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Should I have spinal fusion surgery?
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Jessie13 posted:
I have had lower back pain throughout the lower back, right buttock, weakness and "funny-bone"feeling in right leg, numbness and burning in out 3 toes of right foot for 4-5 year, was sent to neurosurgeon-got x-ray, MRI, PT, 3 epidural steroid injections and now recommended to have spinal fusion surgery for L4-L5 and L5-S1. My concern is that surgeon is planning to do posterior fusion of facet joints using rod, screws and BMP (bone morphogenic protein) AND on another day, an anterior approach to replace discs with cages and bone material, though my discs inthose areas don't show drastic deterioration-his explanation is that total stability is needed for pain/arthritic deterioration relief-both facet joints and vertebrae should be fused at same time.
Any experience with this? Similar advice/experience? I am going for a second opinion at large university tertiary care facility before going for surgery.
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bj1208 responded:
hi Jessie13 welcome to the support group -

before deciding on surgery it would be a good idea to get several opinions from both Orthopedic Spine Specialist and Neurosurgeon Spine Specialist - this way you will know what your treatment options are.

you can also get treatment advise from a good pain doc -

http://www.spineuniverse.com/treatments/what-physiatrist

this way you know all around what your options are. remember surgery should always be the last result and only you can decide if that's what should be done. surgery is no guarantee to reduce or eliminate pain. fusion surgery will stabilize the back - click on my name or pic and read my story.

keep us posted -
Take care~~

~~ Joy ~~
 
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trs1960 replied to bj1208's response:
I'm with Joy. I would see a neurosurgen and an orthopedic surgen. Get two opinions of what to do and go with the one you feel better about.
 
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judylabrador responded:
My husband has had 22 surgeries in the last 25yrs for back and hip issues. He had fusion in July of 2011. The rods and screws with the cage. It was done in Durham NC by one of the best in the country. He has since had worse pain than before, it goes down the back of the buttocks, down the left leg and foot. He says that every time his heart beats it is like someone is stabing him in the back and walking on hot coals. They are now talking about inserting a pain pump to try to help with the terrible pain he is in. He can not sleep, walk far or sit in his favorite chair for a very long time. He has no quality of life. I do all of the work at home and he stays in the bed or chair most of the time. He wishes he had never done this last surgery. He does not have any diseases other than the degenerative disc disease. He had his hips replaced due to degenerative bone disease as well. Please, before you do this get all of the opinions you can. If you do it, then you can not take it back. His surgery was in the same places as yours. He is 57 and has said to his pain management Dr. that if they could not do something soon he would rather be paralized! He has fought so hard to stay out of a chair but now wishes he was in one! I cry about this all of the time because for him to want to be dead or paralized is something that hurts me to no end. I wish I had better news but, I see how much damage it can do. Here again maybe if you see the right Drs they can help you more. Please do your research about this...I thought we could trust this proceedure. Now, I am not sure this was the right choice. It is 2012 you would think they would have better ways to help with the chronic pain that some of these people are in.

There is a web site that helps with some of the pain issues call The American Pain Foundation. They have blogs and conversations that you can research some of the proceedures that are out there.

Good Luck to you and I pray it will be a better outcome.
 
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AOlhava responded:
Absolutely do not have a spinal fusion surgery. It is the worst decision I ever made in my life. I feel a lot worse since my back surgery in 2008. I have had to quit work and go on disability. I cannot do anything for myself anymore. I spend my miserable days sitting on the couch. I am a widow and have no one to help me and I am still searching for ways to get some relief. I can go into a lot of details but this is a general answer. There are multiple options these days to help with your back so please check them out first. Once you have this surgery there is no going back!! Don't do it please.
 
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bj1208 replied to AOlhava's response:
Spinal Fusions are done to stabilize the back - this does not mean it will help reduce pains - as with any back operations there is no guarantee.

I had a single fusion - Anterior Lumbar Fusion L5-S1 done 2/08 my disc not only ruptured but it also splintered pressing on both the right and left S1 nerve root- my surgery was a success as I did fuse 100% and there is bone growing back. I do have worse pains now than before the surgery and because of the severity of damage I have permanent nerve damage in both legs.

Do I regret having the surgery? NO - I am glad I had it done.

As stated above, there is no guarantee that back surgery will correct the issues or reduce any pains.

Research is the key here. I did research for an entire weekend and spoke to lots of people who have had same or more levels done before deciding.

It has to be your choice to have surgery done but you should get as many opinions as you can so you know what all is involved.

best wishes -
Take care~~

~~ Joy ~~
 
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dfromspencer responded:
I had spinal fusion on my neck. Metal plate and four screws, with a bone chip in between. It was the best, no, only course i could choose. The nerve damage was getting worse, the pain would be so intense sometimes, i would hit my knees on the floor. Immediately after the surgery, i felt relief. It was awsome, like I had a new neck.

That was a few years back, now. Now my Dr.s are telling me, I have degenerative bone disease in my neck, and lower back. Plus, I have two more buldging disks in my neck. Surgery is schedualled for the 31st. of Dec., this year. Great New years gift, eh?

