What are people's experiences with spinal fusion surgery?

Posted by heatherm @heatherm, Oct 27, 2020

After trying pretty much everything, with little pain relief, my surgeon has put me on his priorty elective list for fusion of my L3/4/5, and maybe S1. I've heard both positive and negative experiences with this surgery. What are people's experiences, with this? ,

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@rwdixon4

I had fusion of my L3/4 & L4/5, with Dr Phillip J Orisek in Sacramento. He does a LLIF it is a
minimally invasive procedure Lateral Lumbar Interbody Fusion is a method of spine surgery in which the lumbar spine is approached through the patient's side. With the use of x-ray imaging, this procedure allows for dilation through the psoas muscle in a muscle splitting approach rather than approaching the spine anteriorly (through the abdomen) or posteriorly (through the back). Anterior (ALIF) and Posterior (PLIF/TLIF) approaches would require a larger incision with more muscle, bone and ligament disruption.
You are not alone in your pain and this should save you from some of it !
SURGICAL PROCEDURES

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I am adding to my previous two postings.
My first fusion [L5 - L4] was the traditional posterior approach.
Result: 4 pedical screws / two rods / bone graft from my hip.
Greater recovery time / much more pain / but very successful.
My recent Fusion [L4 - L3] was LLIF - side at waist.
Cage with bone graft and side plate / two screws.
Much less invasive - less pain and I am 5 weeks in recovery and
actually feel quite well - no more "opioids" - only Lyrica for nerve pain.
Thank you - I hope this helps. @peterpaul

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@jenniferhunter

@heatherm My direct experience with spinal fusion surgery is for a fusion at C5/C6. That is an easier recovery than lumbar spine surgery because the lower end of the spine is bearing most of your body weight. It took 3 months for my bone graft to begin fusing and during that time I wore a neck brace all the time. After that, I weaned out of the brace and began physical therapy rehab. After 3 months of non use, muscles get very weak. You do need an expert surgeon with a lot of experience with the type of surgery that you need. After spine surgery, patients need to avoid twisting and bending. This is critical for lumbar surgery. If you have rods and screws placed on the spine, the angle and placement of the screws is critical to the success or failure of the hardware. The screws can pull out if placed at the wrong angles. I don't say that to worry you, but these are questions to ask your surgeon to see if you get a confident informed answer. It is best to get several opinions before you decide on surgery because it is a big decision. Learn everything you can about the procedure. Most surgeons do not promise that spine surgery will relieve pain. My surgeon didn't promise me that, and I don't think they can give you a guarantee. That is why you should get multiple opinions. Successful surgery can leave lasting pain. Physical therapy with myofascial release work to release the surgical scar tissue can help relieve some pain. I did have a lot of pain from spinal cord compression that was all over my body, and my spine surgery relieved all that pain. After surgery, you are left with the pain of the trauma from the surgical path and the healing required.

What surgery does is decompress something. For example if a disc collapses, the vertebrae get closer together and the space between them where the nerve roots exit (foramen) may get compressed if there is already arthritis there. If there is instability, vertebrae can also shift forward of back and increase pressure on the nerve roots or spinal cord. The body tries to stabilize the spine by remodeling the bone and growing bone spurs which causes a lot of nerve or spinal cord compression. I do know a patient who had lumbar spine surgery who has a lot of pain that she lives with. Find the best surgeon that you can. I tried to have my surgery locally, and came to Mayo after 5 surgeons turned me down because my case was unusual. I was very impressed with my care at Mayo and I had a great recovery. It will be a long recovery after a big spine surgery, and you will need a family member as a caregiver and to help with meals and chores. You can also find a good physical therapist who rehabs spine surgery patients and ask what the recovery is like and what kinds of difficulties arise. Make the decision in terms of regaining function or preventing further degeneration. Fusing the lumbar spine will change the body permanently and you will be stiff and move differently. Surgeons really can't guarantee to take away pain, and if they are saying that to you, please get several more opinions. The surgery can improve pain by correcting the source of it, but it is easy to mistake where the pain is coming from because there can be overlapping symptoms for different problems that cause the same pains. Sciatic pain can be caused by a pelvis out of alignment or overly tight hip flexors muscles that pull on the lumbar spine which are not spine problems, but mimic the symptoms of spine nerve root compression. A patient can have these and also a spine problem at the same time, and they all contribute something to the overall pain. These are things that a neurologist tries to separate, and this should be figured out and understood before going through spine surgery to avoid guessing about the outcome. The MRI imaging should be able to be connected to the source of the pain if it is a structural problem in the spine, and the surgeon needs to be able to explain why it causes pain in your specific case, and how their surgery can address it. Myofascial release therapy helped me have an easier surgery because my tissues were easier to move during surgery, and it helped take away pain after I was recovered enough to start PT.

Here are some links that may be of interest.
https://mskneurology.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

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I wish I had read this before I had surgery I went to Nashville didn't ask any questions and now I have a neck that doesn't bend a back and shoulder area that stays swollen and tight and the surgeon just makes excuses. I stay so depressed because he ruined my body because I didn't ask questions and get second opinions. You are very wise keep passing on your insight.

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@anitacoffman

I wish I had read this before I had surgery I went to Nashville didn't ask any questions and now I have a neck that doesn't bend a back and shoulder area that stays swollen and tight and the surgeon just makes excuses. I stay so depressed because he ruined my body because I didn't ask questions and get second opinions. You are very wise keep passing on your insight.

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@anitacoffman I wanted to welcome you to Connect. I'm glad that you are recommending patients always ask questions before going through surgery, and I feel for you since you didn't have a great recovery. Are you early in your recovery? Have they offered to send you to physical therapy? I know that sometimes, early in recovery after spine surgery, it seems like it will always hurt or stay swollen. I remember being in pain for a good 6 weeks, and then fairly suddenly within a few days of that, it started improving rapidly. It does take that long for an incision to heal, and longer for bone to fuse.

Decisions about spine surgery often involve loss of movement and are a compromise in order to lessen deterioration of functions and nerves. Sometimes there are no easy answers.

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