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Spondylolisthesis and pars defect: Considering L5-S1 fusion
I am 46 year old - athletic and active. Was diagnosed with Spondylolisthesis and pars defect 2 years ago after sudden onset back pain. I have seen 3 spine surgeons and tried physical therapy, steroid injections, nerve blocks, therapeutic massage, fascia massage, and most recently stem cell/PRP injections. Nothing has relieved the pain and unfortunately surgical fusion of L5-S1 is the only option left that I haven't tried. I have heard differing things from each surgeon. From get the surgery now and enjoy the rest of your life pain free - to put off the surgery until the pain is completely unbearable and incapacitating. I also heard differing opinions on what a fusion will mean as far as increasing my chances for needing additional fusions in the future b/c of the stress fusions put on the vertebrae above. It is very difficult to make decisions when I don't feel like there is a consensus with the information. My biggest fear is regret. Either regret that I do the surgery and open up pandora's box that I will suffer from for the rest of my life OR regret that I don't do the surgery and unnecessarily live additional years in pain.
Has anyone had L5-S1 fusion? If so, are you glad you did? Were you able to participate in the activities you previously enjoyed afterwards? Did you have to have future back surgeries as a result?
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@dallison1961
I’m sorry to hear of your accident and need for surgeries. I have had cervical (c5-c6) and lumbar (l3-l5) decompression/fusion surgeries. I need to have c6-c7 done next.
Did you have an EMG/nerve conduction study by a neurologist before surgeries? If not, definitely get them now. You may also want to get a neuropathy bloodwork panel and small fiber neuropathy skin punch biopsy.
Did you get pre- and post-surgery MRIs of your cervical and lumbar spine? Did you review the reports and impressions made by the radiologist in detail? Cervical spine injuries can cause issues below the level, including bladder/bowel/legs/feet.
You may want a vascular/vein specialist to ensure your blood flow is good and get an ankle brachial index test.
@dallison1961
Lumbar spine fusion can take a long time to heal. I had mine in August 2024 and it took 6 months to start feeling better and have less nerve pain. Nerve injuries take a long time to heal if it is possible.
Do you know if your spinal cord was compressed/injured or just your nerve roots/nerves injured? Did you have any broken vertebrae/bones or just soft tissue injuries?
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1 ReactionWas your spinal problem due to the accident? Was your BP elevated prior to the accident or surgery? Do you have a family history of elevated BP? Are you using a home blood pressure machine to track your BP and has it been calibrated with your doctors office to ensure accuracy?
Hi
Does anyone know good neurosurgeon in NV, CA or AZ who can take out hardware after unsuccessful back surgery L1-S5 plus laminectomy. My girlfriend is in horrible pain non- stop after back surgery performed in 2021.
Thank you
Hi jana 133, Dr Pawl Jankowski is an excellent neurosurgeon In Irvine, California. My brother had a complex cervical spine surgery 1 year ago and we are very happy with the results. Please read his Google reviews and Yelp reviews. He is specialized in scoliosis surgeries. There is a 6 weeks wait time for the appointment and 8 weeks wait time for surgery.
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1 Reaction@jana133 Hi, Dr McClendon at the Phoenix Mayo Clinic is absolutely amazing. If you google him, there are several youtube videos of him talking about spine issues and surgery, etc.
He performed a T11 to L4 fusion on my back last December and my pre-surgery pain is completely gone.
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4 ReactionsDid he take out the hardware ? I have been told that I need fusion, but on the other hand I was cautioned that it might be a very bad thing for me with osteoporosis. I'm going to look him up and see if I can get an appointment to see what he thinks.
Thank you very much
Thank you much
@annie1 no he did not remove any hardware, this was my first surgery.
I called his office and sent him my x-ray, MRI, and CAT scan. I can tell you that it will get you a long ways if you are proactive and give them everything they need. It was a little bit of work for me getting everything from my doctor’s office, but the people at the Mayo Clinic are very helpful and will give you the right mailing address to send your imaging disks to. They also have a program called Power Share where some hospitals/doctor offices can electronically push the images and medical reports to the Mayo Clinic.
I was just persistent in my communication with the Mayo Clinic and it was a great experience. Dr. McClendon accepted my case and then I met with him for an evaluation. That would be a good time to talk to him about your osteoporosis and his thoughts on future surgery.
Wishing you the best! 😊🙏
Sherry