Considering L5-S1 fusion

Hello Slowgo,
It's been about a month since your last comment so I am wondering where you are at with considering a fusion? In all honesty, I hope you are WAITING!! You and I sound very similar. I too am basically a healthy, fit individual who taught aerobics for a number of years when I was younger. I had my first fusion at age 53 - one level L3-4 and I thought I had horrible pain before surgery, but I can tell you my pre-surgery pain was nothing compared to what I suffered after. Unfortunately, I had adjacent segment disease just as you described as one of your fears and I had slips above and below the fusion. I am now 66 years old and suffered greatly for 13 years and finally after seeing 4 NSs and 2 Othos decided to have the original fusion revised and fusions also done above and below (so I had 3 levels fused from L3-S1). The ONLY reason I decided I had to move forward was due to severe 10+ debilitating pain that occurred when I made the slightest wrong movement in a forward position. The pain was intense, would not subside & did not allow me to straighten. I would have to lie down until I could find the right position to release the pinched nerve. It was no way to live & as time went on it was becoming almost impossible to find that "magic" way to release the nerve. All of that being said, I am now 7 months out from my triple fusion surgery and am happy to say I no longer have the debilitating pain! YAY! However, I suspect you would ask me, "do you still have any pain?" And my reply is a resesounding, "YES!" Like I said, my reason for doing this huge surgery was the 10+ debilitating pain but the "regular" day-to-day (4-7 pain on the chart) with back pain, SI joint, hip, leg and foot pain is ALL still there. Yes, I can walk but is it pain-free...NO! The decision to have a fusion is a major one and you have my sincerest thoughts & prayers with you. My last piece of advice is to stay active (mentally, physically & spirtually) and know that "...after you have suffered a little while, HE will himself restore you and make you strong, firm and steadfast." 1 Peter 5:10 Thanks be to God.
Prayers are being said for all of my sisters & brothers in back pain.

I just went through L4-S1 fusion in April L5 was loose . My personal opinion I wouldn’t have done it if it wasn’t that I about fell each time I bent over. I just went to see a 3rd surgeon yesterday they all say the fusion healed but there is so much nerve pain. Anal, testicle(switches sides when my back flares but has nothing to do with my back they say) inner thighs, tailbone pain, now sciatic, bowel and bladder issues I never had before. I tried an Epidural, now they all say try a pain stimulator. They don’t want to do another surgery and open up another can of worms. I have noticed non have them have looked at my back after the surgery they only go by the leg tests and say everything’s good. 51 year old male using a cane and don’t dare go to a store unless there’s a scooter to ride on . Unfortunately I did have someone come up behind me while I was sitting 3 weeks after my surgery and start twisting my shoulders, NP said it might be a set back but should be ok and that at 4 weeks I could start twisting, bending, lifting up to 30lbs.

I had spinal fusion of S-1 - L-4 in May of 2023. Have sensory deficit of my right foot but sciatica was immediately relieved. They believe my sensory nerves will come back.

Back surgery, especially for DDD is not easy or necessarily predictable.

Hello Slowgo
I had an L4-S1 surgery in May of 2020 at Mayo Clinic in Rochester. I had both a neurosurgeon and orthopedic surgeon performing my surgery. When I finally had the surgery I was using a wheelchair to get around anywhere that much walking was required. I was 70 at the time and felt I was too young to be in a wheelchair. I had always been active skiing, swimming, biking, walking and hiking. Sitting the rest of my life just wasn't an option. I have had 3 back surgeries, my fusion being the last. I have a severely degenerative spine with spondylosis, spondylolisthesis, and of course sciatic pain. The major discussion I had with my surgeons was about the possibility of future back pain because of the fusion. They weren't able to say I would be pain free after the surgery. My surgery was a 2 level fusion of my lumber spine. Am I in pain daily - yes! Am I glad I had the surgery - again yes! The pain is not as debilitating as it had been and, it is not constant. I find if I sit for a couple of minutes when the pain begins, it goes away and I am able to move and work again for a while before the pain starts again. With the fusion I had I am still able to bend and I can lift 20 to 25 pounds. It was recommended that I use my knees to lift and I keep a grabber nearby for anything that needs to be picked up off the floor. If it's a heavy box, my husband moves it. I had to rearrange my cupboards so that I didn't have to bend to get things that I use regularly out of the base cabinets. In my upper cabinets, the things I use daily are also within reach. I keep a kitchen stool available and sit when doing a lot of my cooking. I wish I had more drawers in my cabinets as they are easier to use. I need to buy another living room chair that is more supportive for my back. I also keep an ottoman by my chair to rest my legs. It's almost 4 years now since I had the surgery and, as I expected, I am having more pain from the segments above the fusion. I am not in a hurry to have another surgery so I try to avoid doing things that could cause problems for me. That said, I don't know if I would wait so long if I really need another surgery. A fusion surgery takes longer to recover from. You will be under general anesthesia for several hours and will need at least a couple of months of physical therapy. I needed four. It will be around a year before you will feel you have recovered. The best advice I can give is to make sure you have the best doctors possible for your surgery and then follow all the guidance you are given for recovery.
The one activity I always recommend is swimming. I go 4 or 5 days a week to a local pool. I spend a half hour just walking in the water and there are also some water exercises I do for another half hour. I find my back and legs are much stronger now. The waves and buoyancy of the water support the weight of your body, reducing the impacts on joints and the intensity of pain you feel. The temperature and water pressure of warm water relax muscles, relieve stress, reduce muscle stiffness, and make movement easier. Look for a pool that keeps water temperature of 83 to 90 degrees. Warm water will make exercise much easier and more relaxing.