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Is lumbar fusion worth it?

Started by Danielle Miller... on 01/22/2017 9:50pm

Hi all, I'm Danielle and this is my first post. Have dealt with facet syndrome, ddd, and herniated disc at L4/L5/S1 for 10 years, started off mild but now is unbearable. Have had numerous injections and RFA (nerve burns) through the years as well as weight loss, physical therapy, drugs (NSAIDs, narcotics, nerve blockers, etc) acupuncture, spinal decompression through chiropractor, but Pain Mgmt Doc has finally agreed that this isn't working at this point and I had a surgical consult last week. I must have a new MRI this week to confirm current condition, but it sounds like spinal fusion is his recommendation.

While I was prepared for surgery (discectomy or the like) this has thrown me for a loop and I've been googling it all weekend ... the good, the bad, the logistics of it all and I'm concerned that there's more bad than good that goes along with this procedure. Do you feel that's accurate or do people not always talk about the good that comes from this surgery, only complications and pain?

Thanks so much for any advice or experiences you're willing to share!

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Thank you for your post, Danielle! We are sorry to hear about your severe low back pain. You've clearly exhausted all nonsurgical approaches, and now you face surgery. While spine surgery has helped countless people reduce their pain, it can be daunting when it becomes a reality.

There are risks and benefits to any surgery, but if you're uncertain about whether a spinal fusion is right for you, you should have a discussion about it with your surgeon. Perhaps asking your spine surgeon these questions will help you make your decision:
1. How many spinal fusions have you performed?
2. What complications have your patients experienced as a result of the procedure?
3. What is your success rate for spinal fusion?
4. How long have you been performing spinal fusions?

If you receive answers that leave you questioning the decision to move forward with a fusion, perhaps getting a second opinion will provide some clarity. SpineUniverse has an article that might offer some help--it's about getting a second opinion when considering spine surgery ( Second Opinion on Spine Surgery: Rude or Smart? ). It's a big decision and a very personal one. We wish you the best of luck!

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Hi Danielle,

I also suffered from herniated disks causing sciatica in both legs. Been to physical therapy, had injections, tried NSAIDs and nothing worked. A few days ago, 1/24/2017, I had a fusion done of the L4,L5 and S1. I was nervous, anxious and slightly scared because of all the negative after effects I keep hearing about. But the truth is that I woke up and immediately noticed the pain I had been suffering from was gone. Only the surgical pain remained. About 3 hours after awaking, I stood up by myself and walked around. You will feel pain but its only surgical. I was released the next day, 1/25/2017. I wear my brace religiously right now and I walk around the house alot and I can feel myself getting stronger and the surgical pain going away. Today is 1/28/2017 and I am so happy I made the decision to have the surgery. My whole attitude and mentality is so much better and I look forward to whats ahead... only negative so far is the extreme constipation and the pain of pushing so hard when pooping. Otherwise no other negatives, only positives.

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Robert - it is so good to hear a success story about lumbar fusion! Did your have open surgery or minimumly invasive surgery?
I am anticipating surgery before long, having tried almost everything I else I can. My neurosurgeon wants me to try epidural injection first. I'd appreciate an on-going discussion about your recovery. Best wishes!

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BonnieRae,

It was MAS. Doc went in from the back left. It took 5 hours exactly to perform. I was awake a little less than 2 hours after and up in 3 after that walking. I am so very very happy to have had this surgery. I am getting some tingling in my left foot but its the nerves that were pinched for so long coming back to life. Takes a little to get comfortable when laying down in bed but once I do, I'm out for hours. I didn't get much sleep before the surgery and now I am. I just overall feel great. I think the negatives we all hear about is from people who don't follow the doctor's specific instructions or possibly from not having a good doctor. Either way. The fears I had before the surgery I now see was just wasted energy. The epidural shots only worked on 1 side of my body and they only lasted a few weeks. Glad I had them cuz it confirmed my belief that they were only a temporary band-aid. The surgery is what was required to fix me. If your considering the surgery and its the only permanent fix. Get the surgery. Don't be afraid. Prep your house ahead, practice wearing the stiff brace while you sit, stand, lay, and walk. Practice the no bending, lifting and twisting. Work on strengthening your legs ahead of time as they will be used alot when standing or slightly squatting. Get your mind into the after surgery mindset before you have the surgery and you will do just fine.

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Robert, thank you SO much for sharing your experience!! I've now seem my surgeon for the second time and we are definitely moving forward with surgery ... praying insurance will approve L4/L5/S1 fusion but doc is unsure if disc between L5/S1 is in the nerve bed enough for anthem to approve. I've talked to a few others who've had this done for different reasons (trauma caused their issues ... accident, fall etc) and they all believe it's worth it 100% and I might have an easier time with recovery since I have had this level of pain for so long now ... my cousin said it will be more muscle pain than the deep down ache I've had. Either way I'm focusing on the possibility of the month to come at this point!

