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L4, L5, S1 - Gill Decompression with Fusion

pattikppattik Posts: 7
edited 06/23/2015 - 8:14 AM in Back Surgery and Neck Surgery
My problem is 5 years in the making and consistent in nature. Pain down the left leg which is aggravated with standing. Can stand for 3 to 4 minutes and then the pain/burn is too severe to remain upright. Occasionally this includes the right leg.
MRI shows degenerative spine with L4 and L5 slipped on S1. Have had epidural injections which work beautifully for the first 2.5 weeks and then nothing. My quality of life is limited to sitting, as I am unable to get around much. The neurosurgeon offers the only remedy as Gill Decompression with Fusion of L4 and L5 with plate and 4 screws (because of the considerable slip). A tough decision for me. I have never had spinal surgery but have had both my knees replaced.
PattiK
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Comments

  • Well, with the usual caveat that I am not a doctor dispensing medical advice, I will tell you that I was where you are this time last year. I spent months unable to stand more than a 3-4 min. before it became too excrutiating. Eventually, even sitting became impossible (and along with that, any hope of a normal life as I couldn't even drive or take a shower/bath. It was miserable.

    I had a major rupture of m L5/S1 disc with what turned out to be severe arthritis in the facet joint, DDD, little bit of lordosis and scoliosis. I tried a microdiscectomy 2 times, each time with perfectly great outcomes....for a few weeks, then the disc would reherniate. So my only option was a fusion with instrumentation (TLIF). I was 35 at the time and while it was definitely not a walk in the park and I had some unusual outcomes, I still wouldn't go back and change the decision to have the fusion. I know that it means that I will very likely need more surgery in the years to come, but I can live again. I can be a wife and mom and while I'll likely never walk without a limp due to what seems like permanent nerve damage in my left leg, I never want to be in that much pain/misery again.

    I'm not familiar with the Gill Decompression, so I can't really address that and your circumstances are a bit different than mine, but you have to weigh the risks (a lifetime of additional stress on all the levels above your fused vertebrae and future surgeries) versus the likelihood of serious and painful nerve damage (and still possibly needing a fusion).

    What other measures (besides the epidural) have you tried? My guess is that your surgeon is correct that there's not much else that can be done, but I'd definitely exhaust all the other conservative methods first (I did) and make sure that you get a few other opinions. It's a tough decision, especially when you hurt so much. Best wishes!
    Christina
    Left leg radiculopathy/sciatic pain
    L5/S1 microdiscectomy - May 30, 2014
    L5/S1 microdiscectomy - Aug 14, 2014
    L5/S1 TLIF - Sept. 24, 2014
    Left-side screws/rod removed along with bone fragment Dec. 29, 2014
  • I too had herniated disc, L5-S1, had discectomy 2 times because reherniated a second time. With truama also had left foot drop and nerve pain. Finally 2 years later in 2012 after 2 MRI's showing herniation again, had a Pro Disc L , so artificial disc. Felt better for a while, but as of late had problems with not only the left leg and foot nerve pain, now the right foot nerve pain. So in the process of figuring out if ADR is giving me problems, taking gabapentin which helps some but do not wish to have to take meds forever. Injections nerve block next week to see if helps, thinking only fix will be fusion which I should have done in the first place. Good luck and stay in touch.
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  • I was wondering if anyone else has had the Gill Decompression with Fusion. My surgeon says this is my only option because of the severe slippage of L4L5/S1. I am good with the idea of the decompression but hesitate on the fusion. From what I hear a lot of people that have had fusion with hardware eventually resort to pain meds for comfort. I take nothing for the pain at the present, since once I get off my feet the pain lessens and eventually passes completely (have tried Gabapentin without noticeable change). I have a decent quality of life as long as I keep a stool or seat in sight and am not looking to go hiking across Europe. I enjoy the grands especially in summer when I can get in the pool and be carefree and pretty much painfree.
    PattiK
  • Coltsfan78, Thank you for your input regarding fusion. I appreciate your positive outlook. I read your surgery history and was wondering about the rods and screws that you had removed in December 2014. Is three months the usual timeframe for removal, or was this hardware from a different surgery than September 2014?
    PattiK
  • PattiK,

    The screw removal was on the left side and was done only because I had very significant weakness in my left leg and nerve pain in my left foot only. The weakness in my leg was not present before my fusion surgery, but I had so much pain....I'm sure there was weakness that I didn't recognize. After my fusion surgery, I walked with difficulty and a cane for about 6 months. My doctor knew (based on a CT scan immediately after surgery) that the screws on the left side were really close to the nerve and he wasn't 100% happy with them, so when, after 3 months of no improvement in my left leg he saw me for a follow-up he recommended that we could see if taking the screws on that side out would fix the problem. He told me it was up to me and basically a 50-50 shot, but that I didn't really have anything to lose. So I decided to try it.

    Unfortunately, it didn't really make any difference for me, but it didn't hurt anything either. I very carefully weighed the potential pros and cons and wrestled with the decision, but in the end it was kind of my last best option for improvement, so I felt like I had to give it a try. Knowing what I know now...I'd have left the screws in, but there was no way to know.

    My story isn't really typical though, so don't be terrified! It's a big surgery and big decision, but I don't regret it at all. I just happened to fall into that little itty bitty worst-case category, but even that is better than the pain I was in before.
    Christina
    Left leg radiculopathy/sciatic pain
    L5/S1 microdiscectomy - May 30, 2014
    L5/S1 microdiscectomy - Aug 14, 2014
    L5/S1 TLIF - Sept. 24, 2014
    Left-side screws/rod removed along with bone fragment Dec. 29, 2014
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  • pattikppattik Posts: 7
    edited 07/07/2015 - 12:49 AM
    Just wondering if the Injections and nerve block that you had last week helped any. I know you were hoping it might help and avoid fusion. Just checking in to see how it is going for you.
    PattiK
  • Some good news. Had a new set of spinal xrays and MRI. Results show no change over period of 9 months indicating that the spine is stable. Neuro is optimistic that he can remove the two facet joints of the sacrum without fusion believing the spine can handle the procedure. Going to wait until August 5th for the surgery since my daughter is pregnant and due any day now. Need to be available to offer help with the other kids. However, will go forward with the surgery and keep you posted at that time.
    PattiK
  • Surgeon performed the Gill Decompression without fusion and removed a broken bone that was impinging the spine. Surgery was "successful" and considerable painless. It's seven days out and the pain down the leg has lessened considerable, however, if I stand for any length of time (more than 5 minutes) i experience the same numbness and pain that caused me to have to sit prior to surgery. Am hoping and praying that the continued problem is from the prolonged pinch of the nerve and is just in need of time to regenerate and heal.
    PattiK
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