L4-L5 Fusion
 

Hello,
I am new to this and this is my first time posting in any type of fourm. I am scheduled for L4-L5 back fusion on Feb. 16th. I am still having second thoughts about this because of some of the horror stories I have read. I have spondylolisthesis and my spine is unstable. I have taken shots but they only worked for about a week with the pain. I have never taken any pain meds. Most days my pain level is about a 3 but some days it hits 7 to 8. I am only 52 years old and fairly fit. I run approx 18 to 20 miles a week on treadmill because running on road is to much much pounding on my back. I now wear a back brace when I run which help hold my back in place. I have not reached a point yet that I can no longer live with the pain but it does bother me that I can't be as active as I used to be. I know that the surgery may not help the pain but I am wondering if I should have it due to my back being unstable. Just looking for some input from others.

I had fusion L4-5 a little over 5 years ago and spondylosthesis as well. Had injections, epidurals, physical therapy before going ahead with the fusion. When I made my decision, my pain was at a level of 8 -10 and didn't have much of a choice. I still have pain; but the doctor said due to the severity of neural compression identified, he thought I might still have some problems. Also, his words "had never seen such a red angry nerve before". Not sure if I had not waited so long whether I would have had as much damage.

Have you had a second opinion? It is a big decision and understand your second thoughts. I don't know if I would call mine a "horror" story; but do think, in my case, it might have been worse had I not had it done.

Wishing you well on whatever you decide. Again, if you haven't already gotten a second opinion; would greatly suggest doing so.

(Ger)

Hello Ed
 

I am glad you found Neuro Talk. I want to welcome you here. You should find alot of information regarding back problems. In my case, Surgery was a must, I didn't have a choice as the condition of my spine could not be helped with injections or increase in narcotics. I also had reversed the curve of my spine. In most cases surgery is a last option. If you are still activelly running, maybe another opinion would be best. Most times they do surgery, you are pretty limited in just about any activity because of the pain. If your pain keeps you from your activities, and is considered a must for surgery, that would be the time to do it. Have you gotten two neruologists to concur that you need this done? I did have a good outcome, but it was after a first failed surgery. There are lots of success stories here as well. I just want to offer a little caution and to make sure you have more than one opinion. Not all back problems warrant a surgical intervention. It is always a last resort. ginnie

Input from others...
 

Hi Ed, Welcome to NT.

Yours is probably one of the most common questions we get on this forum, yet every case/patient/situation is unique. You didn't mention where you did your reading; as many places as you can find (here and elsewhere) is best. There are a lot of discussion threads on this topic here, and you can also use the search function in the upper righthand corner of the forum page, below the page numbers. I think the more specific you can be with your condition and questions, the better people will be able to address your concerns.

Candidly, I am of the opinion that surgery should only be considered as an absolute last resort, and only after all other treatment options have been tried and have failed.

Regardless, I think we all echo Ger's advice on getting multiple opinions. You didn't mention what kind of surgeon advised the surgery, and opinions can sometimes differ between orthopedic and neuro surgeons (other?), so you may even want multiple opinions from each type of surgeon.

If you do go through with surgery, you of course want the best surgeon you can get - not necessarily the greatest number of procedures, but the best success rate with your exact procedure, and that you're confident and comfortable with the success ratio of that surgeon doing that procedure (chance of improvement vs. remaining the same or coming out worse than if you hadn't had the procedure).

Consideration should (IMO) also be given to the cause/type of your spondylolisthesis:
http://www.medicinenet.com/spondylol...is/article.htm
If it's degenerative in nature, it stands to reason that surgery may be better sooner than later, but if it's not, and/or not likely to deteriorate/worsen very quickly, that may buy you some more time to research, investigate, and consider/try other options/alternatives. Do you think you were adequately informed about other treatment options?

One last bit of input (for now); not to scare - just to inform, as in informed consent:
http://en.wikipedia.org/wiki/Failed_back_syndrome

Doc

[QUOTE=ed2012;845277]Hello,
.....because of some of the horror stories I have read. I QUOTE]

Welcome! Sorry for your pain and that you have to make this decision for yourself.

Regardless of which way you ultimately go:
My GP doc advised me that there will always be a disproportionate number of horror tales to success stories because the successes are more apt to be out there living their lives, not seeking help on the internet. Applicable to any malady.

Hey Ed - Since you're still running, I would very much like to know if you were given any direction or advisement on you activity level.

Thank you for reply. I have been to 3 neuro surgeons and each one has said the only way to try to fix my problem is a fusion. They have each said my back is very instable but it is my decision if I want the surgery. I am also having problems with my L5-S1 area but my dr. does not feel it needs to be fused. According to my recent tests my instability has gotten worse in a 12 month period. If I thought that my pain level and instability would not continue to get worse I would say no to the surgery. One of the surgeons told me the instability is a problem and a hard fall or wreck could put me in a wheel chair. The surgeon I am now seeing has told me I should not lift anything over 30 lbs. and if I do have the surgery I will have a 30 lb. limit from then on. When I bend over I can feel the instability in my back but the pain is not unbearable. I do also have pain running down the rear of my left leg and my hips ache alot. Walking uphill is the worst. I feel like I am just rambling here. I do appreciate all the information I have found here and thank you for input. I have told my wife that I can't say for sure that I will go thru with the surgery until they have me on the table and asleep. Also my son in law is a chiropractor so I go see him approx 3 times a week for adjustment. The adjustment is great but goes back out the same day. I'm going to quit rambling now but any input would be appreciated.

