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fusion

Started by maxxter on 04/21/2010 12:23pm

I have been troubled with back pain for many years and now getting worse. I have had many tests including MRI which shows that degenerative L4-L5 and L5-S1with spondylose and arthroses.

I am told b y my Orthopedist and Neuro Surgeon that I need an operation which is major. It means going through my belly and then I am turned over and into my back.

I can't make a decision to go ahead. The problem is the nerves are being pinched and is effecting my ability to walk or stand for more than 20 min.

Any advice would be appreciated

Joseph

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I have almost the same problem. I am scheduled for the same surgery next month. I guess my thoughts to your are: do you trust your doctors? Are they experienced in the surgery?
I went for a second opinion because the first doctor told me my back in good condition. The second, known world wide said my back has several problems. He is going to start on the worst issue but it is difficult to know if the rest of my back won't get worse at any time. I've off work for 4 years because of my back. I'm ready to go back to living with less pain. Of course they surgery may not work . That's the risk I'm willing to take. Hope you find the answer your looking for.

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I recently (about 5 months ago) went through a 2-level fusion on L4-L5 and L5-S1. My surgeon went in through my back though. I am in as much pain now as I was before the surgery. My advice to you is to try EVERY other option first. I did and still ended up with an unsucessful surgery, which at this time, the doctors are telling me that pain meds are my future. But that isnt the right anwser either. Be careful and best of luck to you!

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Hi, Joseph. I've been struggling with degenerative disk disease, scoliosis and sciatica since at least Aug., 1993. For three years we tried all options(P.T., aggressive P.T., multiple types of electrical stimulation, hot packs, cold packs,massage, ultra sound, traction and of course the ultimate array of medications. I was seeing a neurosurgeon at the time and was told that I wasn't a candidate for surgery. Well, through the course of time, scar tissue started compressing my nerves in and around me whole lumbar area. Walking, sleeping and pretty much all daily activities became quite hard to do. I lost my job as an Executive Chef on Aug. 6,1993 and have never been able to work again! (I've been fighting SSD since the fall of '96 and will not give up). Then I saw an Orthopedic surgeon who immediately performed an L4-L5 laminectomy fusion. He also decompressed the nerves by removing all of the scar tissue. I was still deemed permanently disabled, but at least some pain had subsided and I was walking upright.After that first fusion, I was told without the surgery, I would have been paralyzed in 12 to 18 months.This was all in the fall of '96.By 2001, things regressed and then came surgery #2. The fusion of L3-L4-L5 & S1. These surgeries guarrantee no extreme pain relief, but with the hardware supporting the spine and the bones fusing, it stabalized my spine & did give some relief. Yet, the pain again increased, more degeneration and I didn't want another surgery right away. Boom! In went the intrathecal pump implant which eventually got up to 14mg./day of morphine into my nervous system. Now, at the Pain Clinic of Michigan, we tried a few procedures with no positive results. It's time for surgery #3. L2 & L3 are bone to bone and L1L2 are almost there, also. On Tuesday April 20, my pump cathedor had to come out to get out of my surgeons way I had to take Oxycotin to combat the withdrawls that my nervous system was going through since it had been medicated with morphine for 6 years. Not fun, but I got through it. May 11 is my surgical date to fuse T12-L1-L2-L3-L4-L5 & S1, then in about 3 months the pump can restart and with any luck , and God on my side,this could be my final surgery. THERE IS NO WAY TO TELL. Am I sorry I opted for surgery? H--- no. I might be battling pain but your threshhold for pain wii increase, and at least I will be walking upright again. This started when I was 32 and I'll be 49 in December. I pray that my situation can help you come to some decisions. I know there not easy to make. If you do, don't stop talking to the Big Guy upstairs. He helped me. All me best, Marty Questions, comments or concerns--contact me by e-mail and then who knows? )This took me about 3 hours to type out!) Joseph, I wish you the very best. Remember, everything happens for a reason. We just don't always know why! Also, after surgery, you'll start P.T. which will be a tremendous help. It will take about a year for the bones to fuse, but in a few months you will start to be up and around.

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I want to thank you very much for the informative response of my question on surgery.

I am still talking to doctors and have an appointment this week to discuss my back. The nerosurgen tells me he will not do the surgery until I have a Disogram and the waiting time is 2 years. I can have it done privately for $1500.00 and not covered by Health Care. 2 years is a long time to wait. My back continues to get worse.

Thanks for your comments of the Big Guy Upstairs, I could hot have come this far without Him. I a m a church goer and I find it impossible to attend these past few weeks because of my back. The Pews are not comfortable and I can't sit that long.

