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Spondylolisthesis: Spinal Fusion at L-4-L5

Spine Health | Last Active: Jul 18 7:36am | Replies (29)

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@kremer1

Thanks for your timely reply @upstatephil. My case / back discomfort and pain has been going on for quite a while, probably 15+ years ago. But the DDD was indicated from a lumbar MRI done in 2019. Neurosurgeon then suggested the typical non-invasive approach with PT and OTC pain med. I've been doing that since, and added pain management DR in 2021 for facet and epi both cervical and lumbar. The first ones helped some, but the more recent ones last year didn't do much. I tried MBB pre ablation, it didn't help enough to consider the ablation. Had more MRI done last fall, stenosis and some osteophytes are progressing, but the initial neurosurgeon is saying my symptoms are not warranting fusion. The second opinion neurosurgeon said fusion L4/5. So yes, I need a tie-breaker opinion.
I'm able to manage the discomfort and pain for now, the tingling / numbness varies as well as the localized pain at the lower lumbar. I don't have much choice with ease of appointments. I don't know that it is more or less difficult for people in other parts of the country for getting in to see your PCP or specialist, but it is typically a long wait time here, I guess unless it is a life threatening situation.
I was just wondering what your overall time frame has been. How long you have had back issues, to when you had DDD diagnosis to when you were able to decide on the surgery and surgeon team. And I think you answered that pretty much.

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Replies to "Thanks for your timely reply @upstatephil. My case / back discomfort and pain has been going..."

@kremer1
I have cervical/lumbar congenital stenosis/DDD and neurogenic clarification. My pain in lumbar region started when I was 41 after my only pregnancy. I had ACDF surgery C5-C6 for myelopathy (spinal cord compression injury) and just saw my surgeon yesterday to plan for lumbar surgery. It has been about 13 years of progression/worsening of pain/numbness/weakness which has really impacted my quality of life (I am currently 55 and a single parent of a teenage son with no family/support system except for my ex-husband which luckily we are amicable in raising our son).

My surgeon is considering minimally invasive surgery to decompress/fuse L4-L5 at a minimum due to severe stenosis and L4 slipping over L5. He will need to use hardware to stabilize my spine. I am getting an updated MRI of lumbar spine to determine if L3-L4 and L5-S1 would need to be included.

The CT spect scan may help your surgeon narrow down the source of your pain to help plan targeted surgery. I have not had that done but believe I will need to have a CT scan done before my lumbar surgery to help my surgeon plan and focus surgery. I had a CT scan right before my cervical ACDF surgery to supplement my MRI.

Here is a link for CT spect scan from Mayo.
https://www.mayoclinic.org/tests-procedures/spect-scan/about/pac-20384925