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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@sassytwo

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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I will send you a private message reply.

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@westcom

I will send you a private message reply.

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Thanks .. do you need info from me?

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I really feel for you. Back surgery is a major surgery and so painful I know that for me, I had significant stenosis with the cord itself becoming depressed. In terms of the cord you have something called a dura sac and the spinal nerves float in there I believe my cord was reduced to 7. So you can have severe stenosis with the dura sac being so compressed that it affects the cord itself. Without surgery you’re bound for potential paralysis. From your MRI it appears you actually only have one area where you have moderate to severe stenosis. In your shoes I would look at only doing that level. I’ll also say that my surgeon requires both mri and CT. Interestedly they didn’t always match. If you haven’t considered a second opinion I encourage you to be open minded about getting one. You also could try doing a steroid epidural in that area and assess your pain from there. I’m sorry these decisions end up complicated. I was on a FB group for anterior neck surgery and was shocked by the number of people getting significant multiple level surgery. The more levels done the higher the complications. It also seriously extends the surgery time and I know factually the longer the surgery the higher odds are for problems Whatever you decide, I wish you great success and for your ability to stay as active as you want

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@sb4ca

I really feel for you. Back surgery is a major surgery and so painful I know that for me, I had significant stenosis with the cord itself becoming depressed. In terms of the cord you have something called a dura sac and the spinal nerves float in there I believe my cord was reduced to 7. So you can have severe stenosis with the dura sac being so compressed that it affects the cord itself. Without surgery you’re bound for potential paralysis. From your MRI it appears you actually only have one area where you have moderate to severe stenosis. In your shoes I would look at only doing that level. I’ll also say that my surgeon requires both mri and CT. Interestedly they didn’t always match. If you haven’t considered a second opinion I encourage you to be open minded about getting one. You also could try doing a steroid epidural in that area and assess your pain from there. I’m sorry these decisions end up complicated. I was on a FB group for anterior neck surgery and was shocked by the number of people getting significant multiple level surgery. The more levels done the higher the complications. It also seriously extends the surgery time and I know factually the longer the surgery the higher odds are for problems Whatever you decide, I wish you great success and for your ability to stay as active as you want

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Thank you. Thank you for you input. It is very enlightening to communicate with people who have experienced spine problems. My 2nd opinion doc today just referred me to pain doc .. who I see tomorrow. I have already tried epidural with little relief and am not handle gababentan that works for some.

However this doc says I have confusing symptoms that do not aline but there is an injection other than steroids that may buy me some relief or at least tell me if my pain is from L4L5 and delay a full fusion. Fingers crossed.

I have a 3rd opinion doctor next month. I was told he is the doctor that the doctors search out when they have problems.

I appreciate you taking the time to respond. Thank you
Tam

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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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I don't totally agree with that. I think what you're really seeing is that medicine is an art, not a strict science. That doesn't just apply to Orthos's, it's true in all medicine. Every individual doctor will approach cases by their own instincts, intuition, knowledge, experience and diagnostic capabilities. In this case, the ocean between each doctor's recommendation really mandates a third opinion. Maybe switching to a neurosurgeon instead of an ortho.

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@sb4ca

I don't totally agree with that. I think what you're really seeing is that medicine is an art, not a strict science. That doesn't just apply to Orthos's, it's true in all medicine. Every individual doctor will approach cases by their own instincts, intuition, knowledge, experience and diagnostic capabilities. In this case, the ocean between each doctor's recommendation really mandates a third opinion. Maybe switching to a neurosurgeon instead of an ortho.

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Yes, I think you are correct and they all seem to want to run their own tests. Definitely going to take my time with this decision.. appreciate your kind reply.

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I'm a 59 year old woman with scoliosis. I had my back fused from T4 to S1. My surgery was done over three days, an 8 hour surgery through the abdomen, a rest day, and a 10 hour surgery through the back. My surgery was May of 2022. I was also scared of not being able to be active again and it was hard to find anyone that had a long fusion to give me perspective.

My restrictions of no bending, lifting, or twisting were in place for one year. All I was allowed to do was walk. Within 2 months I was able to walk over 3 miles and after 5 months I was able to walk 6 miles, pain free. Prior to the surgery, my back would have started to hurt after about 2 miles. The only thing now that prevents me from long distance walks is time. I also went snowshoeing. That's walking, right?

After one year my restrictions were lifted. I'm now in the rehabilitation stage. This past summer, I was able to ride my bike again. The longest ride was 20 miles. Not as far as before, but it is improving. I didn't have back pain, but I was struggling a bit with shoulders aching and my seat not hitting me correctly. I'll be riding more next summer after I have some adjustments made to my bike. I'm not yet willing to get an e-bike.