Yes, I am going through with the surgery. Why not? It helped the last time! Sure, this time is a little diferent, but hey, it could work out? I certainly am looking foreward to it. I'll make the promise right now, to report back to you here, at WebMD.!!!

The "Procedure", is a little like this. First, they will have you do a work-up, or "Pre-Op as they call it. Then you check in, get prepped for surgery, put under, then operated on. It took about five hours for my neck. That was removing the bad disk, incerting the bone chip, then screwing down the plate. Sewing me back up, and incerting a drain tube from the wound. I spent one and a half days in the hospital. Recovery was the long part. That was about six weeks.

With it being the back, I don't know? I may have to do that soon enough, I will have to wait and see? Please let us know what you decide to do, and we will be here for you.

We are all in this together, living in chronic pain sucks!

Dennis
 
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medatationman responded:
Hi Jessie13,I read your problem and it gave me chills.I have gone through all that your doctor has planed for you thirteen years ago.Everyone is not the same but i can say all of that did not help me and things have gotten worse over the years.I have bad pain around my L5-S1 area going down through my butt cheeks spreading to my hips around my anus to my testecles shooting down both legs to my feet.Right top of my foot to my big toe and the bottom of my left foot from my arch to my three little toes.I get a electrical shock to my little toes with fire burning pain till i can`t walk and have to sit and take my shoes off.Both of my legs ache like a tooth ache along with the shooting pain and burning needle stick pain in certain parts of both legs.Movement,standing,sitting and movement make my pain rise.I`m on pain meds and every two to six months i go for pain injections.In two weeks i go for a caudal epidural injection which helps for a while.Hate to bore you but i wish they had the new surgery they have now.Its done in one day and you go home the same day.They cut a one inch cut and go in with a scope where they can fix most problems.Check with a spinal laser clinic.Check on line for one, you send them your MRI and they can tell you if they can help.I went through two surgeries through the back and the third through the front.CHECK WITH A LASER SPINE CLINIC before you do any thing else.They say they are awlsome.I wish they had laser spine years ago, I`m full of rods screws,and cages and had bone sawed from my hips for the fuisons.All this stuffs hurts and it took me over a year to get back on my feet.But everyones different.Please check with laser spine treatment.Good luck to you hope to hear from you.Dan
 
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medatationman replied to judylabrador's response:
judylabrador has your husband tried a spinal stimulator? They implant it in your back and place wires to a small plate they insert in the spine up in the middle of your back. It gives electrical impulses that block the pain that goes up the spine to the brain.I have seen people like you husbands pain be able to get there life back and some able to go back to work without having to take pain meds. It would not hurt to try.Allmost all pain clinics do these.Good luck to you and your husband.Dan
 
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imabookworm1943 responded:
I watched my husband go through this same struggle. He initially had the surgery by an excellent surgeon and achieved many years of relief. However, as bones do, there was further deterioration and it finally became necessary for addtional surgery. They removed all that had been done before, replaced that and added new hardware to handle the new damage. He got on fine at first but developed an UTI infection (gratis of the hospital) as he was to be dismissed. He was assymptomatic with this infection until he collapsed with 103 fever. Back to hospital, infection went septic. Addtional infection developed. After weeks in hospital and ICU he was dismissed to Rehab facility still on antibiotics but they were discontinued after just a few more days. Nearly three weeks later, his mobility and condition were worse than pre-surgery. Back to hospital due to pool of infection beneath the surgical site. Drained, treated with meds for a few days, then back into surgery. Debridement of putrid flesh, etc. packed and more meds. Two days later, another surgery, debridement, packed, more meds. Two more days complete replacement of all hardware, surgical site "pink and healthy with good blood flow". After 5 days seemed to be on the road to recovery, finally, but infection reared it ugly head again, breathing difficulties, rushed to ICU, placed on respirator. Remained so for almost three weeks. He died 10/27/09.

If you have the surgery, be sure you KNOW the surgeon, KNOW AND TRUST NOT ONLY HIM/HER BUT THE HOSPITAL AS WELL. Be very proactive. Do not blindly accept procedures, meds, tests, etc without first knowing why they are necessary but what the expected result should be.

Demand that nursing care be as careful and caring as if they were taking charge of their own mother. Make sure things are kept clean and sterile, any problems, ask for new setup.
 
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golden3 responded:
Don't do it!! I had 2 back surgeries for low back pain radiating down both legs. The 1st surgery I had cages put in L5-Sl. Came out of surgery in worse pain and ended up with burning pain in my ankles and feet instead of just pain. Surgeon told me to go back to the pain Dr and have more injections which didn't help in the 1st place. Then I had another surgery with screws and rods put in L4-5 which didn't help at all. Recently had an EMG which showed damaged nerve in S1. What a surprise. If they would have done an EMG before the last surgery I could have avoided surgery. I've been told there is no cure for a damaged nerve. Also have been told by several people including Dr's that cages are not done any longer. They found they were no help and some people have had them removed. My advice, find another Dr and have an EMG done to find out just what is going on before going under the knife. Wish I had.
 
