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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I'm scheduled for spinal fusion T2 - Sacrum, 73 yr old woman, and apprehensive, scared of complications of fracture, segment degeneration, complications requiring more operations. Medical insurance denied Forteo because I do not have osteoporosis, only osteopenia, so I have been taking Fosamax for the past 6 months. It's been denied again. My surgeon is disappointed that I could not get the Forteo, and stated that women my age who have been on Forteo have better outcomes. I live alone in a townhouse, will stay with my son in his 2nd floor apartment 4 weeks following surgery before going home. Has anyone else had experience with full spinal fusion like this, and if so, with what recovery and problems?

REPLY

Imagine having a rod attached to most of your thoracic spine i.e. 10 vertebra in your case. There goes your ability to bend. Fusion causes the adjacent discs to erode.
I just had five artifical discs implanted in my neck in Germany. This allows movement at each level and eliminates the degeneration above and below created by fusion.

I live in Canada and there isn't even a surgical option for me here....not that I wanted fusion for five discs even if it were offered. Unfortunately this was a cost I had to pay myself and it wasn't easy as I am not wealthy.
I also have severe osteoporosis and have been on everything there is including Fosamax. There is no mirace cure that is going to turn the tide. If you chose you could request a free consult from Germany. They are the leaders in artifical discs and have been doing it since the late 80's. They are also the only country that does more than two levels. I am also a massage therapist and I can't imagine having that many discs fused. Let me know if you'd like mre info. I spent many hours searching researching all this.

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@barrquinn

I don't know about that. Alot of research stated closer to 90 days of physical therapy strengthening. I was walking everyday, an in my case I got electric shock and ruined my nerves, n muscle tissue further. But thanks for your reply.

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I was told to walk every day after my fusion of l4-5. PT started after 90 days. As I had osteopenia them and osteoporosis now, I also was told to wear my brace for 90 days. This was in January 2021. I am now deciding if I want to fuse L5-S1, which I think was needed at the time. Be careful not to do damage to yourself by overdoing it too quickly.

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@sandpiper49

Imagine having a rod attached to most of your thoracic spine i.e. 10 vertebra in your case. There goes your ability to bend. Fusion causes the adjacent discs to erode.
I just had five artifical discs implanted in my neck in Germany. This allows movement at each level and eliminates the degeneration above and below created by fusion.

I live in Canada and there isn't even a surgical option for me here....not that I wanted fusion for five discs even if it were offered. Unfortunately this was a cost I had to pay myself and it wasn't easy as I am not wealthy.
I also have severe osteoporosis and have been on everything there is including Fosamax. There is no mirace cure that is going to turn the tide. If you chose you could request a free consult from Germany. They are the leaders in artifical discs and have been doing it since the late 80's. They are also the only country that does more than two levels. I am also a massage therapist and I can't imagine having that many discs fused. Let me know if you'd like mre info. I spent many hours searching researching all this.

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@sandpiper49 Perhaps this needs some clarification.

According to several studies that I have found, artificial discs may reduce the risk of adjacent segment disease over spine fusions, but adjacent segment disease also does occur in patients with artificial discs, and it also occurs in patients who have had no spine surgery with multiple levels of pre-existing adjacent discs affected. According to the studies, there are a lot of additional factors that increase the risk of adjacent segment disease, such as spinal misalignment, body mass, cervical hardware plate near a disc than can rub against it, osteoporosis, length of fused levels, instrumented fusions, age, genetic factors, kyphosis, and poor correction of sagital alignment. I would think that habits like posture and activity of the patient can play a role because poor posture will stress discs more than a properly aligned spine with good core strength.

Consider this.
"2019 Position Statement from the International Society for the Advancement of Spine Surgery on Cervical and Lumbar Disc Replacements"
https://isass.org/2019-position-statement-from-the-international-society-for-the-advancement-of-spine-surgery-on-cervical-and-lumbar-disc-replacements/
The literature from the International Spine Society reads:
"Possible complications with cervical disc arthroplasty include heterotopic ossification, subsidence/migration, device wear and tear, and adjacent segment disease."