My surgeon advised me no lifting over 30 lbs. and should give up running for walking, swiming, or biking. I have been a runner for over 30 years and hate to think about giving it up. I used to do alot of races and marathons but have given them up because of my back. Now I only run for fitness and pretty much on the treadmill.

Ed, you're not rambling at all! So sorry for your plight, but what you refer to as rambling is interesting and may indeed help us.

That you run at all is amazing to me, along with taking no pain meds. You're a strong soul aren't you?

My daily 4 mile/hour walking is the hardest thing I've found to give up. Take a pain pill, grit my teeth and do it anyway, although not as far anymore or quite as fast - some days not fast at all. Fusion has been mentioned by 2 of the 3 dr.'s I've seen but we are waiting on the CT for certainty. Don't have a dr. to do surgery yet due to $$, but I will eventually just out of dogged determination and the Grace of God. Nerve compression seems to be my biggest pain factor.

I understand completely your fear, indecision - and love of motion (running)!

Goodmorning seahorse
 

I just wanted to tell you what I did with my first neuro surgeon, I told him I didn't have insurance or money and actually asked him to do the surgery and give me a discount. He did that for me, and cut my expenses by 2/3rds. The hospital didn't charge anything through this program. The one who put me to sleep I wrote a letter to also, and asked for mercy, He didn't charge at all. I think sometimes you have to ask for help, and confront the doctor and just lay it out for him kindly. Many doctors are willing to reduce their charges. I also have no doctor who accepts medicaid. They drop the 20% I would owe.
My pain specialist gave me two katemine infussion for nothing before I had medicare and was waiting for coverage. There are good souls in the medical profession. Asking the doctors is a good way to find out what kind of physicians they are on the inside. ginnie

Oh Ginnie, what good ideas. The PS I see is one of those good souls you mention. I now have another appt. w/him to talk about the meds & what's going on as far as a neuro search. It never occurred to me to write letters. I guess I've never considered that anyone would be that...generous, for lack of a better word, after all they have student loans to pay and hard work that they spent many years to obtain the knowledge they have now in order practice their profession. I really do understand why neuros want to get paid big bucks, but dire circumstance and pain can lead to creative and humble ways to ask for assistance. Your post is extremely helpful!

ED, SO NOT MEANING TO STEAL YOUR THREAD!!

No Problem. I enjoy all information here and find it helpful.

Thank you!
Echoing Ger's question, have you had more than 1 opinion of your options?

Yes I have been to 3 different neuro surgeons now and each have told me the same.

Good Ed
 

It is good that you did go ahead and get all those opinions. If all agree, you probably really do need the surgery. I wish you all the best. ginnie

Ed
 

I mentioned previously about fusion L4-5, laminectomy as well. The doctor that perfomed my surgery was an orthopaedic doctory specializing with problems of the spine.

Just wondering if you have given any thought about seeing an orthopaedic doctor specializing in problelms with the spine?

(Ger)

More Input for Ed
 

Ed,

You're not rambling. The doubts/uncertainty, the questions, the sharing of experiences and information, the moral support, a sounding board... These are what a support group is about. Before the internet, if people didn't live someplace big enough to have a face to face support group, they were pretty much SOL...

I found some more great (IMO) stuff for you, and everybody else considering surgery.
Google: questions to ask before back surgery

Doc

Thank you
 

Thank you all for your input. I'm still on the fence on weather or not to go ahead with the surgery. I talked with one of our employees that had a 2 level fusion done at the end of November. He is doing great and wishes he would have done the surgery 10 years ago. He said as soon as he came to in the hospital the pain he had before was gone. He is now driving himself and doing alot of walking. He is a carpenter that we employ and plans to return to normal work that he did before which includes hanging drywall.
I am suprised by the difference in his back brace he wears as opposed to what they have given me. His brace is very wide and comes upto his chest where as mine is alot smaller much like what I already wear when I run.
Also he has a bone stimulator that he uses and he is going to physical therapy. My doctor said my physical therapy would simply be me walking each day.
Again thank you all and I will update you on what I decide and if I do go thru I will try do give updates how things are going.

ed2012,
I recently underwent a multi level discectomy and fusion. like 8 weeks ago... I worked 30 years in the building/remodeling business. although I feel great as to no more pain or numbness...my strength may be gone for quite some time. as far as hanging or even finishing drywall I would be no good right now. once I raise my arms above my shoulders I can feel the pressure in my neck and have absolutly no strength.
I feel for ya and I hope your younger than me...at 45 I am slow in healing and this made me retire. at least I can tie my shoes now...

forgot to mention the fusion was cervical...but the lumbar is scheduled next..good luck.