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whats the truth folks ???



  • here are the statistics i have heard 1/3 get better, 1/3 get worse, 1/3 stay the same. After 4 i believe i am in the 1/3 get worse category. ist one was good then when my other disc blew, stress from first fusion screwed up my other disc, things got worse. now i can't walk more than 100 ft without stopping
    good luck
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • I believe that both have valid arguments. Sue, I am inclined to agree with you however with a twist that leads into the mechanics of it all that Bkins explained. It being that the adjacent disc would have eventually failed, however the fusion just accelerated the process.

    Kind of like having a defect in the sidewall of your car tire. You may never know it exists if you always drive around town. However if you place additional load on it by traveling many miles on a bumpy road, it reaches a point where it can no longer handle the added stress and it blows.

    Most surgeons will tell you that they try to do only the very minimum that is needed to stabilize the spine. If the adjacent level is found to be holding its own at the time, they will gamble and leave it be, in hopes that the patient will get a few more years without it being a problem. It seems that very few surgeons will do "preventative maintenance" when it comes to the spine.

    Tony, I hope you get to a point where you are able to get some sleep. One thing that I have done to help alleviate my fears, is to write them down. Write them out in exactly the words that they create inside my mind. I then go back and read what I wrote down, and it somehow no longer has as strong of a hold on me. It's not something I would write to share with others, but the gut wrenching reality that I have inside, that needs to be let out.

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  • I've read most of this, been a while since I had time to come visit.

    Anyway, I agree with many and "C" in particular as to not being able to deal with the what ifs should I turn down a possible improvement. I would forever be wondering what if. My wife and I did the very same questions when I underwent my second arthroscopic procedure. Knowing that if he found the dead bone had softened the cartilage the I would wake up with a partial shoulder replacement and months to years of recovery time. Yeah, you guessed it, of course here I sit 2.5 years later, with the titanium cap and? yeah, my shoulder still hurts. Do I regret the procedure? No, I fully believe that I would be far worse if I had not had it done. Not only would my shoulder hurt, it would not function properly on top of it.

    I try to look at it this way, when my Bi-polar depression lets me. I try to compare my now to my just before surgery days. NOT to the days before the accident! Most of us don't ever get those days back.

    I bought a T-shirt while on vacation, it says "Scars are tattoos with better stories" (not realy helpful I know, I just needed a new T-shirt! :D )

  • SueD said:

    I'm not sure I agree with the notion that having a fusion always puts added stress on the discs above and below and therefore it seems that people have gone on to have further fusions at adjacent levels.

    Let me throw a theory out here.

    The reason that I believe, and has been explained to me by two different surgeons, that the upper and lower discs are at more risk after having a fusion is that those areas, the upper and lower discs, have to carry the load that the fusion area previously carried. It is really just basic mechanics.

    Think of what a pryamid looks like with a very wide bottom and a very small top. The reason for the wide bottom is to be able to carry the load of everything up top. As you go up to the top less and less downward force is present and therefore less size and width is needed to support the load.

    Our spines are much the same in that the top, cervical area, is much smaller in size then the lower lumbar areas. The one big difference here is that our spines in order to be able to move have a disc between each level. When you take out a disc and fuse two levels together you are creating more load on both the top and bottom adjacent levels. The added load that is now not being cushioned by the area(s) in which a fusion took place gets transfered to the lower adjacent level mostly but some also gets transfered to the above level as well. All discs in our backs were designed to carry a certain amount of weight, or load, and when discs are taken out that load has to go somewhere. If you look at the discs between each level in a spine you will see that they not only are bigger in height, and wider in width as you go from the cervical area down to the lumbar area.

    Does that make any sense?

    Anyway, from a engineering standpoint it makes sense. A fusion will always add more loads to adjacent areas that were not designed for it. This may or may not create more problems as it in a large part depends on the health of the adjacent disc's. You and everybody else are wise to protect your back from further loads once you know there is a problem.
  • Tony,

    In 2008 I had horrible arm and shoulder pain along with what I call "old man neck" (at 46 at the time). I had a 2 level ACDF on C5-C7. Woke up with no pain and almost no surgical pain. Over next two years, things got worse again. Found out one level previously fused had cracked and the ones above and below were bad. Plus the foramen on several levels were blocking or rubbing nerves. Just did a 4 level posterior fusion 8 weeks ago and was scared to death. My ortho told me the same thing that this one was going to be rough. Ultimately did it and now 8 weeks later I still have some arm and shoulder pain, but not enough to take pain killers for. And that says a lot since I was on 80mg of Oxycontin plus 5 to 10mg of Oxycodone IR every 6 hours for breakthrough pre-surgery. Could I justify still taking some of the meds at my pain levels? Yes, but I want to give my body a chance to not only detox off of the drugs, but to tell me what really still hurts and what doesn't. Ultimately I had to sit down with my wife and weigh the "what's most likely" options of doing or not doing the surgery. For my part, I'm glad I had it done. But I will admit with a 4 level posterior fusion, the first 2 weeks were tough. But then it improved quickly. Best of luck and our prayers are with you.
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  • I'm basically in the same boat as you. The surgeon offered surgery...a fusion for my cervical discs, but he gave me 50/50 odds. That's just not good enough for me. I hope you figure it all out and God bless!
  • In the US, there has been an upswing in the number of fusions, especially multilevel, done. This is coincident with the change in the US psyche to the belief that higher intervention levels are universally better.

    Anyway, there were recent studies here basically showing the increase in fusion numbers were NOT linked with better outcomes (in other words, stating the obvious, that fusions are NOT helpful for people who are not good candidates, and is in many cases harmful), and suggesting that doctors should be more careful about choosing their fusion patients, especially for multilevel fusions.

    Anyway, I think the answer is- no, fusions are not safe. No operation is safe. But is it as or more safe than living with your damaged back? When the answer "yes" and the surgeon can offer some hope of improved functioning, it's time to start planning the surgery.

    Because that is the scary truth- it's not safe for us to live like this either. Sedentary, with chronic severe pain chipping away at us, taking multiple strong painkillers. That's kind of a frightening life to look forward to.

    You've chosen your surgeon well, you're doing all of the tests, and you're really trying to do this right. You are not the audience toward whom those warnings are aimed.

    I have my fingers crossed for you!
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