"Currently, there is compelling level I and II evidence with long-term follow-up which supports the use of TDR as a viable alternative to fusion procedures for appropriately selected patients. Those with exclusions per FDA labelling (e.g. > Grade I spondylolisthesis, instability, osteoporosis, etc) should not be considered for arthroplasty."

You also mentioned severe osteoporosis which brings a question to my mind because bone quality is very important when hardware is secured and held by screws, and failure can happen causing migration of a device. My elderly mom who has severe osteoporosis has had a spontaneous spinal compression fracture that added an abnormal curve to her spine when it healed.

Here are a couple other links to literature that may be of interest.

"Long-Term Residual-Mobility and Adjacent Segment Disease After Total Lumbar Disc Replacement"
https://journals.sagepub.com/doi/10.1177/2192568220935813
"Adjacent Segment Disease Perspective and Review of the Literature"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963057/
"Adjacent Segment Disease
Current Evidence and the Role of Motion Preservation Technologies"
https://journals.lww.com/isoj/Fulltext/2023/06010/Adjacent_Segment_Disease__Current_Evidence_and_the.2.aspx
Of course every patient is different with different health considerations and risks, so the choice of what spine surgery is best for a patient has to be carefully considered by the surgeon. There isn't a one solution that fits every patient. I am a cervical one level fusion patient. I have no hardware, only a bone graft. Not having hardware allows my bones to retain their natural flexing ability that would have been lost if rigid metal had been attached. I also get to avoid any possible immune responses to foreign materials in my body. I am at the 7 year post operative mark with no further complications at this time, and according to one the studies I cited, 7 years is when aging should start affecting the spine after a fusion.

I can say that I maintain core strength, and spinal alignment, and having worked extensively with a physical therapist, I can address any muscle spams that can change spine alignment right away. I learned a lot of this from my PT, and the success of my spine surgery can also be attributed to myofascial release therapy that was done during several years before my spine surgery, and after it to maintain the suppleness of muscle and connective tissue. Tightness, and scar tissue tightness from surgery does play a big role in restricting movement and adding pressure to the body. If you keep that in check, you can move better and function better, and keep these extra forces from affecting the spine. I believe that this reduce my risks of further spine degeneration due to pressure on discs. My fused level is C5/C6 which doesn't do much at all in my ability to turn my head. I just lost a little bit of being able to bend forward to touch my chin to my chest. It is very close. My head turning range is the same as before surgery. C1 through C4 do more of the turning neck movements with C1 and C2 doing most of head turning because they are constructed specifically for that purpose.

REPLY
@jenniferhunter

@sandpiper49 Perhaps this needs some clarification.

According to several studies that I have found, artificial discs may reduce the risk of adjacent segment disease over spine fusions, but adjacent segment disease also does occur in patients with artificial discs, and it also occurs in patients who have had no spine surgery with multiple levels of pre-existing adjacent discs affected. According to the studies, there are a lot of additional factors that increase the risk of adjacent segment disease, such as spinal misalignment, body mass, cervical hardware plate near a disc than can rub against it, osteoporosis, length of fused levels, instrumented fusions, age, genetic factors, kyphosis, and poor correction of sagital alignment. I would think that habits like posture and activity of the patient can play a role because poor posture will stress discs more than a properly aligned spine with good core strength.

Consider this.
"2019 Position Statement from the International Society for the Advancement of Spine Surgery on Cervical and Lumbar Disc Replacements"
https://isass.org/2019-position-statement-from-the-international-society-for-the-advancement-of-spine-surgery-on-cervical-and-lumbar-disc-replacements/
The literature from the International Spine Society reads:
"Possible complications with cervical disc arthroplasty include heterotopic ossification, subsidence/migration, device wear and tear, and adjacent segment disease."