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bj1208 replied to golden3's response:
Hi Golden3 -

In regards to just having an EMG/Nerve Conduction Test done this would have shown the reason you were having such problems is because of disc issues. Your L5-S1 disc was bulging and pressing on the S1 nerve root. Depending on how long this had been going on shows by the pains you had coming out of surgery as there was evidence of nerve damage.

The reason for your first surgery was to remove the damaged disc and put a cage in to help stabilize the area. There is no guarantee that spine surgery will help reduce pains - it's only done to stabilize the spine.

Your second surgery was done to further stabilize your spine more by putting rods and screws in at the L4-5 area.

What point your missing here is is that your spine is more stable now with the hardware in place. And this is what your surgeon was doing - stabilizing your spine.

Nerve damage to the S1 nerve roots can happen over time from discs that are bulging from injuries esteeming from when were were children (as mine was) and not showing up til we're older, from work related injuries or other types of accidents and can also happen because of hereditary (bad backs on one or both sides of family).

I had a couple of surgeons and pain doc's tell me that if surgery can be done within 6 months of the damaged disc then there is a good chance the S1 nerve root will repair itself but that this repair can take up to a year or a little longer. However, discs that have been damaged for longer than 6 months and pressing on the S1 nerve root for long times are less likely to repair itself thereby showing signs of nerve damage.

As with my surgery (click on my name or picture and read my story) the nerve damage had already set in. My surgeon stated that the reason for the L5-S1 fusion was to stabilize the spine. He could only be hopeful if it did help reduce pains. He did what he said he would do - stabilize my spine. My surgery was a 100% success as I have fused 100% and have healed - yes I do have pains worse than before my surgery and I have nerve damage in both legs but this is not from the surgery yet it's from the many years my disc was bulging and pressing on the nerve roots causing the nerve damage to set in.

I did have a plate, 4 screws and a cage put in and I am happy that I had the surgery as my spine is more stable now. If I need to have future fusions will I have them? Yes because it will help stabilize my spine.

Research is the key as with having more than one opinion.
Take care~~

~~ Joy ~~
 
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suelovessewing responded:
I have the exact I have had 5 shots now over 2 years , first just pain pills, then lidoerm patches worked then to the shots tried thearphty made worse, my knees are bad too, when do you stop shots & turn to sugery, my have all came because of having to take to make steriods over my lifespan an causes your bones to weaken. I already had to herniated disc in my neck the last surgery in 2005 there wasn't enough bone to put in screws to hold in it place so it shifted a little. I want to have surgery on my back before it is to late, they now label it as DDD, degenertive bones disease.
 
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coldcanuk responded:
Hi Jessie13: I had spinal fusion on L3-L5 a year ago, August. This was due to severe spinal stenosis. It happened that when the surgeon went in he found that all three discs were herniated at the rear which didn't show up in the imaging. He then had to take a piece of bone for grafting from my spine, then do a decompression lamenectomy; then fuse all three areas. I now have 6 rods and screws in me as well as my own bone graft, no cages though. This past year is the first time in 32 years that I have lived without pain in that area. My left leg was numb for 5 yrs, that is slowly disapating.
I also have a number of other spinal problems (this is all due to severe osteo-arthritis in the spine) and we will be tackling each one in due course.
I was very luck to have an excellent surgeon. I was walking the day after surgery (with a walker) and was home in 4 days. I follow his advice on walking everyday, alot, and doing the required physio exercises and do not even need pain killers for this area.
I advise you to take your time making the decision and get other opinions. Remember, as time goes on, so does technology which means this type of surgery is gettting better all the time.
My father was one of the first patients who had a disc removed by the surgeon who invented the surgery, in the early 1950's. It was incredibly different from mine! Hang in, do your exercises and walking, as much as you can and get other opinions.
 
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michele0530 replied to AOlhava's response:
Everyone's experience is very different, of course! I had severe stenosis of the back and two discs that needed to be fused
1-1/2 years ago when I was 64 years of age. PT was not an option; nor were steriod shots to the spine. Sitting and sleeping were my only comfortable positions. I could not stand or walk well and began deteriorating at a rapid level. My posture was at a 90 degree angle, and I needed the support of a walker.

Going to an orthopedic doctor is not the answer. Only neurosurgeons should do this kind of surgery as they went to school and studied everything about the central nervous system. I sought the opinions of two neurosurgeons, here in Las Vegas where I live. Both suggested a laminectomy as well as fusion of two of my discs. Having this surgery was an absolute blessing. It took nearly a year for a full recovery, but I am 75% back to where I was before I developed serious back problems. I also have stenosis in my neck and three discs that need to be fused. However, with my neck I DO have options. I take 300mg Gabapentin at night. When anti-inflammatories stop working, I will have shots to the neck. Surgery is a last resort for me.

For every horror story, there is a great story to be told. Unfortunately, we do not hear them often enough! The surgeon I chose had operated on the backs of two male friends of mine who were told no one would touch them and that they would never walk again. One died a few years ago; he was in his 80's. The other man is in his 70's, was wheel chair bound, and is now on a bowling league five days a week.

Do not be discouraged! Weigh your options and get the best surgeon to be found. If anyone needs a referral to my Vegas surgeon, please write to me.


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