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L4-S1 fusion



  • hollypophhollypop Posts: 86
    edited 12/20/2013 - 5:08 PM
    I had L4-L5 fused after a laminectomy to decompress severe spinal stenosis at that level. My disc was OK but the fusion was required because I had too much slippage of L4over L5 (I absolutely cannot spell the word for that condition!), which would have only worsened without a fusion since the laminectomy removes some of the weight bearing bone volume and thus would already leave me vulnerable to instability there. I am 9 weeks post op today. I have none of the neurological and pain symptoms I had before the surgery. I dealt with the severe stenosis for about two years before finally accepting the need for surgery after seeing that I had cauda equina compression on MRI. Many of my core muscles and hip flexors and extensors are atrophied and very contracted and tight because i spent those two years trying "conservative" treatments and becoming increasingly crippled in the process. I am finishing up a course of aqua PT and will transition to land based PT in the coming weeks; the amount of PT I am requiring is basically because I waited so long to correct the condition. But I do see progress! Today I realized that my leg strength had made an incremental improvement and I actually climbed a short flight of stairs like a grown up instead of one foot at a time like a toddler. Everyone has a different experience and I'll be praying that yours is positive. You can read my posts on the October surgery buddies thread. It's like a diary, LOL. There's also a thread about important things to have at home afterwards. My most useful items have been a satin fitted sheet on my mattress so I could slide in and out easily, a grabber, a long dressing stick, and arms for the toilet because it's a little hard to get up and down for a few weeks post op. Oh, and shoes with Velcro closures or simple slip ons, because it was impossible for me to bend and tie any other types-though that is gradually coming back now as well. I do not regret having this surgery at all. Remember that you will always have to take care of your back in the future.
  • The nerve pain I had was weird, numb but hypersensitive to the point of pain when it was touched. This was mostly in my foot but it calmed way down after surgery. Now it's numb but the hypersensativity (I have no idea if that's the right term, that's just how it seems to me) isn't painful, it's unpleasant in a creepy feeling way. Makes shoes and socks a challenge. It's not bad as long as I don't think about it, but of course right now I'm thinking about it. I had quit taking the nerve pain drug Gabapentin but my doctor put me back on it because it can improve the healing process ( ?) I hadn't heard that before but I'll take his word for it.

    Anyway, the nerve pain was completely different than sciatica pain for me. The numbness is a more of a problem because its impacted my balance.
    L5 S1 MicroD - August 21, 2013
    L5 S1 Fusion - October 17, 2013
    44 year old
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  • sibsiessibsie Posts: 49
    edited 12/21/2013 - 8:35 AM
    Good luck with your surgery.

