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4 level fusion advised...I sent mri and report to Mayo in Scottsdale

Posted by normadela67 @normadela67, Apr 24 11:25pm

First ortho said ALIF PLIF 360 L1-L5, Second Ortho said PLIF L2-S1, I attached Mri Report. I sent MRI and report to Mayo, Scottsdale. That is 6 hours away if they accept my case. I will be having injection in a week. My symptoms are inner thigh and groin pain/discomfort. Dr. believes its coming from L4-L5 so if the injection relieves the pain, it is from my lumbar, if it doesn't relieve the pain then it might be a hip issue. The injection is diagnostic he said. He also said, "you have a lot going on in your back, I just want to be sure what I'm looking at". Im currently on pregamblin 25 and using a walker to get around.. Thank you for reading this. Id really like some input if you have similar experience and also experience of being from out of town and having it done at Mayo Clinic.

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larry68 | @larry68 | Apr 27 8:57pm

I told them that i was tired of the pain and pain management doctor made it happen,My Dr. does not wanna do fusion till there is no other way

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1 reply
normadela67 | @normadela67 | Apr 28 5:38am
In reply to @sassytwo "I have been reading about burning the nerve pain. None of my 5 surgeons even mention..." + (show)
@sassytwo

I have been reading about burning the nerve pain. None of my 5 surgeons even mention this as an option. Since I suspect the majority of pain is S1L5 & L5L4. That might be my short term solution and buy me more time before fusion surgery . I am curious..Did your docs offer this or did you research and present this to them?

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Thanks for responding,, I just ran across this as an option. I see the pain management Dr. this week so I am going to bring it up. I think its called ablation. I do feel that the ortho wants to exhaust every option before fusion surgery.

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normadela67 | @normadela67 | Apr 28 5:40am
In reply to @larry68 "I told them that i was tired of the pain and pain management doctor made it..." + (show)
@larry68

I told them that i was tired of the pain and pain management doctor made it happen,My Dr. does not wanna do fusion till there is no other way

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My Dr. also wants to wait until fusion is the only option. Thanks for responding.

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larry68 | @larry68 | Apr 28 7:39am

Radio Frequency Ablation.

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larry68 | @larry68 | Apr 28 7:52am
In reply to @orloffjr "Hello I do have some similar experience with left sided lower abdomen, groin, inner upper thigh..." + (show)
@orloffjr

Hello
I do have some similar experience with left sided lower abdomen, groin, inner upper thigh and testicle pain that has been successfully treated with epidural injections at T12/L1 and L1/2. I've recently develop pain lower down in the outer hip and inner thigh that doctor(neurosurgeon) though was probably coming from the L4 nerve root. Mri showed that wasn't the case. He ordered a pelvic MRI. Insurance has just denied this scan so still unsure what the problem is. I am fused from L4 to S1. I've had 2 laminectomies with discectomy at T12/L1 that helped considerably. The last one was 4 yrs ago and have had probably 10 epidurals since then. Those, (along with PT and staying fit) have let me avoid the big fusion and still be somewhat
active. I would seek at least 3 opinions and not rush into such a big fusion. I hope this is helpful. Best wishes to you!
Ps-I'm 58.

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I changed neurologist because i went for appointment and fell to the floor and couldn't get up.Other patients picked me up.I went in to PA of neurologist and she gave a clean bill of health after seeing me hit the floor.Much happier with new Neurologist.

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orloffjr | @orloffjr | May 7 5:42pm
In reply to @larry68 "I was having the same pains on the same side.Never will understand how it affects testicle,but..." + (show)
@larry68

I was having the same pains on the same side.Never will understand how it affects testicle,but it does.I have a epidural and they burn the nerves every year for a years worth no killer pain.Dr.'s and surgeons all told me no to fusions and surgeries of any kind.So i do this every year and is working so far.

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Thank you for the input. My pain management doc and everything else i have read indicate ablations are for facet nerve problems and not the nerve root itself. I will look into it further.

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1 reply
larry68 | @larry68 | May 7 8:27pm
In reply to @orloffjr "Thank you for the input. My pain management doc and everything else i have read indicate..." + (show)
@orloffjr

Thank you for the input. My pain management doc and everything else i have read indicate ablations are for facet nerve problems and not the nerve root itself. I will look into it further.

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Please let me know!!

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lmandriese | @lmandriese | May 7 11:55pm
In reply to @sassytwo "I am 66. Yes, I do believe once you have surgery, you weaken the spine structure...." + (show)
@sassytwo

I am 66. Yes, I do believe once you have surgery, you weaken the spine structure.

I have a lot going on and will need a fusion at some time. Standing is difficult as is walking. However, I can sit and sleep with little pain or interruption, so I punting for a bit longer.

Stenosis and Scoliosis mainly. I can opt for a cage for S1/L5 & L4/L5. (Surgery with two surgeons through the tummy) I believe the majority of my pain comes from this area. Probably will help with my scoliosis and will not take care of the full scoliosis. There is slippage at L3/L4 and L2/L3 (1st surgery 2015) and it possible it will become less stable with more surgery and I may end up having to have another surgery to fuse this area and another long recovery. I believe I will end up with a full fusion from S1 - T 12. Not quite at the tipping point to move ahead. That is a very brief version.:)

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I’m interested in the surgical approach through the belly. Were you told why they’d go this route and not directly on your spine? (If i misread/misunderstood your post, I apologize.)

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sassytwo | @sassytwo | May 8 10:26am

They can place a larger cage. It requires two surgeons… vascular surgeon and spine surgeon. I know two people that had this. One had a 2nd surgery and the other only required one. Different spine problems. It can only address S1/L5 and L5/L4.

In my case they would operate on L/3/4 and L2/L3 from the side or off to the front side with a different incision. Or possibly address the rest from back. Could be a two day surgery. The scoliosis docs both enter from the back and would fuse T12-S1. One also discussed bolting into the pelvis which would be removed in a year or two as people find this uncomfortable??

I could just have the cage and hope that that is where most of my pain is from vs actual back and perhaps not have to address the scoliosis or at least not till later. Do I want to have two major spine surgeries??

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choosejoy | @choosejoy | May 9 11:55am

I’m so glad you mentioned the hip possibly causing the groin pain. While I am fused L4-S1 due to herniating discs and major sciatica due to the impingement on nerves, I later had groin pain. I went to PT for pelvic floor dysfunction but pain continued. After doing Dr Google research, I requested a hip MRI and found the culprit to be a totally torn labrum. At that point walking had become very painful and I opted for a labrum reconstruction surgery.
You may have two issues going on - hip and back. MRI definitely shows spine issues with the nerve impingements in your lumbar spine. I held off on my fusions until I lost control of my foot movement (foot drop). I would not wait as long as I did though, as I ended up with some permanent nerve damage.
Best of luck.

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