"Currently, there is compelling level I and II evidence with long-term follow-up which supports the use of TDR as a viable alternative to fusion procedures for appropriately selected patients. Those with exclusions per FDA labelling (e.g. > Grade I spondylolisthesis, instability, osteoporosis, etc) should not be considered for arthroplasty."

You also mentioned severe osteoporosis which brings a question to my mind because bone quality is very important when hardware is secured and held by screws, and failure can happen causing migration of a device. My elderly mom who has severe osteoporosis has had a spontaneous spinal compression fracture that added an abnormal curve to her spine when it healed.

Here are a couple other links to literature that may be of interest.

"Long-Term Residual-Mobility and Adjacent Segment Disease After Total Lumbar Disc Replacement"
https://journals.sagepub.com/doi/10.1177/2192568220935813
"Adjacent Segment Disease Perspective and Review of the Literature"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963057/
"Adjacent Segment Disease
Current Evidence and the Role of Motion Preservation Technologies"
https://journals.lww.com/isoj/Fulltext/2023/06010/Adjacent_Segment_Disease__Current_Evidence_and_the.2.aspx
Of course every patient is different with different health considerations and risks, so the choice of what spine surgery is best for a patient has to be carefully considered by the surgeon. There isn't a one solution that fits every patient. I am a cervical one level fusion patient. I have no hardware, only a bone graft. Not having hardware allows my bones to retain their natural flexing ability that would have been lost if rigid metal had been attached. I also get to avoid any possible immune responses to foreign materials in my body. I am at the 7 year post operative mark with no further complications at this time, and according to one the studies I cited, 7 years is when aging should start affecting the spine after a fusion.

I can say that I maintain core strength, and spinal alignment, and having worked extensively with a physical therapist, I can address any muscle spams that can change spine alignment right away. I learned a lot of this from my PT, and the success of my spine surgery can also be attributed to myofascial release therapy that was done during several years before my spine surgery, and after it to maintain the suppleness of muscle and connective tissue. Tightness, and scar tissue tightness from surgery does play a big role in restricting movement and adding pressure to the body. If you keep that in check, you can move better and function better, and keep these extra forces from affecting the spine. I believe that this reduce my risks of further spine degeneration due to pressure on discs. My fused level is C5/C6 which doesn't do much at all in my ability to turn my head. I just lost a little bit of being able to bend forward to touch my chin to my chest. It is very close. My head turning range is the same as before surgery. C1 through C4 do more of the turning neck movements with C1 and C2 doing most of head turning because they are constructed specifically for that purpose.

Jump to this post

There is a vast difference between one or two fusions than 10. Re: osteoporosis. There aren't any screws in the disc I was given which was one of my concerns.
I agree that post ADR surgery is not risk free but in the end it's a matter of selecting the best option given each individual's circumstances.

REPLY

Sadly I don't think you'll learn much by reading peoples' experiences. People are medically different, surgeons are of differing skill levels, and Person A's experiences might not be applicable to you. Said another way - probability stats for spine surgeries are, at best, gross indicators and may NOT be indicative of what you may experience...

I just have completed three planned surgeries in C and L and my strategy was this: (1) Select the best facility possible for the surgery. (2) Have all radiological work (and there's lots of that) done on the very best equipment there is. (3) Connect with a top-notch surgeon (I was adamant it had to be neuro rather than ortho). (4) Mutually develop a surgical plan/strategy. Then - just execute the plan and trust the process. Good luck!!!

REPLY

I'm 73 yr female, scheduled for spinal fusion T2-sacrum Aug 31 and am scared to death. I live alone, and have a son who lives about 15min away. I am afraid of needing more surgeries and the doc told me that his patients who have taken Forteo over Fosamax have had better outcomes. I've been denied twice for Forteo due to no diagnosis of osteoporosis, only osteopenia. Does anyone have experience with extensive spinal fusion like mine? w/Forteo or Fosamax? Live alone or w/supports? Help please!