    I had a L4-S1 fusion with laminectomy on October 18th. I was very fit before the surgery and am already working out again (no weights), so it can be done. I think the better the shape you're in before, the easier the recovery is and that's something my surgeon strongly agrees with.
  • Single level fusion at L4-L5 due to slippage (spondololisthesis). Come join us on the December surgery buddies board if you haven't already! Lots of people who have had their surgery this month. Prayers for a speedy recovery!
    Synovial cyst removal in 2008. L4-L5 facet joint.
    Lumbar fusion at L4-L5 in December 2013. TLIF posterior entry
  • I have a two level fusion, but my fusions were done at seperate times. The fusions were a success, felt immediate relief. If you a disciplined and watch how much bending, lifting, or twisting you are doing. You should be fine. I agree the better shape you are in before the surgery the less complicated recovery will be. The only problem I am having now is sacroiliac joint dysfunction, which I am going to PT for. I am kinda going backwards with SI joint issues. I have already had the treatment of last resort which is injections. They don't work to well on me only lasting a couple of weeks. Hope fully the PT works or I am sure I will being my SI joints fused too. I wish you the best with your surgery and recovery. Keep us posted.
    Discectomies 05/08 and 04/11, fusions L4-5 Feb 9,2012 and L3-L4 June 28,2012, Staph infection washout 3/2/2012, Bulged L5-S1. SCS trial on January 17th, 2014, which was a success! Permanent SCS on February 20th.
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  • are you having ALIF/PLIF ?? and is this your first spinal surgery .?? you have one thing going for you ..your age ,,I know some people will tell you that you will be pain free in 3 months and life will be back to normal ..THIS IS HIGHLY UNLIKELY .I am 47 and my problems started following a MVA back in 1997 ,I had a simple open laminectomy and had a reasonable recovery from it ..then as the pain got worse this take us to 2007 I was in so much pain 24.7 I had another open laminectomy and a DISKECTOMY and S1 as well the L4/L5 .this operation was a disaster and I was left with intractable pain for another few years ,,I went to see many consultants but they all refused to do any more surgery on my as my spine was so messed up eventually I found a guy that would operated on me but he told me that the operation was required to stabilise the spine and any pain relief would be a bonus and NOT a guarantee I had ALIF L4/L5 and S1 back in 2010 dec and as far as pain goes its been the worse thing ,I have been in awful pain since the operation and I have had other problems that I did not have ..like leg and feet problems ..I saw the consultant last Friday and he has ordered a MRI scan to see what's going on ..he thinks maybe adjacent disk and or sacroiliac problems all I know is I am in pain all the time I am unable to do almost anything that a normal person can do .I live on my recliner .and I need massive amounts of painkillers to get me through the day .. my outlook prognosis is poor and I am probably going to require more spinal surgery I am only 47 and I was a slim fit guy ,,I can only sleep for 2 hours a night max then pain wakes me I am never out of pain even with 400mg of oxycontin . all is does it lower the pain from 9.5 to a 9..i know its not much but its makes it just bearable .I wanted to warn you that things may not go as well as you think or have been told and recovery is a lot longer than the optimistic consultant will tell you ..my consultant was very honest with me and told me that I would always be in pan {due to previous poor surgery and disease] and my recovery would be around the 3 years mark .and he could not say how I would be ..ALIF is about the worst as your abdomen is opened up ..its like two operations ..even worse that that is what they call a 360 or a global or a ALIF.PLIF this is where your opened up front and back ,at the same time !. .I wish you luck with your operation and be aware that it may not be as easy as some have said .you will need help for at least 2 months with personal hygiene as you won't be able to dry off after showering .you are also not allowed to drive a car for 6 weeks ..now is the time to get yourself a grabber and if you can a recliner ..they are a must with a bad back {even consider a second hand one see ebay and the local free papers there are many bargains with recliners ..normally purchased for granny at the end of life and they hardly have been used and the relatives just want to sell it off as cheaply as they can .a rise and recliner one would be the best ..I have a rise and recline bed and recliner .also a raised toilet seat .will be hand for the first few weeks ..if you want to keep your dignity .it's a good idea to have as many gadgets around you as you can ..this way you're not totally reliant on other to help you ..I have been there and got the tee shirt ..I get many private emails from people that I have never even met asking for advice .they have read many of my post on this and other sites .I received an email this morning from a lady that I don't know but she had read some of my posts and could identify with what I had written .she was after advice as she was told rubbish by an over optimistic consultant too ! ..good luck and let your operation be one of the better ones ,,remember your having a major operation and its a repair and you may need it redoing with in ten years ,,
    sorry to be a little on the hard side but I am a realist and don't want to raise your hopes up .but also don't want to scare you to death ! //again
    best wishes
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • I'm scheduled to see my surgeon on the 31st to discuss a L5/S1 fusion so please keep us posted. Every time I decide that yes I'm going to do it, I read a non-success story and freak myself out.
    MollyAk it's great to hear you are doing well a few months post-op and I hope you continue to progress. The nerve pain sometimes is unbearable.
    Herniation of l5 S1 l4 , DDD , microdisectomy in June 2013 and re herniation in September
    Cervical herniation at C5-7 Jan 2014 with impingement of spinal cord. 2 level cervical fusion Feb. 2014 and 2 level lumbar fusion in April 2014
  • MollyAkMMollyAk Posts: 115
    edited 12/22/2013 - 7:16 AM
    Hi, I think it's really helpful to read through the previous surgery buddies forums. You can get some genuine reactions to pre and post surgery results and see where people ran into problems and read successes as well. Its really reassuring to know you aren't the only one going through something and you get honest results, and opinions. Like Hollypop said, these forums are like our diaries of this experience.

    Good luck to everyone and hopes for a healthy pain free New year!
    L5 S1 MicroD - August 21, 2013
    L5 S1 Fusion - October 17, 2013
    44 year old
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