Again thanks, my personal e-mail is: jnavery@ca.inter.net

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Find the best surgeon available, get the disco gram, After spending years with this same condition, including DDD, wasting thousands of dollars in co-pays, 15+MRIs and a few CT scans, useless PT, feels good while your getting it but pain returned with in 6 hours, I had fusion of L4-L5, 2 titanium rods, and six screws. Am i better off, no! Had the surgery on June 24th of 09 and still suffering but working. It is very tough but with meds I am getting by. The surgery changed my posture and now my hips hurt all the time, plus have nerve damage [will find out tomorrow how much] I am going in for a Mylo gram, will see what happens from there. My insurance sucks bad, I now owe the surgeon $135,000 and change. The total cost was in the neighborhood of $275,000.
I try to be positive about it, but am often very depressed, have not played golf in 10 years, my favorite playtime, sexual desire is gone, I feel like a junkie most of the time, even though I am only on Hydro, and Soma. Prior to surgery was on Fenytenal patches, Morphine, and Vicodine. Every 6 weeks going in for epidermal band aids. If you can stay away from the morphine type drugs, I was on time release and missed a dose several times, which sends you into withdrawal, not a pretty picture.
I am sorry for rambling, telling my pity story. If you do not have the surgery you will never get better, it depends on your age and bone condition, turns out I also have Osteomalicia, softening of the bone, so after 10 months I have had very little healing. I am on steroids now to help with the Osteo, the steroids I need, Deca, no longer available in the USA, HGH $1200 a injection, I am 54 now and have the feeling I will be in a wheel chair with in 5 years. Mine case is complicated, but I say take the chance if the Disco gram shows you need it. God willing you will get a good surgeon, and heal, mind you total healing time is up to 3 years for this type of surgery. One good thing I have read about are the new plastic discs they are using, fusion time much faster!
Good Luck and God Bless!!

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Did you have the surgery and how, if you did, is it working for you? I am scheduled for an anterior Lumbar spinal fusion Oct. 11. Pevious to this I had a Laminectomy and fusion of L3,4,5.This was in May of 2009. The hardware(screws) did not "fuse" in the L4,5 area,so they were removed in April of this year. I have continued to have pain in my back as well as down my left leg, hence the upcoming surgery.
I too am very anxious about going in from the front,but I just want to get back to living,and making a living. I am 56 yrs. old,a Registered nurse. Out of work since April 2010, because I was no longer able to do my job.
Any advise........anyone!!!!
The lord will take care of me, I know.Just getting my head around this pain and financial responsibilities is a huge stress!!!!HELP!!!!!

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I had the same surgery and it helped me greatly. I think it depends on the Surgeon though. Luckily I had a very well respected Orthopedic Surgeon. It still hurts even with a pain pump but it;s still alot better than it was. I have 4 fusions in my neck and can feel the discs above and below have gone cause they hurt so bad. My neck involved 2 surgerys because I had a failed fusion with cadaber bone on the first 2 fusions and had 2 other bad discs with the spurs and all. My neck has never stopped hurting. I have been told it's really a 50/50 chance of getting better with the surgery. The lower lumbar though is a very wieght bearing area and thats why my Dr. did it from the front and rolled me over and did the back like you are talking about. That surgery did wonders for me and if my neck wasn't so screwed up I think I would be in good shape. The pain pump also helps so you may want to check into that after the surgery for added relief. I personally would have the surgery due to the wieght bearing aspect of where your back is messed up. When they get the space back where it should be the pressure will be off of the nerves, but remember it takes time for nerves to heal. Also you will have the added support from the screws,rods and plates. Hope that helps a little I'm not a Dr.

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I had the anterior/posterior lumbar fusion Oct. 11,2010. So I am about 4 months into recovery. I am happy to say that, this being my 3rd back surgery, I am actually feeling relief!!! First time in years. However I am still wearing a body cast,for another 2 months. Just have to have LOTS of PATIENCE!!!!! As healing takes a long time,so place your life in GOD's hands....he will take care of you. I couldn't have done this without my faith!!!
PS. I understand how you feel,I could not walk,stand or sit for longer than 20 min. before the surgery,and I still can not do any of those activities for too long,but it is truely becoming easier!!!

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By the way Martin Good luck on your surgery, you too Joseph if you have one. I hope both of ya'll come out of it doing a lot better. Best wishes.

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Hi to all my friends here,i would like to ask for your prayers as i am going in for an anterior ,posterior lumbar fusion on March 25th,2011.Like you Joey,i have the neck issues so i am concerned about how i will deal with the recovery of my back when my neck is in so much pain all the time.Any positive insight or advice would be greatly appreciated.
Blessings,
Nancy Nurse

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Hey Nurse
It's been a long time since I looked at this post. Ihope your doing well after your surgery. If you read this post again let us know how your doing. I hope the surgery worked as well on your lumbar as it did for me or better. I have to go back in on my neck but kinda holding out as long as I can. All the screws are backing out of the plate over my four fusions. It's causing the plate to push into my throat and I have trouble swallowing food. I wish they could just stick a screwdriver in there and tighten them back down but I geuss they can't cause that would be too easy and less money I guess. by the way one of the fusions is halfway gone so they have to re do it also. How can it fuse and then desintigrate, is that normal. I am rambling here so let us know how you are. I'll hopefully run into how you are on another posting.