REPLY
@shirleyd

I'm 73 yr female, scheduled for spinal fusion T2-sacrum Aug 31 and am scared to death. I live alone, and have a son who lives about 15min away. I am afraid of needing more surgeries and the doc told me that his patients who have taken Forteo over Fosamax have had better outcomes. I've been denied twice for Forteo due to no diagnosis of osteoporosis, only osteopenia. Does anyone have experience with extensive spinal fusion like mine? w/Forteo or Fosamax? Live alone or w/supports? Help please!

Jump to this post

@shirleyd Hi Shirley, is this your first spine surgery? This will change everything about how you can move. Did your surgeon explain how your ability to move will change after surgery? Did your surgeon explain why they need to fuse so many levels? Are they correcting a spinal deformity?

I was looking for some other discussions that may have active members who had also gone through an extensive lumbar surgery and I found these:

Spine Health- "Severe Stenosis - Doc Advises Surgery"
https://connect.mayoclinic.org/discussion/severe-stenosis-doc-advises-surgery/
Spine Health - Two Stage Fusion Laminectomy- Anyone Have Perspective?"
https://connect.mayoclinic.org/discussion/two-stage-fusionlaminectomy-anyone-have-perspective/
I am a cervical spine surgery patient, and I can tell you, I was scared too. I did come up with a plan on how to deal with my fear using a bit of creativity. The first thing was to start listening to relaxing music that I loved and do deep breathing in time to the music. I was learning to lower my blood pressure and I could drop it by 15 points because I measured it before and after. Then, I wanted to find a way that I could be comfortable with my surgeon, so I added in looking at anything with a picture of him, either a photo from the facility's website or a video of him speaking, except I didn't listen to his words, I had the music instead. By doing all of this, I had my own tool that I could use to combat my fear whenever I needed it.

There was a day I had to use my plan when I had an spine injection that caused me horrible pain immediately and I was going to pass out, but I did my breathing and I played the music in my head, and that time, I imagined I was an eagle flying high above everything and free and I held that picture in my head. So I learned that I had the ability to cope with pain, and didn't need to fear the pain. Instead I could start looking for the reasons that my fear of pain held such a grip on me. I worked through it, and when I got nervous, I drew pictures of my surgeon. I am an artist and I was loosing my ability to control my arms, so that meant a lot to me, and I had to face this fear to get my ability back by having life changing surgery.

You have to consider where you are now and how that can change for you after surgery. All surgery is a compromise, and a choice to be made. If the outcome would give you a better quality of life than you have right now, it is worth considering. Fear can hold people back, and I have heard of patients who become paralyzed and very disabled who could have been helped if they had spine surgery.

Facing my fear was such a turning point in my life, and I defeated my fear which is something I never expected I would be able to do. I made a plan and decided I could get myself through this and I did.

Here is another discussion I would like to share with you, and there is a video in it about facing fear.

Just Want to Talk - "How can I defeat my anxiety about medical tests and surgery?"
https://connect.mayoclinic.org/discussion/how-can-i-defeat-my-anxiety-about-medical-tests-and-surgery/
Have you tried any music therapy before like I described? Do you have some images that help you feel happy and safe that you can focus on during your deep breathing with the music?

REPLY
@jenniferhunter

@shirleyd Hi Shirley, is this your first spine surgery? This will change everything about how you can move. Did your surgeon explain how your ability to move will change after surgery? Did your surgeon explain why they need to fuse so many levels? Are they correcting a spinal deformity?

I was looking for some other discussions that may have active members who had also gone through an extensive lumbar surgery and I found these:

Spine Health- "Severe Stenosis - Doc Advises Surgery"
https://connect.mayoclinic.org/discussion/severe-stenosis-doc-advises-surgery/
Spine Health - Two Stage Fusion Laminectomy- Anyone Have Perspective?"
https://connect.mayoclinic.org/discussion/two-stage-fusionlaminectomy-anyone-have-perspective/
I am a cervical spine surgery patient, and I can tell you, I was scared too. I did come up with a plan on how to deal with my fear using a bit of creativity. The first thing was to start listening to relaxing music that I loved and do deep breathing in time to the music. I was learning to lower my blood pressure and I could drop it by 15 points because I measured it before and after. Then, I wanted to find a way that I could be comfortable with my surgeon, so I added in looking at anything with a picture of him, either a photo from the facility's website or a video of him speaking, except I didn't listen to his words, I had the music instead. By doing all of this, I had my own tool that I could use to combat my fear whenever I needed it.

