the chances of me having to have this surgery in the next 2-3 years is high. I'm in the best shape I've been in since high school. Why instead of waiting until I have an episode and I have to go in for emergency surgery while hooked on pain pills and not in shape? Why not plan for it now.. plan with work. Plan with my family.

    Just babbling I guess at this point.. anyone feel the way I do?
  • Borderless,

    Surgery as I mentioned is a very "personal" decision! We all, if it comes to it, sort of *know* when enough is enough and we have to have some sort of surgical intervention. It just seems that your episodes are kind of predictable? After a few weeks you recover and are good again? If I read that correctly, why not stop those activities for a while and see if there is a difference?

    If that doesn't work for you, then surgery might be the 'fix', but just remember some end up with GREAT results, while others, not so great or even worse then we were. I don't think you will see people "pound" on you to NOT have surgery. We are just saying since we've been there, look at all avenues and then make your decision, only you can do that. :) We support each other in our decisions.

    Before my surgeries I was 24/7 with my symptoms, and with all conservative actions done with no improvement, if not back slid more, had surgery. You have to decide when "enough is enough" is all. Please let us know either way. We're here for ya!! *hug*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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