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Risks of not doing fusion with a very thin degenerated disc?

mchell6789mmchell6789 Posts: 15
edited 06/11/2012 - 8:59 AM in Back Surgery and Neck Surgery
So I have had two microdiscectomies. The last one back in 2008. Haven't been doing too bad since then. All of my symptoms never competely went away but I actually was able to go bike riding 20 miles last summer. I did some other things like raking thatch out of my yard that herniated my disc again. (I think that was what did it) Just got done with a medrol pack. Hoping my body resorbs the herniation like it did the last time.

My question is that my disc is looking dangerously thin now. It's all black on the MRI and looks like it's bulging out on many sides not just where the herniation is. The radiology report only mentions how thin it is and the herniation. My surgeon has not seen it. I am trying to decide if I want to go in to see my surgeon and see if he will do a fusion. I am concered about what my risks are if I do not do the fusion since the disc is getting so thin and causing back pain. Can it cause damage to other things like the facet joints?

I have this delema because I'm really not in extreme pain but I can't sit for long periods of time. And I also am supposed to watch my grandbaby coming up in a few months and need to be able to be in shape for that. OH what to do. Backs are so frustrating. It would just be 6 hours a day four days a week watching the baby. I'll be putting myself at risk with that I think too. Going to try to be very careful.


  • Are the discs above the L5/S1 in good shape? If so, I think definitely you should go for the fusion. I've heard that many people who have one level fusions at L5/S1 have great results. I have a fusion at L4/L5, and I don't feel any change in my flexibility, and I think there's even less risk of that at your level. My fusion wasn't successful because the discs above and below it are bad too - so the fusion just puts more stress on them. Good luck!!
  • I worry about the same thing, my L5-S1 has degenerated I would guess about 50-60% maybe, the tip of my L5 vertebrae looks like its about 4 millimeters from touching the L4 vertebrae through the disc.
    I've had a lil bit of instability in the area and I think some of the weight and stress gets transfered to the facet joints. Thats just my guess tho, all the docs ive asked about this dont say anything.
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  • Yes my discs above the L5-S1 are in great shape. Very thick and look totally normal. No other disc problems. It's just the L5-S1 that is bad. Yeah that's what I'm worried about that it's going to start putting pressure on the facet joints. It maybe is already I don't know the symptoms of that. I would think the radiologist would have mentioned that in the report though.

    Right now I just have a small herniation that is displacing my sciatic nerve 3mm. Most of the pain is in my back with that. I have been doing physical therapy excercises since 2008 and stretches along with that that have kept the sciatic nerve from becoming stuck in there so it moves through the area I can feel it when I do stretches. So I think that has helped keep my symptoms from disabling me. Everything I do is careful and I try to keep proper form.

    How long does it take to recover from a one level L5-S1 fusion? I know my back will never be new again but I'd like to be able to watch the baby. I have two grandbabies on the way. One is due in July.
  • And what happens when you get to be bone on bone? Is is it horrible pain that drops you to the ground? Or limited range of motion? I'm actually surprised I'm not in more pain looking at the MRI. But I want to avoid that pain that drops you like I had before.

    My surgeon refused to do the fusion back in 2008. He's supposed to be the best around here and my husband works with a couple people who swear by him. One of the guys had gone to a different surgeon and was still having a lot of pain but as soon as this guy worked on him he felt so much better. So I want the surgeon I have been going to to do the fusion. I think I'll set up an appointment for after the baby shower coming up here in a little over a week and see what he says.
  • Oftentimes (from what I understand, and I could be wrong), when you get to bone-on-bone, you tend to get a natural fusion going. If your disc isn't pressing on nerves or causing you great difficulties, I'd forego the fusion surgery. Trust me, I've had three levels done. Spent nine hours in surgery the first day, lost lots of blood, had to stay, get more units of blood and go back to surgery from the front four days later. The recovery was sheer hell, but my reduction in pain has been worth it. I could barely walk before the surgery. If you don't have a lot of arthritis or spondylolisthesis, you don't really have the risk of your spine sliding out of place, etc.

    Now, on the other hand, if you continue to do things like raking, etc., you do risk reinjuring your spine. I pay my niece to come and do my yard work for me now. Vacuuming is done by walking slowly along beside the vacuum -- not by pushing it back and forth. You have to be careful!!

    Best of luck.
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
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  • Thanks for the reminder I do need to stop doing things like raking. Generally when I did rake last year I did it without twisting at all. But that one day I really got into trying to remove the thatch and I'm sure that was bad. I just need to hire people to do that kind of thing. I have to remember to be strong when telling people no also.

    So often people try to get me to do things that I should not be doing. Like just two days ago when planning the baby shower someone trying to get me to help move large tables saying if the legs fold then we can just roll them. I said I am NOT moving tables. I have found that to be one of the biggest things is knowing when to say no I can not do that and standing up for yourself. People who have never dealt with this do not know what it's like.
  • I didn't read all the responses but if you are generally okay, then why opt for a fusion?

    From what I'm reading you want to have a fusion as prevention but I'm not clear why.

    I have very little disc at L5S1 (2 MDs) and just recently went for another MRI. The disc is lousy. The one above it is not super but holding steady.

    My surgeon said I could lose more disc and probably wouldn't notice but that I could also fuse naturally over time. Remember, MRI is only part of what the doctor considers before recommending treatment.

    As for your grand baby, very exciting! Even with a fusion, you will always need to be careful lifting.

  • Well I have had a lot of back pain recently. That's why I had the medrol pack. Which has really helped. My biggest issue though is sitting for long periods of time. At Christmas we were at the in laws for 5 hours and I was laying on the floor by the end because of the sciatic nerve pain. I don't normally have a lot of nerve pain unless I sit for a long time. I don't know if a fusion would help that though. That's why I'm here to find out some of these things. Sometimes just sitting for a couple hours really makes my nerves hurt.

    So basically I have spent the last 4 years avoiding sitting for any longer then an hour. I'm lucky I don't have to work because I'd never be able to do what I was doing before with sitting all day. That's why I am considering fusion. But if my nerves arn't being compressed and fusion can happen on it's own that's an option too that I was not aware of. It would just be nice to be able to go on trips where a lot of sitting is involved. I have friends who just went on a 14 hour car trip and I could never do that with my sitting limitations.

    And thank you I am very excited about the grandbabies :)
  • A natural fusion of two vertatrae? Is that really possible? I would think that if the vertebrae touch each other It would be extreemely painful, Wouldn't it feel similar to a broken bone grinding under weight?
    I mean the vertebrae's are the main weight bearing structure.
  • I would think it would be very painful. I guess each situation is different. I searched on the board and the web after hearing about this and it seems some doctors even remove the disc material and just leave the disc and wait to see if it fuses naturally. I was wondering about the stability of the spine in this situation also.
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