There was a day I had to use my plan when I had an spine injection that caused me horrible pain immediately and I was going to pass out, but I did my breathing and I played the music in my head, and that time, I imagined I was an eagle flying high above everything and free and I held that picture in my head. So I learned that I had the ability to cope with pain, and didn't need to fear the pain. Instead I could start looking for the reasons that my fear of pain held such a grip on me. I worked through it, and when I got nervous, I drew pictures of my surgeon. I am an artist and I was loosing my ability to control my arms, so that meant a lot to me, and I had to face this fear to get my ability back by having life changing surgery.

You have to consider where you are now and how that can change for you after surgery. All surgery is a compromise, and a choice to be made. If the outcome would give you a better quality of life than you have right now, it is worth considering. Fear can hold people back, and I have heard of patients who become paralyzed and very disabled who could have been helped if they had spine surgery.

Facing my fear was such a turning point in my life, and I defeated my fear which is something I never expected I would be able to do. I made a plan and decided I could get myself through this and I did.

Here is another discussion I would like to share with you, and there is a video in it about facing fear.

Just Want to Talk - "How can I defeat my anxiety about medical tests and surgery?"
https://connect.mayoclinic.org/discussion/how-can-i-defeat-my-anxiety-about-medical-tests-and-surgery/
Have you tried any music therapy before like I described? Do you have some images that help you feel happy and safe that you can focus on during your deep breathing with the music?

Jump to this post

Hello Jennifer, yes, first spinal surgery. I've an 80% deviation, levoscoliosis. I am aware that I will not be able to bend for the first 4-6 months. Thereafter, if all well, I will be able to bend no more than 90 degrees from the waist. Will have to bend at the knees, with straight back.
Following surgery I have planned to stay at my sons apartment, 4 weeks. He has not yet had approval of 4 weeks FMLA from his employer, only 2 weeks so far. Then after 4 weeks I go to my home and a friend will stay with me for one week. I dont have anyone lined up for week 6 but will explore home care agencies, so long as I have a script from doctor to cover insurance.

I am aware there are risks, 2 pages of them. Worst are fracture, misalignment of the spine at the junction, adjacent segment degeneration, need for another operation.
I live in a townhouse, 2 hours + away from my surgeon in NYC. I have friends that live 20-30 min away.

I am afraid of going through additional surgeries. I am afraid of myself causing damage by overextending myself. I believe in covering all bases. I thought I was doing good by being on Fosamax but my surgeon prefers Forteo to build the bones. However I'm refused by insurance for Forteo. So I'm facing going ahead not prepared. That is not acceptable to me.

REPLY
@wheelerma

I am anxious to hear opinions on this. I was told mine involve 10. I am 71 and have read that the results aren't good for my age group and seriousness of the surgery.

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I'm 73 and in 2021 completed my 9th spinal fusion. I have 3 levels fused in my neck; 8 levels of my thoracic spine and 5 levels of my lumbar spine. This has all happened over a 34 year period.

This all started in 1989 and still a part of my life. I would never have had such an active life without having these fusions. I know that one fusion usually leads to further fusions.......but one must consider what type of life they want to live. I had no plans on living in my recliner. I did give up tennis, but then played golf for 22 years. Have given that up and now play pickleball. I have more work to do and expect to figure out how to return to the pool as I am a big swimmer. Due to my 2021 8 level thoracic fusion surgery I have been unable to swim the freestyle and breast stroke as unable to life my head out of the water. I will not give up and work out in the gym regularily.........keep moving is my strategy and works for me.

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