NeuroTalk Support Groups - Lumbar Fusion-Was it worth it?

Quote:

Originally Posted by SDFencer (Post 1020744)

We're looking at 11/11 as a date for my surgery. For those of you that have had it was it worth it? Can you run, jump, romp with you grandkids?

Discuss

SDFencer, there are many reasons to perform lumbar spinal surgery and multiple techniques for each condition. Surgeon experience and a number of other variables enter into ones mind as well. It has not been my experience that most or even half of the lumbar fusions are worse after surgery. And if you could find a meta-analysis on the topic, you would probably find a more favorable result than not.

I think the more important consideration is that when thinking about surgery, have you tried all reasonable conservative avenues, failed at them which now leaves you with this decision? If that's where you are at, have a long talk with your surgeon or maybe two, and make sure you are there. Also be prepared to accept possible bad outcomes. But if you truly have tried all else and you are unhappy with where you are at, the answer should be fairly clear. While your problem may or may not be represented here, I did a little poking around and found the following which seems to be fairly representative of what's out there:

Clin Interv Aging. 2013;8:1063-9. doi: 10.2147/CIA.S49802. Epub 2013 Aug 12.

Axial lumbar interbody fusion: a 6-year single-center experience.

Zeilstra DJ, Miller LE, Block JE.

Source

Bergman Clinics, Naarden and NedSpine, Ede, The Netherlands.

Abstract

INTRODUCTION:

The aim of this study is to report our 6-year single-center experience with L5-S1 axial lumbar interbody fusion (AxiaLIF).

METHODS:

A total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with AxiaLIF at L5-S1, and were followed for a minimum of 1 year (mean: 21 months). Main outcomes included back and leg pain severity, Oswestry Disability Index score, working status, analgesic medication use, patient satisfaction, and complications. Computed tomography was used to determine postoperative fusion status.

RESULTS:

No intraoperative complications, including vascular, neural, urologic, or bowel injuries, were reported. Back and leg pain severity decreased by 51% and 42%, respectively, during the follow-up period (both P < 0.001). Back function scores improved 50% compared to baseline. Clinical success, defined as improvement ≥30%, was 67% for back pain severity, 65% for leg pain severity, and 71% for back function. The employment rate increased from 47% before surgery to 64% at final follow-up (P < 0.001). Less than one in four patients regularly used analgesic medications postsurgery. Patient satisfaction with the AxiaLIF procedure was 83%. The fusion rate was 87.8% at final follow-up. During follow-up, 17 (13.0%) patients underwent 18 reoperations on the lumbar spine, including pedicle screw fixation (n = 10), total disc replacement of an uninvolved level (n = 3), facet screw fixation (n = 3), facet screw removal (n = 1), and interbody fusion at L4-L5 (n = 1). Eight (6.1%) reoperations were at the index level.

CONCLUSION:

Single-level AxiaLIF is a safe and effective means to achieve lumbosacral fusion in patients with symptomatic degenerative disc disease.