Cervical Fusion Needed Before Lumbar Surgery?
 

I have had long standing right leg sciatica with two prior surgeries. Recent MRI reports indicate I need an L3/L4 and L4/L5 decompression and fusion. This has been confirmed by multiple surgeons.

My primary care mistakenly ordered a cervical MRI along with the lumbar (I am asymptomatic for cervical issues) but the results showed C5/C6 and C6/C7 degeneration.

A couple of the surgeons told me they would not do the lumbar surgery unless I fixed the cervical first as there was risk of quadriplegia from spinal cord ischemia due to head position and lowered blood pressure during surgery. Two other surgeons said it was not critical.

Has anyone faced a similar situation? I was planning on getting an XLIF for the lumbar so head position might not be as damaging as a PLIF where I would be prone.

I would greatly prefer not to have the cervical fusion done right now as I have no neck or arm problems.

Do any of the surgeons have a lot more experience than the others?
If so what is that Dr's opinion?

Did all Drs actually see the C spine MRI and did they ask if you had any symptoms before making that fusion opinion?

Do you think some of them are trying to get the extra "job" of the cervical fusion, money wise??
I mean are they the ones that would do the surgery?

Logically I would think they have ways to support all parts of the body properly during surgery...
But I don't have any first hand info on it.

Hi ~ I think the surgeons who said you needed cervical surgery are nuts IF your MRI said you only had cervical "degeneration." If that's all it said, it is NOT critical. If it says you have cord compression, then YES it is critical. But degeneration just means that the discs are dried out and probably the disc space height isn't maintained. There "might" possibly be some bulging too, but if it doesn't say anything about herniation or cord compression, they're nuts. They just want to do surgery and get the money. THAT DOES HAPPEN YA KNOW. :rolleyes:

One thing I want you to know about fusion too, is that after fusion many times the levels above and below become unstable and will end up herniating. Then you're back where you started and will be back in the operating room somewhere down the line. The sometimes happens with decompression surgery too, like it did me. I didn' have fusion after i had L4-5 decompressed and had to have L3-4 done. Now both those levels have re-herniated cause you know they don't take the whole disc out ~ just the part that is herniated. So I'm herniated again, but they can't do surgery on me cause my whole spine is shot and I'm inoperable.

Just wanted to warn you. Also don't expect ANY surgery to ease your pain. Surgery isn't intended to ease pain ~ it only fixes mechanical problems. So don't go into surgery expecting your pain to be eased cause you may have the same pain or more. If you've had the sciatica for a long time, you will still have it. i've had mine for 24 years, because if it's long-standing, the nerve has been damaged. sorry to be the bearer of bad news. God bless and take care. Peace, Lee

They are 110% right on the money, cervical damage can indeed damage our spinal cord where it can never be help, now the back will not do the same as there much more room there.

The higher up the spine the less room there is and the higher the risk, in most cases if some kind of damage is happening in the cervical spinal cord after a year, the changes of a operation fixing is very slim.

You should go to see a neurosurgeon, and have them map it and see what the risk are right away, see you can have bad damage going on in the cervical spinal cord and not even feel it, the DR's know what they are talking about on this one.