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Posted in: Spondylolisthesis, and Surgery.

L4/L5 spinal fusion on isthmic spondylolysis, grade 1 spondylolisthesis

Started by 671723371@facebook on 09/30/2011 9:01am

Hi,

I have had back pain for the last 5 years and after trying every sort of non-surgical treatment to no avail, I have started checking again with doctors. 3/3 opinions so far lead me to surgery, level 1 spinal fusion with grafts, pedicles, screws and everything on. I am really worried to proceed as I am reading lots of testimonies about severe pain after surgery, slow recovery, not great success to relieve pain etc. I am 35 and very active, lots of sports including sailing, skiing, running, waterpolo, mountainbiking and I don't trust the doctors who say that I will be back to normal in 6-12 months. I am afraid that after this things will not ever get back to "normal" ie I wont even be able to do the things I do now with pain. I am afraid that my whole life after this will be more restricted activities, physiotherapies and a different lifestyle. So maybe I should just bear with is as much as I can before going for surgery. Could anyone of my age and activity who had the same operation advise me?

Thanks

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Hi Andreas,
I am not your age ,i am 50 but i was extremely active before my injury in June 2009 and i had very similar symptoms as you,i had the L5-S1 fusion in March 2011,and it has helped a lot.I have just had to change a few of my activities,can no longer do jumping pounding things like step class.It seems like you have been suffering way to long,i would consider the surgery.Sounds like you are determined to get better so i think you will.I was back at the gym doing cycling class 6 weeks post fusion.Best wishes with whatever you decide.
Nurse Nancy

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Hi Andreas,
I am not your age ,i am 50 but i was extremely active before my injury in June 2009 and i had very similar symptoms as you,i had the L5-S1 fusion in March 2011,and it has helped a lot.I have just had to change a few of my activities,can no longer do jumping pounding things like step class.It seems like you have been suffering way to long,i would consider the surgery.Sounds like you are determined to get better so i think you will.I was back at the gym doing cycling class 6 weeks post fusion.Best wishes with whatever you decide.
Nurse Nancy

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Hi Andreas, I am your age and have recently undergone a very successful TLIF operation at L5/SI level. 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 2011; and I am now at 6 months post surgery. I must say that, I am feeling absolutely wonderful and my pain levels are 95% 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.

At this stage, my lower back is coping well and my general functions are unrestricted (I.e. walking, sitting, controlled bending, etc). As the bone fusion is still continuing to form, I still have a few minor restrictions such as no lifting above 10 kg and no repetitive twisting movements.

Although I completed a 6 week hydrotherapy program through the local hospital at 12 weeks post op, I still undertake regular hydrotherapy at least once a week. I must say that, the hydrotherapy is absolutely wonderful as it seems to gently stretch and exercise those deeper musculoskeletal areas which require stimulation.

In July this year, I have a scheduled (post CT scan) review appointment with my neurosurgeon to discuss the degree/integrity of my fusion.

I sincerely wish you all the very best with your decision. In the meantime, please keep me posted on your progress.

PS: I will be able to commence some cross country mountain biking once my bone fusion takes place.

Take care & kind regards,

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