Three Level Lumbar Spine Fusion

Posted by sageacton @sageacton, Sep 15, 2011

I have degenerative disk disease through out my entire spine. I only have pain in the Lumbar region. Severe pain for the last 10 years. After visiting with Dr. Huddleston at Mayo- he has recommended this fusion. There is so much to consider long-term. I am hoping to gain some direction from anyone that has experience. Thanks so much for your time!

Liked by sageacton

Hi Sageaction,

If I have this correct and using this reply correctly, you indicated on December 8, 2011 that you had a two level fusion and a “disc replaced” from Dr. Huddleston. Replacement discs are a bit rare – but then there is Mayo. I have suffered back pain issues for 32 years and on six varying: pain, anti-inflamatory and muscle control drugs, Lidocane & Flector Patches. In all 32 years I have spent or lost over a quarter-of-a-million dollars in medical, PT, procedures, drugs, travel for medical, lost time from work. I too have the almost identical scenario L4-L5 L5-S1 fused 12 years ago and because this wears out the next level every 10 or so years, this past December had the artificial disc procedure done in Barcelona by a world spine neurosurgeon (Germany is the epicenter that invented the artificial disc in the mid 80’s for an athlete and these facilities are the core of best learning center in Europe). I went there because i wanted the Spinal Kinetics M6-L disc (a standard for about the last 10 years). This was $29k cash and I am in the process of endeavoring reimbursement from my insurer. We will see where that goes, appeal etc. I am doing very well.

As you are aware, friends and extended family seem to know someone with escalating situations with back issues and many are treatable with PT, Meds, RF Ablation, etc – which you seem a tune to in your postings. However, some situations potentially suggest an artificial disc may be a wise consideration. So I am looking for resources in the US to refer people to. You, being six yours out have a story to tell. May I ask how you are doing, meds, any problems with facet joint pain in the artificial disc region? Also, I am interested in finding out what artificial disc people had surgically implanted?

Thanks for considering sharing.

Best of health to you.

Jim Peterson – Chicago

REPLY
@susansman

I had a 2 level L5 L4 fusion done i had back surgery 12 years ago for a herniated disc, 2 years ago was my fusion. My low back and right leg still have considerable pain if i’m not on pain meds. I have tried everything besides narcotics and nothing works. I have been on Fentynal patch 25mcg for 6 months now. I want to know how many people are on pain meds after spinal fusion but i can’t find any percent anywhere?

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Hi Susansman,

I read your January 17, 2012 post about your fusion from 12 years prior and on Fentynal patches. I found that every 10 years the next level disc wears out due to the friction from the two fused bones – as you move, etc. After long research of my 12 year mark after double level fusion surgery (now 32 year of pain) my research found that an “artificial disc” was the best solution. I flew to Barcelona to a world neurosurgeon to have the *Spinal Kinetics M6-L implanted on top of my L4-L5 L5-S1 fusion at level L3-L4. This was in December 2016 and I am fantastic. I paid $29k and am trying to get reimbursement from insurance. I see that Mayo offers an artificial disc, according to the posting by another patient. My point is, the right decision was what I refer to as one of the top ten best decisions I made in my life.

I am attempting to find out if you went to Mayo and elected an artificial disc? If so, what brand/model? How are you doing, meds, etc.

I appreciate your consideration to respond. To be clear, I am asking so I have a place in the US to refer people to. Many wont do what I did.

Best regards.

Jim Peterson – Chicago

REPLY
@susansman

I had a 2 level L5 L4 fusion done i had back surgery 12 years ago for a herniated disc, 2 years ago was my fusion. My low back and right leg still have considerable pain if i’m not on pain meds. I have tried everything besides narcotics and nothing works. I have been on Fentynal patch 25mcg for 6 months now. I want to know how many people are on pain meds after spinal fusion but i can’t find any percent anywhere?

