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Revision surgery for a spinal fusion
Is it advisable to have revision surgery on a S1 - L5 fusion that was performed in September 2024? I have numbness on the left side from buttock to bottom of foot on the outside of the leg only. My surgeon suggested it was neuropathy, and a neurologist performed a nerve conduction test and found that my nerve on the L5 was being affected. So, the orthopedic surgeon suggested a revision. This is less than a year from the fusion surgery. A second opinion was from an orthopedic surgeon reported that he would not recommend surgery at this time. I am scared and hesitant to undergo another spine surgery so soon after the first one. Has anyone else been in this situation?
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@elizamoore
I had L3-L5 decompressed and fused in August 2024. I still have some healing to go and understand it can take a full year. There are some nerve sensations and stiffness but I do not have what you have (had neurogenic claudication before my surgery which caused pain/numbness/weakness from lower back to feet but this has improved significantly).
I don’t blame you for not wanting to do another surgery yet. I would do more digging to find out what is affecting and compressing your zl5 nerve on the left. Is it pinched at the root by scar tissue, bone growth/osteophyte, or is there a new disc bulge/herniation at L4-L5 which is not pressing on L5 nerve root? Would the revision surgery be at L5-S1 or would new decompression/fusion at L4-L5 be needed? When you get fusion, there can be issues with levels above and below.
@elizamoore Welcome to Connect. Perhaps more opinions would help you with this decision and I suggest you seek opinions at a different medical center unrelated to where you have been seen. Sometimes when surgeons advise against surgery, it is for their personal reasons of not wanting to take a risk on a case that may not have a great outcome. Since they are judged on their success statistics, they don't want to bring that score down with a poor outcome. It may also be an honest opinion, or they don't know if surgery would help. Another surgery would add to the scar tissue.
There is a chance that another surgical procedure may not correct the pain. There may be surgical scar tissue that is compressing a nerve. One thing you may want to look at would be a physical therapist who can stretch surgical scar tissue. The myofascial release techniques do that, and it would be worth trying before considering another surgery. You can learn more about MFR in this discussion:
Myofascial Release Therapy (MFR) for treating compression and pain
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
There is a provider search at this link. https://myofascialrelease.com/find-a-therapist/
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/