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Deciding on surgery-L4/L5 PLIF fusion



  • sandisandi Posts: 6,269
    edited 09/27/2014 - 5:03 AM
    make. it also depends on the reasons for the surgery. anatomical problems and nerve compression or cord compression if left too long can lead to permanent damage.
    fusion surgery is a big surgery, and the recovery period can take a year or a little more to see where you are going to wind up.
    surgery is not done for pain relief. it is done to fix an anatomical problem or a neuropathic compression problem. do some get pain relief, yes, they do, if the pain is caused by the mechanica or neuropathic problem, yes.....if there is damage to the nerves , you may not, which is why waiting too long for surgery can backfire.
    nerve pain commonly flares up for days, weeks and in some cases a few months, while the nerves recover from the decompression, and since they only recover at a rate of 1--2 mm per month, depending on the extent, it can take some time before you get relief. that doesn't mean that you won't experience changes in the type of nerve related pain, and that it won't show improvement, but you have to understand that it can take some time to disappear.
    being prepared mentally for the surgery, and the lengthy recovery process goes a long way in heading into surgery, and having support of family and friends is important as well.



  • I'm 45 and had a L4-5 discectomy in May 14. Pain returned with a vengeance as the disc is collapsing and crushing the nerve roots without morphine if I stand for more than ten minutes I'm crying with pain. I'm having the surgery to prevent further / permanent damage. If the pain is less, that's a bonus.

    L5-S1 herniation. Both knee meniscus tear. L4-5 herniation - 2 x nerve block injections. L4-5 discectomy. L1-2 nerve block injection. L4-5 reherniation - TLIF fusion. 2016: L1-2 and L5-S1 retrolistheses and multiple facet joint degeneration.
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  • resbrsrresbrs Posts: 7
    edited 01/17/2015 - 4:43 AM
    I'm just like you- also 37, I just have one child who's 10. I just had a 2 level 360 fusion - ALIF plus posterior instrumentation at L4/5, L5/S1 plus an artificial disc replacement above at L3/4. 2 weeks ago on 12/31. I had severe DDD at with 2 prior surgeries on this area (discectomy/laminectomy) I was told fusion was my last option. I put it off for a long time. On a good day, my back was always sore and I was ready to lay down when my husband got home. And I had a lot of leg pain which kept me from doing a lot. But... I could still function and do the things I needed to do. On a bad day, which is a totally unpredictable episode, I cannot get out of bed. One time I drove my son to school and by the time I got home I couldn't even lay down in my bed I was in so much pain my husband had to leave work just to help me get in bed, and this would last 4-5 days and then get better. However... There was so much that "mom can't do". At 37, I finally refused to let that be ok. I decided it was time and I would be ok with the outcome. I had moved and this surgery was with a new doc, a cutting edge kind of guy. I felt very confident about him. I had the MRI then scheduled a discogram. No biggie. I wanted to know exactly which discs were causing the pain. All 3 tested were positive. So I felt confident about it. I would push for this. Why have surgery on something that may not be a pain generator? It was worth the mild pain of the discogram. YES my fear was the areas above and below degenerating with fusion. My surgeon recommended a hybrid for this so that's why I got the artificial disc above the fusion- it allows for movement- and fused below. Insurance was a nightmare- they do not cover- but we pay $2/mo for this "special care" supplement, and they covered! Maybe I am one of the lucky ones, and I am sure my age has something to do with it, but 2.5 weeks out, I am totally off all pain meds, (they made me very sick- I dumped them day 5 post op) and going out for lunch, and Monday will be driving my son to school and starting PT. I do not work- I am mom, so my new job is getting better. And I plan on giving that 100%. Don't get me wrong, the first week was rough- hospital 4 days then home. BUT the pain I have experienced is nothing compared to pain during one of my episodes. I did not have leg pain when I woke up, however about day 10 it started back. At my post op doc said he wasn't concerned since I did not have it when I woke up, could just be bruised or irritated. I am questioning this, but too early to pass judgement. I had family come stay for 2 weeks. There is still so much I cannot do and won't be able to do for a while. But.... At this point it's been totally worth it. I guess it just depends where you are at with regards to pain and frustration, and knowledge that you are making an educated decision with regards to the procedure and doc. Hope this helps....
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