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Defer fusion or just throw the towel in?
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An_252526 posted:
Ok, so many a year ago I hurt my back shoveling snow. It was a wet heavy snow and I was trying to not lift it, but instead was pushing. I felt my back "pop" and I couldn't straighten up. Fast forward a few years later and I have severe pain down my right leg. I could barely walk, couldn't sit at all and my employer threatened to fire me unless I cheered up. I was stuck in conservative treatment and I didn't want the narcotics so I self medicated. Usually taking 3500mg of tylenol and 6 alieve at one time. After two years of being suicidal, it was finally recommended that I have surgery. L5-S1 microdiskectomy and lamonectory. I was totally pain free for 6 months and then my pain came back. Turns out, the disk reherniated. The surgery might have failed, but I still consider it to be successful because I'm able to function. For 7 years I've been living with regular steroid injections and occasionally medicating on the worst days. I'm never not in pain, it's just a gauge of how much. This past winter I was rear-ended on my snowmobile and was thrown resulting in a back injury. Where as previously I only had sciatic pain, I now had back pain. It was not as intense as the sciatic was I could tell something wasn't right. On a flight between Michigan and Minnesota, I got off and my right foot had dropped. I had never experienced this before and I did some exercises to get the disk back in. By the time I was boarding my connecting flight, my foot was working again. A MRI showed that my disk was pretty much gone and the diagnosis was upgraded to "end stage degenerative disk disease". My new pain was the result of the back muscles spasming. I prescribed more PT. Great. I went to a small clinic and noticed that I wasn't being given exercises, but that he was focused more on massage of the muscles. This was not a sensual massage by any means. He was using his elbows to really dig into the muscles and loosen them up. Surprisingly, it was working! My back was feeling better and my sciatica improved too! There were actually days (plural) where, other than in the morning, I was actually pain free! Of course, the script ran out and the pain has started to come back. Saw the doc again today and he had three suggestions: Do nothing, another epidural (last one, if this doesn't work we give up) and a fusion. Everybody says not to do a fusion until you can't bear the pain. The doc doesn't want to do it because I'm only 41. The thing is, because of the accident aggravating a pre-existing condition, I'll be able to get the insurance company to pay for the surgery, my time off and something for the pain & suffering. This is not a package deal that I'll be able to get in 10 years. My question is... how bad was the fusion? Is it really 3-4 months off? What did you do for income during that time? Was it worth it? How bad do I need to get before the fusion? With the package deal, should I really be considering moving the surgery up? The doc says he will be able to cure my sciatica with the fusion because the offending disk will actually be gone. That alone would be worth it.
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davedsel responded:
Hello and welcome.

I have never had spinal surgery as my back problems are worse than any surgery could help. I have been doing extensive research over the 35 years that I have been managing back pain.

Have you seen a spinal orthopedic surgeon or spinal neurosurgeon? These doctors are the best and diagnosing back problems and offering effective treatment plans. Have you seen a pain management specialist? The best ones are physiatrists as they offer a variety of treatments, not just prescription pain medication.

Any spinal surgery is at best 60% successful for pain reduction/relief and 80% to increase functionality. There are many risk during any surgery and recovery time can be as long as you say. If you decide to have the surgery, you must adhere strictly to the surgeon's recommendations for recovery.

Only you can decide if the benefits of the surgery are worth the risks. Get at least two opinions from different spinal surgeons. Do your research and fully understand all that is involved.

I pray you can get answers and relief soon.
Click on my username or avatar picture to read my story.

Blessings,

-Dave
 
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Anon_24008 responded:
This sounds like a real junction in your life. I agree with Dave, definitely get a couple of opinions. The surgery you're thinking of having is a huge one. I too was told I had DDD & needed fusion. The surgeon was very well respected, told me "I can get rid of 70-80% of your pain". I jumped at it.It's now 15 yrs. later and after the 1st surgery and a re-do I'm worse off than when I started. I'm NOT saying this will happen to you. But I'd be rather cautious of any Doctor that says he can "cure" your Sciatica. I've never heard that one. Usually with conditions like yours, as it's playing out, they continue to get worse. So if I were you do your homework, get a second opinion maybe a third.
One thing you really need to consider is your financial future as well. If you do have the coverage for "everything" from surgery, rehab, med.'s wages etc? Taking into account, are you going to get better or worse in the next yr or 2 or?? As for being off for 3-4 months? Forget that if your getting a fusion, it can take many months to heal up. It just depends on the extent of your surgery? When they're putting in rods&screws or cages to stabilize after they take out the rotten disk?? They can't really say anything for sure until they actually get in there. That's what makes this kinda surgery a real bugger and why you need to be as well informed as possible.
I really hope things work for ya.
 
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TnD1w replied to Anon_24008's response:
My surgeon is actually gently pushing me to postpone surgery. They'd like me to wait 10 more years until I'm in my 50's. Generally my sciatica has been stable for the last 7 years or so. I do get flair ups, but I can deal with a constant 3-4 for pain. This back pain is something new and my sensations have not deadened to it yet. PT helped a lot, but it's becoming obvious that it would need to be continuously maintained for it to be of benefit. As for "curing" my sciatica, I have a new, albiet small disk bulge that is giving me trouble. They won't operate on it, but by removing the disk totally, the offending piece would also be removed.


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