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L5-S1, Surgery options. Help! I need your opinion please.



  • If the doctor says depression is in your head find a new doctor. It isn't and there are ways to help with it. After years of seeing a counselor I finally found a good one who sent me to a psychiatrist (who can prescribe) and I got on lexapro which really helps. Mental illness runs in my family and I am this for the rest of my life. It has minimal side effects but they are worth it.

    Sorry you are having such a hard time seeing the doctor. It shouldn't be that way. If you keep pestering them maybe they will do something.

    Good luck and keep us posted.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • Hi Sally -

    I had L5/S1 fusion surgery because my surgeon could see on my MRI that my disc was completely blown out and I had bone grinding on bone. He said there was only one surgery option - posterior lumbar interbody fusion. In case you don't know, that's when the surgeon goes in through your lower back, spreads your muscles off the affected area of your spine, cuts off the lamina (part of your spine) at the affected area, grinds the cut off bone into a paste, sticks it in plastic cages, removes what in my case disc debris, sticks the plastic cages between your vertebrae, and then stabilizes your spine (to enable the fusion and reduce pain from friction) with titanium screws and bolts.

    Because the surgery is a big decision, I sought a second opinion from a neurosurgeon. He agreed with my surgeon's diagnosis, but disagreed on the procedure. He said "no" to any form of surgery at first, recommending a nerve block instead (I had already had 3 epidural/steroid shots in my lumbar that did not prove to be a solution). He then said that if surgery is ultimately necessary, he would do a decompression surgery that was less invasive than fusion surgery and wouldn't involve all of the hardware.

    I took this opinion to my orthopedic surgeon and he nixed it. He said that my disc was "gone," so decompression was not a solution for an injury where bone is grinding on bone. He said that even if I felt better after removing disc tissue compressing the nerves, without interbody fusion and stabilizing hardware, I'd be back on the operating table within a few years.

    I had already entrusted my spine to my orthopedic surgeon for C5-6-7 fusion surgery and could not have asked for better treatment, so I decided to trust his opinion with my lumbar, and I do not regret following his advice regarding the fusion surgery at all.

    But I did find the dramatic difference of opinions between the orthopedic surgeon and the neurosurgeon very interesting. The neurosurgeon was, as you might expect, very focused on the nerves and the orthopedic surgeon, again, as you might expect, was thinking about the bones. Every person and every injury is different, so I don't know which might be right in your circumstance, if either. But I encourage everyone to get both perspectives before making a decision on surgery.
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  • I sincerely appreciate your feedback! more to research and weigh options!
    I, honestly, had lost all hope in my life. Thought, this is it.
    Now-- after finding this site.. and ONLY THIS SITE-- I do feel.. so much better. I am very lucky with supportive family- but that record gets really old played so long. they just don't know what to do either! I feel like I have found a thousand friends. Real, honest people. On the computer!! yes, I am shocked.

    Didn't know that could happen.:) so very very glad it has.

    yesterday is history-- tomorrow is a mystery-- today is a gift. that's why we call it the present!

    Onwards and upwards. thanks again!!!

  • I felt the same way when I found this site. I was severely injured in April 2008. The first diagnosis was my L5/S1 injury and I spent 8 months doing everything possible to mitigate the pain without surgery. The only thing that had an appreciable effect were the spinal shots. They helped enough that I tried going off the heavy daily prescriptions because they were interfering with work, and tried getting through the daylight hours on Advil.

    It's a good thing that I did, because within a week, a horrible pain began in my shoulder that then spread down my arm into my elbow. My fingers started tingling, and after a couple weeks, I lost feeling in my hand. When it didn't get better, I called my doctor, and he didn't even need to see me to know what it was. When I was injured in April 2008, I had been slammed down on my head (before the guy landed on top of me, bending me backwards and crushing my lumbar). I went for an MRI, and they found two severely herniated discs in my neck, one of which was putting on so much pressure on my spinal cord that it was displaced - virtually invisible on a few slices of the MRI. It looked like my spinal cord had been snapped. The symptoms of the neck injury had been masked by all of the drugs that I had been taking for my lumbar injury. My surgeon told me that if I so much as had a bad fall, I could be paralyzed or even worse.

    So, off for nonelective surgery I went, and six months later, knowing that there was no nonsurgical solution for my lumbar, and unable to take the pain anymore, I was back on the table for L5/S1 surgery.

    No one can understand that pain unless they've been through it. My family tried to be supportive, too, but they just couldn't appreciate what it was like. No one could, nor do they understand the long road of the research and consults to determine the best course of treatment, and the time and personal work involved in recovering. When I got back to work after my second surgery, many people thought I was going to be back to normal, like the surgeries were an instant fix - they couldn't understand why it was taking a year for me to feel somewhat human again, and that I would never be able to pull the all nighters and kill myself the way that I used to to get the job done. They still don't.

    But, the people posting here do. Even reading some of the stories of hardship can be comforting, because at least you know that there are people who can relate, and knowing that helps keep the people around you who think they know how you should be feeling or what you should be doing from making you crazy.

    So keep reading. I think that when things go well for people, they understandably leave the forum and go back to their lives. I try to come back periodically to post updates because, after more than 3 years of dealing with all of this, thus far, I think I'm a success story (knock on wood). Although every injury and person is different, and the road is a long and tough one, it has been my experience that it is possible to get back to a normal life, even if not 100% back to the way you were before the injury. So, hang in there.
  • hi,
    thought I would update:
    I now have an appt with an ortho surgeon later this month and will see what his opinion is. Not much has changed with me physically. I have found an online course about living with chronic conditions- I have learned some valuable tools regarding pain, distraction techniques, and to take the whole realm of health- eating, sleeping, exercising- the basics we all know-- and applying them daily with action plans. Emotionally and mentally I feel stronger, which can only benefit me. Gotta keep positive!

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  • Hello,
    I saw the next specialist, Ortho- and he agreed no surgery, but wants me to have an ESI- which I will do in early January. Now I am learning all about those short- and others experiences. I am trying to be brave, especially knowing what others have gone through on here, but I am scared. Will keep positive- and keep learning what is out there to help me.
    I feel like I am a perfect cookie but haven't found the right recipe yet! haahaa...
    Happiest of Holidays to everyone!!
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