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TLIF L4/L5 Spinal Fusion Needed

I had a MicroD in May then a revision two weeks later due to reherniation. I progressed extremely well that by week 6.5 my pain after the revision was a 1 and I was heading to a normal pain free life. I was running a meeting for my team starting on Tuesday and was very excited because Monday was great. I woke up Tuesday with a little soreness attributing it to the healing process but it steadily got worse throughout the day barely sleeping two hours. You can imagine where there this going. Wednesday got worse as the pain started to encompass the entire leg and again only two hours of sleep. It continued to get so bad that my team had to take me to the ER that afternoon. 

I could barely walk to the room screaming in pain.  I called my my surgeon and let him know. After repeated doses of dilaudid to control the pain I finally got the MRI. My L4/L5 reherniated but worse than ever.  The surgeon actually received the MRI results before the ER and texted me letting me know it was the worst herniation to date. My disk was literally pushing the nerve against the back of the spine. 

We we learned a couple of things:
1.  My disk will continue to self destruct. 
2.  I wouldn't have known this if I hadn't gone through the other surgeries. 
3.  A fusion of my L4/L5 is needed and required ASAP.  

I am am getting a TLIF done as soon as my insurance approves and I can get on the surgery schedule. I consider myself lucky because I have no back pain only sciatica and the results are even better in that case. I know the cause and solution, so there is a plan.  This is fusion for the disk and not another condition making it less difficult, bun there'd is some scar tissue. 

Some me people have wondered if I should change surgeons. I know I picked the right guy initially based on multiple discussions with other doctors, nurses, reps, and Internet searches.  My condition is about my body. The first and second revisions were working perfectly, but my body failed not the technical aspect of the procedure. 

I'm just worried about the recovery and getting this done. Also, how much stress it will put on my other disks and those around me. 

Any thoughts on fusions for sciatica would help immensely.  Any suggestions about post op care and how is it different than a Micro D?  Thanks!


  • hvillshhvills Suzhou, ChinaPosts: 971


    In most cases recovery from fusion is a LOT more difficult and longer than a discectomy.  The surgery is much more invasive with a lot more trauma... but a TLIF is probably a good choice to help try and minimize the back muscle trauma.  A single level fusion will put some additional stresses on the adjacent discs... but if you practice "being kind to your back" for the rest of your life it probably won't be an issue.  If you continue to lead a lifestyle that stresses and jarrs your back you could potentially create more back problems down the road.  The fusion can definitely resolve your sciatica... but in some cases it may not resolve immediately after surgery... it may take a few months for the nerves to calm down and stop firing... other times the nerve pain is immediately gone when you wake-up from surgery.

    For the post-op care be sure you have a trusted family member that can help you 24/7 during the first week post-op... you will definitely need it.  The first week or two are the toughest...   For most the recovery from fusion is longgggg road of months not weeks... the bone fusion process is slower than snails.  A such... a positive frame of mind is VERY important.... along with lots and lots of patience and a strict adherence to your doctors instructions.  In addition to the physical recovery fusion usually brings with it various emotional ups and downs that can be challenging but again with a good frame of mind and a good daily PT routine these issues can also be overcome.

    Harry - 65 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
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