Spinal Fusion issues

Posted by mylesheath17 @mylesheath17, Oct 18 2:02pm

All, I am currently 27 years old and have undergone multiple lumber surgeries and have had constant issues. In June 2020 I had a micro discectomy at my L5/S1. Approximately 6 months following I re-herniated the same disc and underwent an L5/S1 fusion in July 2021. I have dealt with constant chronic lumbar pain even after being prescribed pain killers and nerve blockers. In September 2023 I severely re-herniated the disc that was left in my L5/S1 that has severely compromised my right leg. Without getting an updated MRI my doctor inserted the minuteman device at my L4/L5 thinking this would relive pressure on my right sciatic nerve. This of course did not cure the right sciatic issue due to the disc at L5/S1 actually being herniated. My doc, not the one that did the first two procedures, says that the disc at the L5/S1 should have been completely removed prior to fusing it. Is this true? I am seeking guidance on this issue while I am waiting to be referred to the Savannah Spine Institute in Georgia, where I will likely undergo a surgery to possibly remove the remainder of the disc or just the herniated portion. My life has been completely overtaken and overwhelmed by my spine issues. I am a husband and father who currently goes from the bed to the recliner in hopes of one day being able to play with my daughter, and be the husband my wife once had. Any and all guidance is greatly appreciated.

-Myles

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@mylesheath17 Hello Myles, and welcome to Connect. I am a cervical spine surgery patient. You are very young to be going through all of this. A microdiscectomy is removing a portion of a disc by trimming off what has herniated. The herniation tends to reoccur because the wall of the disc is weakened. That can only remove something herniated outward. If the herniation goes into the central spinal canal, there is no way to get to it except by going through the disc and removing it, leaving a space that needs to be filled. When vertebrae are fused, typically, the disc is removed completely. I've never heard of partial removal of a disc and fusing bone. To fuse the bone, something must be inserted into the space like a cage or a bone disc spacer to allow new bone to grow through it and fuse the vertebrae. L5S1 is a difficult location to fuse because of bearing most of the body weight there and a partial fusion there doesn't sound like a good idea to me, but your doctor has to give the official opinion on that. I think your newest opinion is valid in that the disc should have been completely removed. That is always the way surgeons describe this procedure. Do you have imaging and a radiology report that shows the disc was partially removed? It's possible that the level did not fuse at all and has some movement which could cause pain and more problems.

I don't know what is best for you, but there are also artificial discs that will allow some movement in the spine. It's never going to be the same as before surgery or before an injury. Not all surgeons do artificial disc surgeries, and they also have risks just as fusions do. Foreign materials in the body can cause immune responses. Bone can grow around an artificial disc in an attempt to stabilize it. I'm not saying that to worry you, but it does happen to some patients. There are environmental medicine doctors who can treat immune problems from surgical implants. You'll need to do your research to find the best surgeon who takes your insurance. If you are able to come to Mayo, you will find many expert surgeons. I had my surgery at Mayo and was very impressed and I had great results. It is worth traveling to get the best surgeon you can. They are all different and don't all have the same training or skill set. Already, you have a problem to solve that will require a revision which will require a better surgeon. My surgeon was Jeremy Fogelson at the Rochester, MN campus. He is a spinal deformity expert and does both fusion and artificial discs. Artificial discs are not appropriate for every situation, and I was not a good candidate for one and I chose fusion.

Recovery can be a long difficult road and I'm sure you know his already. I hope you find the answer you need to improve the quality of your life. You should get several opinions before choosing a surgeon. You have one chance to get this right.

Jennifer

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Myles, I agree with Jennifer. I have a 17-inch titanium rod with four new discs at the 3,4,5 and S1. It has answered my prayers to being able to play golf again. My surgery in 2019 was a two-day surgery with a very talented orthopedic surgeon in Charlotte, NC who implanted 12 inches of rod. He put in the new discs from the front and the next day put in the titanium rod. He had to add 5 inches to T4 due to a fractured disc in 2020. I also have a Spinal Cord Stimulator put in March 2023 from Boston Scientific. I am very active and very pleased with a successful return to activity. I will admit it does help to work and with a Trainer, I follow the instructions working with balls and rollers, bands, and stretching with walking. I am so much better since having the surgeries.
Best Regards,
Judy

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Myles I feel for you. I am wondering you say you severely herniated a vertebra , did you have any accidents or this due to your way of life and things you do.. I ask because I have been dealing with the same issues, even after my Neurosurgeon did a laminectomy on L3, 4, 5 ?? and arthritis removal a year ago. I have a lot of issue but did not want the extensive repair surgery that would have left me recouping far too long than I. I did have some relief but the last 4. 5 months it is all coming back and much worse. I own a retail biz so I am always on my feet standing, then I must sit for some relief on the right leg sciatica.. It is an indescribable pain I think you know. Many do not know of this pain and God Bless them. I am getting a new MRI next week,. I can not wait.. Who gets excited about an MRI , in this case me,, I want to know what went wrong.. I am a very active person. I am sure I have lifted and twisted far more than the normal person,, I still think I am in my 30s to 40's who can lift boulders, landscape my yard, clean my house, all those things I "used" to do I still love , but I pay for it if I do it.. I have a daily ritual of 2 hours on my heating pad in the am just to wake up and get ready for a shower to get my day moving, I am at a comfort level right there,, but I am sick of all of it as I am sure you are. I feel robbed of the last 9 or 10 years with a debilitating cancer and 18 months of chemo which i am sure did a number on all of my joints and bones.. It is depressing when you feel hope , a chance at a new life or maybe a glimpse of the old one that was so good and then boom , you get knocked down again. My back is not my only issue I fight with but it is the one that hurts me the most.. Walking through a mall is almost a no for me now. I don't get far with out the back and leg shot.. Yet I push myself 2 hours on my treadmill every night. I put my incline down to 0,. as the incline was hurting, I had bought a rowing machine, asked the DR if it was ok, this was months ago,, I am wondering of that hurt me, I have stopped using it , too much stress.. I have a lot of stress in my life which I think adds to any health issues we have. I have tried some of the PT exercises I did after surgery , they have a very feel good feeling when doing.. short lived…. I suppose I will know more and be able to make a better decision this time on just how far I want to go with surgery or maybe I slipped a disk or something as I feel something cracked in there,.. In closing, The reason I asked if you have had any accidents to cause your condition it because you are young, and at such a young age your bones should not be so fragile as to cause these problems for you, I do wish you relief , and some form of normal life to share with your family, 🙂 J

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I had C4-C7 fused w discectomies a year ago. Cages were placed between the vertebrae and filled with bone putty. The discs were removed as part of the procedure, or there wouldn't have been space for the cages, and to correct the herniated disc(s). I don't know if the procedure is different in thoracic/lumbar spine

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