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Hi Joseph,

3 years ago, I was diagnosed with Isthmic Spondylolisthesis Grade 1 at the L5/S1 vertebral level. I experienced daily mechanical pain for which I am sure that you can also attest to. I was told by a chiropractor that it was more than likely that my spondylolisthesis would not deteriorate any further and that conservative treatment ( I.e. physiotherapy, chiropractory, and topical formulas) would suffice.

However, 8 months after being diagnosed, my pain levels had substantially increased and I was having intermittent flair up's which involved multiple disc bulges (this is the domino affect from a destabilized spine - spondylolisthesis was the stressor). Despite continued efforts to mitigate my evolving daily pain, conservative treatment was not helping and I was then starting to experience neurologic issues which involved intense sharp stabbing and burning neuropathic pain down my right leg (sciatica).

After persistent pain and obvious neural problems which were associated with the isthmic spondylolisthesis domino affect, I had undertaken extensive research for a prospective neurosurgeon before my first consultation in February, 2011. Upon my consultation with my neurosurgeon, he arranged an MRI for me and the results confirmed significant further deterioration involving Neuroforaminal stenosis (nerve impingement from narrowed foramina nerve canal) at L5/S1 level; disc bulge with annular tear and facet joint degeneration at L3/L4; and disc degeneration, broad based disc herniation, and facet joint degeneration at L4/L5 level. Upon seeing the evidence, my neurosurgeon arranged for me to have a Minimally Invasive Transforaminal Lumber Interbody Fusion (TLIF) with hardware at L5/S1 level.

Furthermore, I had my surgery on the 11th July this year and I am now at 9 weeks post surgery. I must say that, I am feeling absolutely wonderful and my pain levels are 90% better than they were before surgery! Without surgery intervention, the reality is that I would have continued having long term crippling pain not to mention more serious neurologic deficits (I.e. loss of muscle function; incontinence; decreased leg sensations; leg weakness; abnormal reflexes; paralysis; and further deterioration of my lumber spine area) Therefore, not being able to work and maintain any quality of life.

If coupled with a suitably experienced/qualified spinal surgeon, the TLIF procedure has a low incidence of complications and in fact, many clinical studies and surveys indicate that the majority of TLIF patient's report substantial pain reduction as well a successful fusion rate (i.e. 90%>).

As with any surgery, you need to weigh up the risks verses the benefits (in my case, the benefits clearly outweighed the risks). When considering spinal surgery, you also need to make sure that you select a suitably qualified and experienced orthopedic or neurosurgeon who has demonstrated expertise in successfully performing spinal surgery procedures as such careful selection will heavily influence the surgery outcome. Yes, there can be potential issues that may arise from surgery implications, though, having an experienced and well recognized surgeon can mitigate such risks.

If you have concerns about the anterior approach (i.e. via stomach), then, raise the prospect of having a TLIF procedure (posterior approach with removal of bone from the side of the vertebra for disc access) which is less invasive and recovery is generally shorter. I sincerely wish you all the very best with your decision.

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Thanks Robert
I really appreciate the advice. I wonder if they could use the procedure on my neck. 2 surgerys and 4 fusions already I hope they can do a better job of holding it together. I'll Let you know the outcome.

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Hi Joey,

My response was intended for "Maxxter - Joseph". Though, you asked if TLIF would be suitable for your neck? The Transforaminal Lumber Interbody Fusion (TLIF) procedure is only intended for the lumber area of the spine, hence, the corresponding Lumber description.

I hope that you have success with your neck issue? I also have a problem with my neck, I have neuroforaminal stenosis at C3/4 & C6/7 levels. My radiculopathy symptoms are intermittent periods of intense burning pain, ache and numbness which is felt on both arms down to forearms and extending to middle fingers.

At this stage, I plan to have a Cervical Foraminotomy to avoid any further neurologic deficits. Unfortunately, conservative treatments only provide short term symptomatic relief.

PS: I note that your photo shows you on a motorbike, are you still riding? I previously had a Honda CBR1000.

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Hi Robert
I still ride but I can't very far before I start hurting. I usually just ride it now when the Patriot Gaurd has a mission for a Soldier. It's not too far to the Veterans cemetary from here. And the Airport where they usually bring the Soldier back is behind my house. I think it's worth getting into a little pain to Honor them . It's a Harley Superglide and rides really smooth with a really comfortable riding position. You should get one. They are the lower cost of the big Harley Twin 88. I can do about a 100 mile round trip on it. I got it used for 6,000.00 It is a 2001 and only had 10,000 miles on it so it was a great deal compared to new cost. I hope you can find a bike to ride again, it sure helps taking the stress level down. Even if it's a short run to the store it helps. It makes you feel like you can still do something fun outside at least.

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Hi Joey,

You are doing a very compassionate gesture for the Patriot Guard. The Harley and the fallen soldiers are certainly American icons.

It's great to hear that you can still get some therapy from riding the Harley. I may look into getting another bike in the near future, maybe a BMW sports/touring model?

Take care & best regards,

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