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@jrchicago Hi Jim and welcome to Mayo Connect. I’m so glad that you found this website and that you have shared your story about your journey to get help. I admire how proactive you have been in order to feel better! I’ll be interested to hear from others who have had the artificial disc and see what is being said about it. Here is a Mayo website http://www.mayoclinic.org/diseases-conditions/back-pain/expert-answers/disk-replacement/faq-20057995 where this disc replacement is briefly discussed. Dr. Paul M. Huddleston, III, who wrote this article, seems well known in orthopedic care, here is his website, http://www.mayoclinic.org/biographies/huddleston-paul-m-iii-m-d/bio-20053564. Glad to hear that you are feeling better with your new disc, Jim. Keep in touch with Mayo Connect, I think you will find the support here very beneficial and you will undoubtedly have much to offer to the discussions as well. Teresa

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@sageacton

Tomorrow it will be three weeks since my surgery. Dr. Huddleston replaced a disk and fused the two levels below. I am doing FANTASTIC. I wish I hadn’t put it off for so long! I cannot believe how incredible the process has been. I was concerned about so many different things. Really- Bending probably the most concern. I am trying to heal and I am not pushing anything. I have considered going back to work next week and upset my family by the thought, so I will wait. I really feel great. I am weaning myself off of the pain meds because I don’t need them as much. The first week was incredibly challenging due to the pain. My husband wasn’t able to help me much but my 20yr old daughter was by my side and helped me sit and lay down. I’ve been out a few times and am taking is slowly. I’ll probably drive in the next few weeks. I do not regret a single thing about this surgery and I would encourage anyone to get the care you deserve. This surgery has given me my life back already!!! I cannot wait to see what the next 6 months bring. There is no better care anywhere- AND no better team than that of Dr. Paul Huddleston. I have been blessed by the Grace of God that Dr. Huddleston was able to help me. If you consider this surgery or any surgery and need any help from me, please let me know. I would love to help you make helpful changes for hope in your life. THANK YOU SO MUCH, Dr. Huddleston!!

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I had the l3 disc replaced and hardware removed from previous fusion and new put in over the l3 l4 and l5 and am 4 1/2 weeks post op. Still in a lot of pain from lower back down. I’m wondering if this is normal at this point.

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@sageacton

Tomorrow it will be three weeks since my surgery. Dr. Huddleston replaced a disk and fused the two levels below. I am doing FANTASTIC. I wish I hadn’t put it off for so long! I cannot believe how incredible the process has been. I was concerned about so many different things. Really- Bending probably the most concern. I am trying to heal and I am not pushing anything. I have considered going back to work next week and upset my family by the thought, so I will wait. I really feel great. I am weaning myself off of the pain meds because I don’t need them as much. The first week was incredibly challenging due to the pain. My husband wasn’t able to help me much but my 20yr old daughter was by my side and helped me sit and lay down. I’ve been out a few times and am taking is slowly. I’ll probably drive in the next few weeks. I do not regret a single thing about this surgery and I would encourage anyone to get the care you deserve. This surgery has given me my life back already!!! I cannot wait to see what the next 6 months bring. There is no better care anywhere- AND no better team than that of Dr. Paul Huddleston. I have been blessed by the Grace of God that Dr. Huddleston was able to help me. If you consider this surgery or any surgery and need any help from me, please let me know. I would love to help you make helpful changes for hope in your life. THANK YOU SO MUCH, Dr. Huddleston!!

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Hello @sarcher and Welcome to Connect. @jrchicago has also recently joined us and has some questions on artificial disc replacement. Perhaps you can help each other. If you would like to join in on a conversation with @predictable, Volunteer Mentor here on Connect What To Expect with Spine Surgery click here http://mayocl.in/2pjOh4L
@sarcher, have you talked to your doctor about the continued pain?

A Mayo Connect TIP –To get someone’s attention when you are replying to a post just put the @ in front of their name and they will be notified, as you were with this posting.

REPLY
@sageacton

Tomorrow it will be three weeks since my surgery. Dr. Huddleston replaced a disk and fused the two levels below. I am doing FANTASTIC. I wish I hadn’t put it off for so long! I cannot believe how incredible the process has been. I was concerned about so many different things. Really- Bending probably the most concern. I am trying to heal and I am not pushing anything. I have considered going back to work next week and upset my family by the thought, so I will wait. I really feel great. I am weaning myself off of the pain meds because I don’t need them as much. The first week was incredibly challenging due to the pain. My husband wasn’t able to help me much but my 20yr old daughter was by my side and helped me sit and lay down. I’ve been out a few times and am taking is slowly. I’ll probably drive in the next few weeks. I do not regret a single thing about this surgery and I would encourage anyone to get the care you deserve. This surgery has given me my life back already!!! I cannot wait to see what the next 6 months bring. There is no better care anywhere- AND no better team than that of Dr. Paul Huddleston. I have been blessed by the Grace of God that Dr. Huddleston was able to help me. If you consider this surgery or any surgery and need any help from me, please let me know. I would love to help you make helpful changes for hope in your life. THANK YOU SO MUCH, Dr. Huddleston!!