I was also able to hike in the mountains (I use hiking poles to help with stability), I'm starting to jog (slowly for short distances), and I'm back at the gym. I also played a few rounds of golf this summer. I can't hit far because I can't twist, but I hit straighter. I've purchased a season pass for downhill skiing, but haven't tried yet...waiting for snow! I'm confident I'll be able to ski, but I know I'll need help getting my boots on and getting up if I fall....don't fall, right?!?

This is a long way of saying, anything is possible. I'm determined to do everything I did before, but it may look a little different. This has been the most difficult and frustrating thing I've ever experienced. Those around me keep telling me I'm doing great. Personally, I'm disappointed that I let the frustration take over at times and I didn't progress as fast as I thought I should.

I have no back pain. I have some discomfort and still feel a little like a spine patient and my shoulders get a little achy and tired.

If you move forward with the surgery, set realistic goals....walk a little more than the day before. I set a goal of walking a 5K under an hour at three months, riding my bike for at least a 20 mile ride, and hiking. I did it!

My goals for the next 5 months are downhill skiing, cross country skiing, jog a 5K, and do 50 pushups the day of my 2 year anniversary.

I wish you luck and encourage patience...something I lack.

Kelly

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@klsteffes

I'm a 59 year old woman with scoliosis. I had my back fused from T4 to S1. My surgery was done over three days, an 8 hour surgery through the abdomen, a rest day, and a 10 hour surgery through the back. My surgery was May of 2022. I was also scared of not being able to be active again and it was hard to find anyone that had a long fusion to give me perspective.

My restrictions of no bending, lifting, or twisting were in place for one year. All I was allowed to do was walk. Within 2 months I was able to walk over 3 miles and after 5 months I was able to walk 6 miles, pain free. Prior to the surgery, my back would have started to hurt after about 2 miles. The only thing now that prevents me from long distance walks is time. I also went snowshoeing. That's walking, right?

After one year my restrictions were lifted. I'm now in the rehabilitation stage. This past summer, I was able to ride my bike again. The longest ride was 20 miles. Not as far as before, but it is improving. I didn't have back pain, but I was struggling a bit with shoulders aching and my seat not hitting me correctly. I'll be riding more next summer after I have some adjustments made to my bike. I'm not yet willing to get an e-bike.

I was also able to hike in the mountains (I use hiking poles to help with stability), I'm starting to jog (slowly for short distances), and I'm back at the gym. I also played a few rounds of golf this summer. I can't hit far because I can't twist, but I hit straighter. I've purchased a season pass for downhill skiing, but haven't tried yet...waiting for snow! I'm confident I'll be able to ski, but I know I'll need help getting my boots on and getting up if I fall....don't fall, right?!?

This is a long way of saying, anything is possible. I'm determined to do everything I did before, but it may look a little different. This has been the most difficult and frustrating thing I've ever experienced. Those around me keep telling me I'm doing great. Personally, I'm disappointed that I let the frustration take over at times and I didn't progress as fast as I thought I should.

I have no back pain. I have some discomfort and still feel a little like a spine patient and my shoulders get a little achy and tired.

If you move forward with the surgery, set realistic goals....walk a little more than the day before. I set a goal of walking a 5K under an hour at three months, riding my bike for at least a 20 mile ride, and hiking. I did it!

My goals for the next 5 months are downhill skiing, cross country skiing, jog a 5K, and do 50 pushups the day of my 2 year anniversary.

I wish you luck and encourage patience...something I lack.

Kelly

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Boy, I needed to hear your story and thank you for sharing!! I am going to try and cross country ski prior to surgery so I will be less likely to fall post surgery.

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@sassytwo

Boy, I needed to hear your story and thank you for sharing!! I am going to try and cross country ski prior to surgery so I will be less likely to fall post surgery.

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Don't hesitate to let me know if you have any questions. This surgery seems to have a lot of different results. I went into in the best physical shape possible. I planned it in advance and was treated with a daily injection for two years (part before and part after surgery) to help my bone strength (osteopenia/osteoporosis). Unlike most people, I had very little pain from the surgery and didn't need to be on narcotics.

Good luck!

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@sassytwo

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

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After my mastectomy, I used liquid marijuana by rubbing the oil onto my skin where I had pain. It worked wonderfully. It really does kill pain. Where did I get the MJ? I grew it on my balcony.

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