Four level lumbar fusion for primarily leg weakness

@bigmuscle72 I want you to know that leg weakness can also be caused by cervical stenosis and compression of the spinal cord in the neck. If your doctors have not imaged your neck, that may be worth doing. I was having leg weakness and limping due to cervical stenosis and I did not have issues in the lumbar spine. It's a big surgery to go through and may not correct the issue is they haven't properly identified exactly where the problem lies, neck, low back, or possible both places. It is worth asking if your surgeon ruled out a cervical problem.

Here are some discussions where you can Connect with other members regarding spinal fusion.
https://connect.mayoclinic.org/discussion/fusion-or-disc-replacement-l4-l5/
https://connect.mayoclinic.org/discussion/success-stories-after-lumbar-fusion/
https://connect.mayoclinic.org/discussion/has-anyone-had-a-failed-spinal-fusion/

Thank you. Yes I’m aware. Cervical lesions can manifest distally. My lumbar spine is a mess. I have had several MRIs over the years years and it’s gotten worse. All lumbar levels to S1.

@bigmuscle72
I am a 55 year old female who had L3-L5 decompression and fusion surgery in August 2024. Very painful (off the charts 11/12 out of 10) because I had open surgery to deal with my severe central stenosis, degenerative disc disease and neurogenic claudication (very painful). It cause lower back, hip, buttock, leg and foot pain, numbness and weakness. It was really hard to stand, walk, do stairs, etc.

Post surgery, numbness has really improved and pain/weakness improved over time. I am still dealing with nerve pain in my hips/hip flexors which makes walking/standing up/going up stairs difficult. My understanding is I also had gluteal tendinopathy and hamstring tears both bilaterally presurgery which made recovery more difficult. The new nerve pain in my hips post surgery may be from nerves regenerating after being severely compressed for 8+ years.

If I would suggest anything pre-surgery would be to do physical therapy to strengthen your body as much as possible which will help in your spine recovery. I didn’t do this and wish I was recommended to do so to support mobility during recovery.

Good luck with preparing your home, self and support system for your surgery. The longer you wait, the more potential damage to spinal cord/cauda equine/nerves/nerve roots and decline in quality of life. I was delaying surgery using spinal injections which stopped working. A doctor said to me that I may not want to wait to do surgery when older because recovery may be easier when you are younger. I decided to schedule my surgery after she said this to me.

I recently had surgery for C4-C7 fusion on 11/20. I have some other issues with L4-L5 and L5-S1. Do you have any bladder related issues. I have a need to have to go frequency when lying down. It is due to a compressed nerve that sends signals to the brain. It happens at L5-S1.

I just had C4-C7 fusion, it had to be done posterior (back of neck) due to findings of a paralyzed left vocal cord, Orthopedic Surgeon did not want to risk damaging the right vocal cord. I can appreciate your off the chart pain numbers. I told them my definition of a 10 has changed, Under my old definition, I said the pain level was a 15. to 20. I was supposed to have a dilaudid pain pump, high dose that I could control every 10 minutes, but the order was not properly placed and I was only being given oxycodone 10 mg every 4 hours. I had to deal with this from 8:00 pm until 10:00 am the following morning.

I have urge incontinence at times, but not overt. Also, no retention: I do fully empty by bladder.

Thanks for the stories and information. Saw my neurosurgeon today to discuss further. Strong medical background here, pushed for full spine MRI to verify no cervical or even thoracic lesions. He suggested a second opinion with a well known OS that does many complex spinal surgeries. I actually had an appointment with that OS but had to cancel due to another issue that came up. NS states unsure if fusion is right for now- told me I will FOR SURE have permanent back pain if a fusion is done. This threw me as I have family that had multiple fusions many years ago and have no back pain. As stated, my MAIN issue is leg weakness, CP deficits. I can walk, but I do have to monitor every step. He fells the legs are not conditioned due to last years multiple knee surgeries and time in brace etc- once elite level powerlifter here, so I don't buy it. My legs have always been very strong, and they are getting weaker-
MRI of rest of the spine and a second opinion are the recommendations now...
I am not classic for MS, but it is always on the list. I feel like I need to get these spinal nerves decompressed sooner than later, and he is not so sure on that.....

My uncle had the same issue and progress over time, he got an MRI from head to chest and finally after so many exams the MRI found out he had ALS. Get a MRI from head to chest, just to be in the safe side

watch for sugar spikes.

I had this done in 2017 and had to have it done again in 2018.because the orthopedic Dr screwed it up so I went to a neurologist and he corrected my surgery. I've also had numerous spinal fusion from bottom to top the only vertebrae that isn't incase in hardware is C-1.