Doc recommends spinal fusion from T12 - S1.

Posted by sassytwo @sassytwo, Dec 2, 2023

66 year old female Considering spinal fusion from T12 - S1 for pain standing and walking. Has anyone had this full lumbar fusion? I am concerned for permanent restrictions or loss of mobility post surgery.

I am active and very social. Looking for what I can expect for future life mobility restrictions as I weigh whether to move forward with this surgery. I would like to hear about your post surgery experiences as I weigh my decision, understanding healing is a very individual experience.

I believe I am at the tipping point and am moving towards surgery, if I can live with the restrictions and if I will be able to acclimate to my body new abilities and be active WITHOUT pain.

Prior Micro discectomy L2 - L3 in 2015.

Pain again about 2018 and has progressed to not being able to stand more than 20-30 minutes nor walk more than a mile. Significant pain when I do either of these things....cooking....walking to an event....putting on make up.

Once I sit, fortunately the pain lessens and eventually goes away. I can sit hours mostly pain free and laying down and sleep without pain.

I had to use a wheel chair to tour a museum with friends and find I am not doing things I want to do to avoid hurting which indicated to me that I should stop kicking the can down the road and consider more surgery.

I was surprised with this full lumbar fusion recommendation and did not realize how restrictive my life will be permanently. I am confident in my surgeon and do not feel pressure to move forward with surgery.

I bicycle 60 miles a week pain free (sitting) and it is my go to escape and exercise. I will be most unhappy if I am not able to bike. Anyone a biker

I am a massage therapist and I have stepped away from work except one worksite client. I golf and exercise and am social. Travel and site seeing is painful, but I do it anyway.

Any new treatments on the horizon? Concerns if I wait to have surgery?

My MRI reports.
1. Progressive moderate levorotoscscoliosis centered at L2, which measures 30 degrees and previously 18 degrees in 2015.
2. Progressive degenerative disc disease in the right half of L2/L3 disc space.
3.At L2/L3, previously noted right parcentral/posterolateral disc herniation has been relaced with moderate-sized osteophytic bone ridge which narrows the right lateral recess and results in mild to moderate right foraminals stenosis.
4. At L4/L5 and L5-S1 mild to moderate broad-based left paracentral and Posterolateral disc bulge/herniation relusts in progressive moderate to advanced left foraminal stenosis.
5. L3-L4, mild multifactional central spinal canal stenosis due to posterior disc bulge/herniation, bilateral facet arthropathy, and ligamentum flavum thickening. Mild-to-moderate right foraminal stenosis. This has progressed.

Thanks in advance for any information you are able to share. Tamra

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@gliebisch01

@sassytwo @jenniferhunter
Earlier in this thread I discussed my similarity to the @sassytwo case. I have had a significant change in my condition, and have seen two surgeons since then. My spine surgeon who did my L5-S1 19 months ago, now recommends an L5-T11 decompression and fusion to replace the original surgery. I sought out a second opinion from a well known and respected spine surgeon in our area, whom I shared my MRI with. He said "you don't want that surgery." He himself is 50 yrs old and has already had two back surgeries. He suggested I get back to my prior exercise and stretching routine, and lose some weight (I am slightly overweight but by no means obese). How could two surgeons have completely opposite recommendations? Are there approaches to surgery in the spine medical community that are that divergent? I could have been left in a quandary with these opposite recommendations, EXCEPT that, at about the same time, my pain was receding, and within the span of about 48 hours was easily down to a pain level of zero to 1. This was after about 8 weeks of pain (levels up to about a 7), with relief only when sitting down. I came to the conclusion that I would be a fool to subject myself to surgery with all its risks and possible complications at this point. Of course I know it could return at any time, and there is no guarantee on how long my relief will last. Had I not gotten the unexpected relief, no doubt I'd be going for a THIRD opinion. For all I know, maybe there is regular debate in neurological medical circles on when to pull the trigger on surgery.

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Wow.... I meet with my 2nd opinion next week. As a few have pointed out, eventually, my scoliosis could affect heart, but I am not at the severe category, now. Keep us posted and I hope the pain continues to fade away! Any reprieve is welcomed!!

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Wow, tough decisions!! I'm 76 yo male and had L4/L5 fusion last year. Surgeon damaged my L5 nerve root with the L5 pedicle screw. Don't know if I'll ever be able to walk unassisted again. My only advice, plan for the worst, hope for the best..

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Again, that is a huge surgery with a long recovery. You know that from having a previous fusion of just one level. Try the suggestions of the second doctor and seek out a third opinion for your comfort level. Also perhaps go back to or try PT to strengthen core muscles. Surgery is always a last resort and a good neuro or Ortho spine surgeon won’t push that on you if not necessary. Having had just one fusion myself I cannot imagine having the whole lumbar column fused.

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This is the very problem with this area of medicine, there is often no universally accepted or agreed on treatment method, there is always debate over when to go for surgery and what the surgery should be. It is highly imprecise because it is an unsophisticated area of medicine, they have very little in the way of new procedures or minimally invasive ones that are proven and everybody has a different physical situation so there is little consistency in what works for one or the other. It seems like a crapshoot and so many just do the most conservative route for as long as possible (although that may not have been the best solution either since a situation may degenerate).

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@dennymt

Wow, tough decisions!! I'm 76 yo male and had L4/L5 fusion last year. Surgeon damaged my L5 nerve root with the L5 pedicle screw. Don't know if I'll ever be able to walk unassisted again. My only advice, plan for the worst, hope for the best..