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@sarcher 5/10/17

I am sorry to hear you are going through such pain. This may that may take a while. I have had back pain for 32 years and solved it by 80% recently and over 95% nerve pain is gone – 4 months post-op. A key message here is you need to be your own best advocate to become more knowledgeable and be forward thinking on your approach. Its been my personal experience from a double level fusion performed from the back, (posterior) that this is a major event. If what I am reading is accurate, you indicate a double level “disc replacement” was implanted – which is commonly done from the front, (anterior approach) – next to the belly button. I had a double level fusion 12 years ago and that wears out the disc above and I had an artificial disc replacement (ADR) on top of the old fusion in December 2017 and I am doing very well. My point is posterior surgery is a major event and that may be the major source of inflammatory pain. Also in perspective, most ADR’s add 1/2″ each, so you may be 1″ taller. This causes muscles to be stretched. I read in an international ADR blog that a 3 level ADR case, it took six months for hamstrings to finally adapt.

A discussion with your Doctor about the necessity of ongoing Physical Therapy (PT) (which will include stretching) and medications like an anti-inflammatory (I.E. prescriptions Daypro 600mg x 2 a day) and pain medication (like Lyrica starter dost 50mg x 3 a day, may need to be increased to 75mg dose), perhaps muscle relaxers like Baclofen (use very limited and cautiously) and also 12 hour patches like *Lidoderm 5% (helps tame and dull the pain surface area) or *Flector (very effective in area specific treatment). You may also find relief from Biofreeze – a cool gel that helps trick the nerve receptors to pay more attention to the cool sensation than the pain, especially helpful at night. I definitely prefer the aerosol spray so you can reach around to apply easier – and you avoid getting it on your hands – avoids inadvertently getting it in your eye by rubbing. You can get the aerosol on line at Amazon for $12. Lidoderm 4% cream and roll on is available at the pain section at the pharmacy – the roll on is easier to apply. Off the shelf IcyHot has a cream that is both Lidoderm 4% and a tinge of hot (I like this). If appropriate, CVS has a Capsaicin (pepper plant hot) and I recommend only the roll on.

A key point here is stiffness and tightness WILL cause pain and PT approved daily stretching are important mitigation techniques – again as agreed and prescribed by your PT. Exercises to ask your PT about would be use of a gym recumbent bike may help circulation and pain relief. You might be surprised how effective this could be – but I sat down with my surgeon with a list of activities I wanted to do and asked when it was okay to do them. Walking was his number #1 recommendation – daily. I went to Barcelona for my surgery – was up and walking in 3 days, walked 15 miles the two weeks post-op literally as a tourist. #2 was daily stretching – I have a rope with a loop end that pops over the top of a door and a foot sleeve (like a kink-shop product) that allows me to easily stretch instantly and its easy to travel with. #3 Bosu ball – stand on top and stretch back and fourth (have something solid to hold on to), #4 PT; and #5 recumbent bike. In ending, every patient must be their own best advocate and asking questions off a list and writing down the answers is wise. I refer back to these notes often in those first few months.

The fact is this is going to take time. The good news is that ARD’s give you a major advantage in recovery. One last comment is that ‘at some point’ – as PT approved) stomach and back muscles should be strengthened – for various reasons, but specifically because most ADR’s can allow hyper extension of facet joints as the ADR is like a ball bearing and moves faster – not like a regular ‘tension in turning’ natural disc. So when your torso turns left or right the facet joints at the ADR level move first and may suffer arthritic friction. Good muscle health in the torso core help mitigate that effect. Back surgery is not a solution, its an attempt at mitigation. In most instances, you will need to stay on your game in exercise. If the pain is disruptive to your life, there are procedures like RF Ablation that burn the nerves. This can last for around a year – and allow a cut back of meds. Right now at only 4 1/2 weeks, you are suffering post surgical pain and have a road ahead. RF Ablation is a consideration a good bit down the road “if” its even appropriate. One other consideration is when on so many meds, consideration of liver help supplements Silymarin are likely wise.