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hi danielle
im in the same boat as you , i recently went to 2 different doctors about my back pain and sciatica seeking opinions.i recently had a microdiscectomy on my l5s1 disc , came out of surgery worse than when i went in, surgery was at a highly advertised on tv spine institute on 9/9/16.here it is almost 5 months later and still having issues with pain in my back and sciatica .but anyway i saw 2 surgeons for second opinions on what my next step should be.the orthopedic wants to do the stand alone alif fusion and the neurosurgeon, wants me to do more pt and come back in 6 weeks to see how im doing, the neurosurgeon thinks i still have plenty of disc height to not do a fusion, the second mri clearly shows the degenerating l5s1 disc, but hes the dr not me.but like you danielle ive researched everything about fusions and most of the info ive seen is bad about this operation, i just dont know what to do, take a chance on more surgery or deal with the pain.it is manageable right now, i just cant sit or stand for long periods because of the pain.

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hi robert
how is your recovery going?which fusion procedure did you have?.have had two surgical opinions. the ortho wants to do an alif fusion, the neurosurgeon thinks that i should do more pt and if that doesnt work do an alif fusion.like you i have heard the horror stories of fusions, and im hesitant to go thru with the surgery, i had a microdiscectomy on the right side of l5 s1 disk in sept 2016, it just made the pain worse.i just want to get back to a somewhat normal life.

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I had the MAS TLIF fusion. L4,L5 and S1. I am doing great! Getting up is a struggle sometimes because of the incision pain but if you squeeze your abdominal muscles as you stand it makes getting up easier. I have a little trouble sleeping in the bed so I switched to the recliner and now I get sleep and I can get up in the morning. Haven't been able to put my socks or shoes on by myself yet but soon I hope. I have stretched my pain meds out at night so I take them at 11pm and go thru the night until 7 am. I still am having bouts with the nerves reawaking. But only on my left side. All in all...I am thankful for having this surgery and I highly recommend it by anybody who has had back pain that just wont get better. I did the injections and physical therapy and they just were temporary fixes. This is a permanent way to be free of the pain. This has changed me in such a positive way that I told my Surgeon to use me as an advocate. I would be happy to talk to anybody considering this surgery.

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hi robert
what is the mas stand for?
and yes ive tried idd therapy, chiropractic, nerve blocks, transforaminal epidurals both sides, pt, currently just taking ibuprofen and gabapentin for pain.
my main issue is i cant sit for more than 45 mins, my low back and legs go to hurting, standing too long gets my low back hurting but i can walk fine, the pain is till manageable.
do you think i maybe am jumping the gun on getting this surgery too soon, or should i wait until the pain is unbearable?
im just undecided on what to do.
i guess its a risk vs reward

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The MAS is Minimally Avasive Surgery. The Surgeon enters into your back on the side that hurts the most. He makes an incision about 4 inches in length and 4 inches in depth. He slices thru the back muscle at an angle which allows for a fast recovery. I was afraid before having the surgery because everythong online and on youtube were all the normal procedure and everything was negative and sounding like have the surgery was worse than before however, for me I was tired of the pain and said screw it. Glad I got the surgery. If your in pain now, if your life just isn't normal, why would you wait? If the surgery is an option. I am all for it. And you will be an advocate as well within days after cuz you will be feeling so much better. Almost as if somebody gave you your life back.

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I had a L5/S1 Fusion in Oct.2015. As it helped the leg numbness and back pain, I still have a constant pain at my incision site, about 1/4 inch into my back. I am currently at a loss as to what to do. I am seeing a second opinion Neurosurgeon later this month. I really don't think there is a clear cut answer to your question. Because everyone is so different. Write out the pros and cons of having the surgery. Make sure you see a board certified Neurosurgeon. Make sure he/she is reputable; do your research. Keep an open mind and write all your questions down. I hope you find the answers you are looking for. I hope you feel better. Kris

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I had a L5/S1 Fusion in Oct.2015. As it helped the leg numbness and back pain, I still have a constant pain at my incision site, about 1/4 inch into my back. I am currently at a loss as to what to do. I am seeing a second opinion Neurosurgeon later this month. I really don't think there is a clear cut answer to your question. Because everyone is so different. Write out the pros and cons of having the surgery. Make sure you see a board certified Neurosurgeon. Make sure he/she is reputable; do your research. Keep an open mind and write all your questions down. I hope you find the answers you are looking for. I hope you feel better. Kris

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hi kristine

i have seen to doctors seeking there opinions, the ortho wants to do alif fusion as he doesnt do plif, he states that plif there are toomany complications associated with that procedure, so he doesnt do plif.this ortho is board certified, fellowship trained in germany,

the neurosurgeon wants me to do 6 weeks physical therapy, if that doesnt work then come back and we will look into alif fusion, but im thinking that 6 weeks of pt is a waste of time, going to see another dr for another opinion on 2.27.17

im just confused on which way to go, the pain is manageable and i feel i should wait it out, but also when i had the discectomy back in sept of 2016, i came out of that with more pain than what i had pre surgery.i mean now im getting by on just ibuprofen for the pain.just cant decide on what to do.

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Hi Danielle. I know the pain your in all too well. I had the spinal fusion surgery in June of 2016 and I am now in more pain that I was before the surgery. I have gone through physical therapy twice as well. I am now second guessing my decision too have the surgery. Now they want too do cortisone shots and I will not ! I have done the research on that. My Dr has switched my muscle relaxers which help sometimes. He recently wrote a prescription for Mr maloxicam and of course, I researched and I will not take that either. I have come to the conclusion that it's me and God. I now add more water, less sugar, less carbs and I have found a very nice super berry tea as well. I will not do anymore surgeries or take any new meds. I feel it has done nothing for me at all

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