Spinal fusion L3 into sacrum (2014) with L3 herniated disc now

ptpatty, the disc at L 3 refers to the L 3-4 disc. At fusion didn't they remove the disc? Were the migrating screws removed? still migrating? It it is the L 2-3 disc, you might be able to have microdiscectomy. While waiting for the pain doctor, you might send the MRI for opinions. These microsurgeries are much easier to get through.

Thank you! Yes, it is the L3-L4disc. It’s the same one that herniated over 10 years ago. They removed part of the disc it seems, but not all of it. The screws were left in because the surgeon said he would have to take all of the hardware out and do a revision. He said I might never have any problems with it so it would probably be best not to do anything. They are still migrating, and have been noted on previous x-rays through the years. I wish it was L2 L3 and they could do the microdiscectomy! I don’t know if they would even try that or if there might be another option other than a revision. Trying not to lose hope but right now I can barely walk to the bathroom and back. I stand in a significant side-bent position to be able to walk and then have to get right back to bed. I have no idea how I will be able to get down the stairs, into a car and ride to the doctors office on Wednesday.

@ptpatty Welcome to Connect. You have a pretty good understanding of spine issues having been a PT. I hope your doctor can find a solution for you. It sounds like it's very difficult for you now with daily living. I think that just removing a herniated part of a disc does leave the possibility that it can happen again as the disc doesn't heal itself. I'm sorry you're going through all of this. I think of 73 as young, and I am not that far behind it myself.

Do you have someone to help you get in and out of the car to go to your appointment?

but Jennifer, how would the bones ever fuse if the disc remained in between the vertebra.

I don’t think it did fuse. I think the motion occurred because the screws were migrating for the last 7 years. You can see the halo around the L3 screws in the Xray. The herniation at L3-4 (according to the MRI last week) must be whatever tissue was left? I don’t understand it either but the nerve pain is following L3-4. Thanks so much for your input. I appreciate it. Patty

https://spinecenteratlanta.com/unlocking-solutions-minimally-invasive-options-for-pedicle-screw-revision-after-failed-back-surgery/ This spine center offer a free MRI review. You could call the office where you had your MRI. Is it recent? Ask for several CDs of the MRI and send them all out at the same time. You probably prefer to go somewhere local, but you'll get several opinions without leaving home.
It takes less tension to retrieve screws with lucency.

Thank you, Jennifer! Yes, I do have my husband who is very helpful and takes wonderful care of me. I did experiment with a walker and that seemed to help a little bit too. I can position myself side-bending left and weight-bearing on my arms to help relieve some of the pain. I’m getting CDs from the radiology clinic of my MRI that was done a week ago. I’ll be submitting them for consultations as “gently”has suggested. I’m truly amazed and thankful at how wonderful this group has been.

@ptpatty Mayo also has patients send in imaging for review when they apply for appointments. They review imaging at no charge when making a decision on accepting a case, and they return the discs later. Good surgeons who are in demand do review a case before accepting a patient. If there are other surgeons you want to see for opinions, you can get multiple copies of your imaging for review. It sounds like you have a plan.

@gently for your question, if a disc has herniated a lot and is collapsed, the bone from the end plates above and below it may be able to make contact and grow together fusing the spine. That bone may be remodeling and producing spurs. Sometimes surgeons just remove a herniated piece of a disc and leave the disc in place. That may herniate again. You are correct that complete removal of the disc is done during a fusion operation.

Jeffifer, if Mayo decides against seeing a patient or the patient decides against being seen at Mayo, do they receive the imaging review?

I saw my pain doctor yesterday (who implanted my spinal cord stimulator) and he is unable to do anything to help me. He referred me back to the neurosurgeon who did my original fusion 10 years ago. I called them to set up an appointment, and during the conversation learned that he does not do revisions or surgery if you have an SCS. The nurse was going to talk with him and get back to me. Is that something anyone has come across before? My pain doctor did say I have a very complex and unusual situation, but evidently he did not know the neurosurgeon didn’t operate with an SCS and failed fusion. Trying not to lose hope as I have to be supine for 99% of my day.