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L3-L4 pain after L4-L5-S1 fusion?
amy_001 posted:
Hi all! I'm new to the community . I've poked around looking for similar situations to mine, but couldn't find any. Hoping to get some feedback...

(history: 36 y/o. Herniated L5/S1 disc 13 years ago, started getting sciatic pain last year, turned out I had major disc degeneration/torn discs in L4/5 & L5/S1, bone spur on L4, & arthritis in all facets in lumbar spine).

I had L4-L5-S1 anterior fusion surgery on Feb. 2 this year. Fusion went well; some sacrum and hip pain which lasted about 4 months. I have been going to physical therapy for the past 2 months now with good success. I feel like my fusion area is doing OK, pain wise; and even stopped taking all pain medication.

However, I now have a lot of pain in what feels like my L3/L4 disc and right facet arthritis, which started 2 weeks ago. I know my back muscles are weak and was thinking that was what is causing my pain. But now I'm wondering if the disc is hurting because it's now carrying my body weight instead of the L4/L5 which are now fused; maybe it's just not used to "working" as the primary cushion. Also, I feel pain on the right side and think it's the L3/4 facet. Sometimes it even pops. My back hurts so bad now that I have to take Tylenol or even Tramadol sometimes. Has anyone experienced this?

I'm trying to exercise and do some back and core strengthing. I know people heal differently and at different rates, but I haven't seen anything about the upper discs hurting after a fustion. Any feedback or insight would be greatly appreciated!!

bj1208 responded:
hi and welcome to the support group -

I had a single fusion (L5-S1) in 2/08 and I fused 100%. By my 3rd month post op my pains came back worse than before the surgery. I complained the pain was from the plate area and also above it. Wasn't til about a year after that I had MRI done and it did show I had bulging discs at L4, L3 and L2 - I have DDD in my entire back and felt the same too that my spine could not handle the stress and pressure of having the hardware in-place of a disc. It is true that stress and pressure will take it's toll on the rest of the spine and may cause more problems.

the only way to know what's going on is to see your surgeon or even your pain doc and see if an MRI/CT Scan should be done. This way you will know if there are other problem areas in your spine.

I hope this helps and hope that nothing serious is going on - please keep us posted - take care - Joy
bb8904 replied to bj1208's response:
I have chronic thoracic and lumbar pain, more thoracic then lumbar.most of my problems are in my my thoracic area.I have annular disruption in t 6-7 t 7-8 t 8-9 t 9-10. radial tear in t 6-7 . t 7-8 7 8-9 t 9-10 diffuse spread. t 10-11 nuclear contaiment. multilevel discogenic syndrome. spinal stenosis of thoracic and lumbar.t 6-7 herniation. disk degeneration at t 6-7 t 11-12 l 4-5. moist disks.cervical,lumbar and thoracic degenerative disk disease.lumbar,thorasic and cervical facet arthropathy.discogenic disease/myofascial syndrome.arthritis. t 6-7 t 7-8 t 8-9 t 9-10 diffuse opacification. t 10-11 central opacification of the nucleus and disk space.loss of disc signal L 4-5 L 5-s1. loss of disc height L-4-5. bulging disc L 4-5 L 5- S1...... and sooo much more....I have no idea how any of this happened.....
Tabby4169 responded:
I'm new here too. Looking for situations similar to mine as well. Long story short, I had fusion of L4 L5 S1 S2 back in 2006. Now, after 2 yrs in pain, it's gotten to the point where walking is painful without pain relievers, and sometimes even with. I cannot stand or walk or be on my feet for more than 20-30 min without my legs giving out. After numerous tests, and cortisone (2) shots ( which didn't work) I am told the vertebra above my previous fusion are unstable. I did the pain management, PT and everything else under the sun to get to this point, but now my doctor tells me a second fusion is my only choice at this point. It's either this or not having surgery and becoming a cripple because I am told this will continue to progressively get worse. After my first fusion, things went extremely well. I had surgery in August of 06 and by December of the same year, I was in excellent health without much back pain at all! I said all this it say, after my first surgery went so well, I am not at all hesitant about having another. My only concern is, will this happen again and again? My doctor told me that it's common for vertebra to become unstable above a fusion, but he can't guarantee it won't keep happening. All I know is, now the way things are, I have no life. I sit most all the time due to the pain, even with pain meds. Having faith in God and my doctor, I am opting for the second surgery hoping for some sort of normalcy to return to my life. I have always been a very active person and all this inactivity is killing me big time. I hope some of my story has been helpful on some level. I see my doctor next week to schedule surgery, I will post as to the outcome this second surgery brings. Praying it goes as well as the first!
bj1208 replied to Tabby4169's response:
Hi Tabby4169 - welcome to the support group -

We are lay people (not professional physicians) and we suffer from chronic spine issues (just as you do) but there are a lot of members here that have gone thru many ordeals.

I had a single fusion (L5-S1) done 2/08 and I have the discs above that are now starting to have problems and we are watching them closely. so I understand your questions and concerns. I asked these questions to my surgeon. He basically said the domino effect could happen since bad backs run on my mom's side (my mom has bad back, her brothers and my brother - all bad backs).

your surgeon is really the only one that can answer this question as there could be other factors involved. In your family history are there family members that may have back problems (hereditary), could there have been damages to the other discs that were not seen before? so there are lots of different ways to look at this.

Sometimes the hardware can cause stress on the disc above causing them to become weak. everyone is different and there are lots of people who have had fusions that do not have further problems while others will have problems.

I would discuss this further with your surgeon and see what type of treatment plan for afterwards can be done to help strengthen the core muscles etc to try to avoid further spine issues.

I know this is not 100% what you were looking for - keep us posted how ur doing - take care - Joy
amy_001 replied to bj1208's response:
HI Tabby, thanks for the reply. Sorry to hear you need another surgery!! When my dr first told me that I needed a fusion, he did say that I would have a 20-30% chance of needing a fusion or disc replacement on the disc above the fusion area in about 15-20 years. I never expected to have disc pain after 5 months! Being that I'm so young (compared to average age of back fusion patients), I'm already betting that I'll need another surgery. Hopefully l can go more than 10 years though...

Keep us posted on your next surgery and hope all goes well.


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