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How did you find out the doctor damaged your L5 nerve root with the L5 pedicle screw. My husband had a back surgery that didn't go well he was still in severe pain. He had it reoperated by another doctor who fused more levels and now he cannot walk without the use of a crutch and not more than maybe 100-150 ft. The doctor that did the last surgery recommended he fuse the ENTIRE back which my husband won't do as he said each surgery left him worse than the last. I'm wondering if he could have something like you did with a screw that hit a nerve. How did you find out?

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@solom174

This is the very problem with this area of medicine, there is often no universally accepted or agreed on treatment method, there is always debate over when to go for surgery and what the surgery should be. It is highly imprecise because it is an unsophisticated area of medicine, they have very little in the way of new procedures or minimally invasive ones that are proven and everybody has a different physical situation so there is little consistency in what works for one or the other. It seems like a crapshoot and so many just do the most conservative route for as long as possible (although that may not have been the best solution either since a situation may degenerate).

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@solom174 Please understand that my response is general in nature meant for everyone who reads this thread. In the US, spine surgery devices must be approved for use in patients by the FDA and there are hundreds of studies listed at clinicaltrials.gov. Approval comes after a period of testing with clinical trials. There are many companies manufacturing various devices for spine and other surgeries and research going on all the time on how to improve outcomes and design new components. This gives surgeons many choices in what to use in their surgeries. Often there are different surgical procedures to solve a problem, and the surgeon decides what is best for that patient in their opinion. That answer often is different when you get several opinions from other surgeons. That may be a bit confusing for patients, and it is worth asking about what other choices would apply to their situation as well as the compromises or risks associated with them. All patients are different, and any other health conditions they have come into play in making a decision to go forward with spine surgery. The issues with the spine are complex and there is little capacity for the spinal cord or for spinal discs to heal once they are damaged. Surgery seeks to minimize further damage or functional loss and stabilize the remaining functional ability. Surgery is about choices and compromises. Sometimes these are hard choices. The best situation is not needing surgery. The second best is to balance the benefit of surgery against the consequences or possible negative outcomes of surgery and hopefully the benefit is greater than the outcome would be without surgery. All of that has statistics recorded in studies that surgeons consider when assessing the risk to a particular patient. Surgeons are not trained in every possible implant device that exists. Medicine is always evolving. There may be choices made by the medical center in what is offered as these devices are ordered in advance and held in inventory until needed for surgery and emergency surgery.

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@jenniferhunter

@solom174 Please understand that my response is general in nature meant for everyone who reads this thread. In the US, spine surgery devices must be approved for use in patients by the FDA and there are hundreds of studies listed at clinicaltrials.gov. Approval comes after a period of testing with clinical trials. There are many companies manufacturing various devices for spine and other surgeries and research going on all the time on how to improve outcomes and design new components. This gives surgeons many choices in what to use in their surgeries. Often there are different surgical procedures to solve a problem, and the surgeon decides what is best for that patient in their opinion. That answer often is different when you get several opinions from other surgeons. That may be a bit confusing for patients, and it is worth asking about what other choices would apply to their situation as well as the compromises or risks associated with them. All patients are different, and any other health conditions they have come into play in making a decision to go forward with spine surgery. The issues with the spine are complex and there is little capacity for the spinal cord or for spinal discs to heal once they are damaged. Surgery seeks to minimize further damage or functional loss and stabilize the remaining functional ability. Surgery is about choices and compromises. Sometimes these are hard choices. The best situation is not needing surgery. The second best is to balance the benefit of surgery against the consequences or possible negative outcomes of surgery and hopefully the benefit is greater than the outcome would be without surgery. All of that has statistics recorded in studies that surgeons consider when assessing the risk to a particular patient. Surgeons are not trained in every possible implant device that exists. Medicine is always evolving. There may be choices made by the medical center in what is offered as these devices are ordered in advance and held in inventory until needed for surgery and emergency surgery.

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I did not state there is no testing of devices for surgery so I do not see why you are stating the obvious. By the way it is not only in the US that such testing occurs it is in Canada too which has its own health agency independent of the FDA. Sometimes the FDA approves something that Health Canada does not. Regardless of this and everything else in the post, this response does not appreciate the point made of the challenge that this area of medicine poses for people who are trying to figure out what is going on for their own health - there is not clarity that is needed for patients and they are left struggling without accountability.

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I had some of my lumbar spine fused and decompressed in 2011.
I just had the rest of my lumbar spine decompressed where applicable and fused the remainder of it including S1. So my L spine is fused L1-S1. My neck is partially surgically fused (2011) and now imaging shows the rest has “autofused” itself! 😳 So my body beat the surgeon to it…
I have chronic neck pain. My back feels great. 🤞

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@westcom

Again, that is a huge surgery with a long recovery. You know that from having a previous fusion of just one level. Try the suggestions of the second doctor and seek out a third opinion for your comfort level. Also perhaps go back to or try PT to strengthen core muscles. Surgery is always a last resort and a good neuro or Ortho spine surgeon won’t push that on you if not necessary. Having had just one fusion myself I cannot imagine having the whole lumbar column fused.

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Yes, I am now realizing how this full lumbar fusion will restrict my life, with no guarantees of no pain but possibly different pain. I am in the waiting room of my 2nd surgeon and have a third scheduled for end of January. I have done a slew of tests and several rounds of PT over the past few years.

For me the question will be do I change my life to accommodate for pain while standing and walking. Simple daily activities are painful or do I adapt my life post surgery and hope to be pain free.

May I ask how does the fusion you have restrict your life. Do you still have pain? I understand the numbness may not leave.

Thanks
T

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Has anyone tried medical marijuana for pain? Massage or nerve flossing.

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