My final comment to back pain suffering folks also reading this is that are consideration treatment is to stay on line and dig. After 32 years of pain and every treatment I could find, I spent $29k and went to Barcelona to Dr. Clavel a world top spine surgeon because I wanted a specific model ADR from Spinal Kinetics M6-L. In my situation, it was best. Whether by appeal I will get any money back is unknown. Most cant or wont do that. Places like Mayo are a consideration. What I found out was that the artificial disc (ADR) was invented in Germany in the mid-80s for a professional athlete. Since then its the epicenter of excellence on the subject. My neurosurgeon had performed over 1700 of these procedures (1200 neck 70% double level and 550 lumbar).

Meds: *The Lidoderm and Flector patches may be refused by your insurer. I found that having a doctor willing to appeal this to the insurer for me worked. I did not go to my surgeon for this, I went to my regular internist. There is a difference in liquid and roll ons mentioned above and the patches are what I prefer to get all night long – good night sleep – protection. Creams and roll on’s seem to last around 4 hours or so.

You went through a major double procedure. The procedure to remove the hardware was a major event. I hope you fell better with more knowledge to consider. The probability to heal well is in your hands. Be your own best advocate first.

Peace.

JR Chicago

REPLY
@sageacton

Tomorrow it will be three weeks since my surgery. Dr. Huddleston replaced a disk and fused the two levels below. I am doing FANTASTIC. I wish I hadn’t put it off for so long! I cannot believe how incredible the process has been. I was concerned about so many different things. Really- Bending probably the most concern. I am trying to heal and I am not pushing anything. I have considered going back to work next week and upset my family by the thought, so I will wait. I really feel great. I am weaning myself off of the pain meds because I don’t need them as much. The first week was incredibly challenging due to the pain. My husband wasn’t able to help me much but my 20yr old daughter was by my side and helped me sit and lay down. I’ve been out a few times and am taking is slowly. I’ll probably drive in the next few weeks. I do not regret a single thing about this surgery and I would encourage anyone to get the care you deserve. This surgery has given me my life back already!!! I cannot wait to see what the next 6 months bring. There is no better care anywhere- AND no better team than that of Dr. Paul Huddleston. I have been blessed by the Grace of God that Dr. Huddleston was able to help me. If you consider this surgery or any surgery and need any help from me, please let me know. I would love to help you make helpful changes for hope in your life. THANK YOU SO MUCH, Dr. Huddleston!!

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I see him on Thursday. I’m just sure at this point if the pain level is where it should be. The last surgery I had no back pain afterwards just nerve pain for thirteen weeks.

REPLY
@sageacton

Tomorrow it will be three weeks since my surgery. Dr. Huddleston replaced a disk and fused the two levels below. I am doing FANTASTIC. I wish I hadn’t put it off for so long! I cannot believe how incredible the process has been. I was concerned about so many different things. Really- Bending probably the most concern. I am trying to heal and I am not pushing anything. I have considered going back to work next week and upset my family by the thought, so I will wait. I really feel great. I am weaning myself off of the pain meds because I don’t need them as much. The first week was incredibly challenging due to the pain. My husband wasn’t able to help me much but my 20yr old daughter was by my side and helped me sit and lay down. I’ve been out a few times and am taking is slowly. I’ll probably drive in the next few weeks. I do not regret a single thing about this surgery and I would encourage anyone to get the care you deserve. This surgery has given me my life back already!!! I cannot wait to see what the next 6 months bring. There is no better care anywhere- AND no better team than that of Dr. Paul Huddleston. I have been blessed by the Grace of God that Dr. Huddleston was able to help me. If you consider this surgery or any surgery and need any help from me, please let me know. I would love to help you make helpful changes for hope in your life. THANK YOU SO MUCH, Dr. Huddleston!!

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Thanks for your input.

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