L5/S1 Fusion.... or not?
 

Last year, I ruptured my L5/S1. 13 mm big or so. I had a micro-discectomy, and then PT, and for a while, I was more or less pain-free....except if I had to move or stretch too far. I wish someone would have told me that first.

At any rate, fast forward a few months after PT, and I'm in near-constant pain. Any time i do too much of anything (walking, sitting....whatever), I hurt pretty bad. I had a second MRI, that showed scar tissue buildup, and that's sure not helping things, but my new doctor (who has MUCH better bedside manner) says that my disc is so 'deflated', the disc itself may be touching my spine, especially with excess movement. While the scar tissue may not be THE problem, it is certainly exacerbating it.

He believes that the first course of action should be epidural steroid injuections and another round of PT. He thinks that building up the muscles around the damaged disc will stabilize it. I'm thinking that the first round of PT did help with pain in the short term, and the steroids might help it work better this time around, but I think it's only a temporary thing.

He says that afterwards, it PT doesn't work, a fusion is the best course of action. He says that if the surgery goes well, after rehab and PT, I will lose a minimal amount of flexibility, but will be otherwise TOTALLY over this injury. I can go horseback riding, or resume my job, which involves a LOT of bending/lifting/stooping.

Also, I'm only 30, and have no (family) history of stenosis.

What do the other doctors here think? What do the L5/S1 fusion patients here think? I'd really love to hear something from you.



Thanks much,



Justin

Sorry to hear about your back, mine was not as bad, ,I did it to myself at work with a 200 lb oxygen tank-L4 L5--but listen your young, and you can heal, I would do the Epudual with Pt, I had four ,opinions, one said surgery, and the others said Epudual and Pt, well I am 63 and in good shape, I told the Dr who told me surgery if he needed money for his morgage payments, I have been doing PT , had the Epudaul shot and its been five months of hell, but I am feeling relief finally--core strenthing is key,I would do everything you can b/4 I would consider surgery, take Tramadul for nerve pain--walk when you are not hurting to bad-use ice packs--I know its a long road--but surgery may not be always the answer try Pt first , it may take months b/4 you start feeling better-- each dr has a time frame , some say six weeks , some say within six months---if you start feeling better with a program , it could take a year--- or more-- everyone is different--- remember, your age is on your side---the only way they will do surgery on me is when I am dead, and then it won't matter---

I wishd to God I had never had my fusion 2 years ago...I thought I was going back to nursing and my pain then was cake and pie to what is is now, and I will never have another day without severe pain...give it much thought and get at least 3 opinions!

There is no one right answer for this situation since so many factors involved. I'm 53 and had L5/S1 fusion done in mid may of this year. I did so after 10 years of exhausting every possible non invasive procedure first. In my case the first month I thought "what have I done" but now things are much better, takes a long time for complete recovery and I hadn't started fusing at my first follow up but feel so much better now something must be happening, I go back early august with new xrays and hopefully good news . Doc was going to let me go back to work until I started fusing but able to talk him into two hours a day and listen to my body. I personally got tired of the only option becoming medication dependant and feeling like a zombie to control the pain. Would I do it the same way again, probably. Some of the injections, blocks and therapy actually gave me relief for extended amount of time. My fear is once you start surgery on the spine chances are more may follow so able to shove it off to the mid 50's want bad.

Cathy

similar story with me
 

L5-S1 herniation. Had micro-disectomy (minimally invasive). Recovery went pretty good, but after a few weeks, it reherniated (confirmed with MRI and X-Rays). Nuerosurgen said I had two options, ADR or Fusing. I'm only 46, so I am trying to do my investigation of what is best for me. My insurance doesn't cover ADR, so I'm working on changing insurance companies, and appealing their decision (I appealed and wrote a letter).

Right now, I wish I would have never had the Micro-discectomy. I am in more pain now, than before that first surgery. My NS made it sound so simple, and the sucess rate was 85% for that surgery. I should have investigated things more before that first surgery. Now, I will have to really think it over before taking the next step, even though I am in more pain now than before. My pain now is from scar tissue, slight reherniation, and misalignment of the bones.

I would like to know how you are doing today. I don't have 20 posts, so I can't email you to ask.

If that doc told you you're be FINE by having a fusion, he's LYING!!! You will STILL have the scar tissue plus MORE. Not only that, but after having a fusion, levels above and below fused levels have a tendency to become unstable, and bulge or herniate and you end up right back where you started! Plus, surgery is NOT an answer to pain. Surgery only corrects mechanical problems. It NEVER corrects pain 100%. Many times you still have the same pain or worse. You're just lucky if you're pain is relieved.

So he did you a disservice by telling you you'll be "fine." You're never the same after spinal surgery. i've had 2 and I'm not the same person I was. God bless and best of luck with whatever you decide. Peace, Lee :wink:

Hi, so how are you now and what did you end up doing? Seems your question was met with a lot of caution?

@Socalman - Microdiscectomy is not a minimally-invasive procedure.

@batfish55 - Where are your pains now? In your legs or in your back?

All best

Although it's different for everyone, I had an L3-L4-L5 fusion. Or so I thought. Three and a half years later I found out the fusion portion of this experiment never occured. I've now developed osteoporosis, but only where the cage is around L3-L4-L5. Unfortunately I didn't do my research until after I found out that the surgery pretty much had failed. It turns out that about 45% of these types of surgery fail. This doesn't mean yours will. I will say I'm in constant pain. It's better than before the surgery since I couldn't walk at all then. Still and all it's a really tough descision. Really research it before you make a commitment one way or the other. And understand the risks. Be very aware that within a short time yuo may feel great or you may be in more pain than you are now. Not trying to scare you, but make sure you educate yourself. I wish us all the best no matter what.:hug: