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3 Level fusion L5-S1,L4-L5,L3-L4
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jayman920 posted:
Have a question, I have been having problems with my low back for several years, today I had my MRI results, and well he wants to do a 3 level fusion with rods and screws at L5-S1, L4-L5, and L3-L4. Wanted to get feedback from some people that had this done. Is this considered a major surgery? How long is the recovery? I did ask the doctor but value people that had this done. How long is the recovery etc etc.. What would happen if I didn?t have it done?

I?m a 39 year old male, and honestly it?s getting harder and harder to keep up with my kids.

Thanks Jay
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SharMaui responded:
I don't know where all our fusion people have gone we usually have plenty of people that have had fusions but this past week they seem to be no where around.

I was suppose to have a fusion and after researching fusions I just felt it was not something I wanted done at the time of my surgery so I just had a 3 level laminectomy/decompression surgery but I do face a fusion still in my future since my spine is not stable (it's still sliding) I can help you with your questions though.

Yes it is major surgery can't get much more major than a fusion. Recovery depends on the person no two people are alike with surgery. I'm not sure what you mean by recovery if it's time in the hospital it can be from a couple days to a little over a week. If you mean till when your spine fuses then that can be a couple months to a year. Spine surgeons consider a fusion successful if your bone fuses not if it relieves your pain. What would happen if you didn't have the fusion. That is a question for your doctor. Here is a site I copied for you that has at least 10 questions that you should ask him www.webmd.com/back-pain/guide/questions-doctor-back-pain. It's very important that you ask him/her these questions. You might want to get more information on fusions also. One of my favorite sites is www.spineuniverse.com and just type in lumbar fusions in their search box. It should give you videos and photo's and information on the subject.

Hope this helped.

Aloha Shar
 
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DianeR01 responded:
Hi Jay,

I had a L3-S1 fusion in October 07. I had repeatedly ruptured disks, L5 had slipped and I had mild scoliosis. I had previously had a successful 2 level laminectomy and diskectomy but unfortunately things went from bad to worse. My surgeon and I discussed more conservative treatment but we both knew we would be postponing the inevitable. We set a date.

My surgery was posterior, about 10 hours long. I was in ICU for about 8 hours and in the hospital for 4 days. I was released to my home to the dismay of the physical therapist but my husband was off work for a few weeks and able to help me. I also have a walk in shower (no tub to climb over) and rails for the toilet. I had problems with muscle spasms and was on muscle relaxants and narcotic pain meds. I had a brace which went from my collar bone to my butt. I was in the brace for about 8 weeks.

I returned to work part time after 6 weeks and full time two weeks later. I work a desk job and had to be careful not to sit too long. I healed well and found I overdid everything. By January I was in pain again but the surgeon could find no cause. I was back on pain meds for a few months but it started to subside by April. At this point I am mostly pain free. I do take a few ibuprofin from time to time.

How long to heal? Day to day activities like getting dressed including tying your shoes? plan on about 4-6 weeks. Long term healing and returning to doing things without having to think and plan and pace yourself? Plan on 6 months to a year. It has been 15 months and I can do just about anything I want. I walk 3 miles most days for exercise, ride my bicycle, stand, bend and I can pick my 20# dog off the floor. I do not climb well because of nerve damage to my feet and right leg.

Do not make a final decision until your surgeon has answered every question to your satisfaction. Please remember a successful fusion will not guarantee pain relief but will help stabalize your spine. The other thing to remember with a fusion is there is a lot of stress on the disks immediately above the fusion which may result in additioal problems in the future.

Only your doctor can tell you what could happen if you do not have the surgery. Everyone is different. One last thought. If you choose to have the surgery make sure your sense of humor is in good contiditon because you will surely need it!

I hope my story helps you in making a decision. I feel I made the best decision for my situation but there have been a lot of ups and downs between then and now.

My best to you

di
 
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Dot40324 responded:
Hi Jay, You have been given great advice already so I will just share my experience with you.

I've had 4 lumbar surgeries with the last 2 being fusions. The 1st fusion was my L5-S1 in 2004. Eventually the disc above my fusion slipped out over it and 9 months ago I had another level fusion.

He removed the old hardware, added another level (L4-L5) to the fusion and installed larger hardware, cages, etc.

It's really impossible to predict recovery times since each person (and their Dr's) are so different. I wasn't allowed to bend at all for the 1st 6 months this time.

While it has helped with the pinched nerve pain in my legs, etc, I still have lots of back pain. So just make sure you weigh all your options before making this decision. Once it's done, there is no going back.

I wish you the best and please let us know what you decide.......Dot
 
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bj1208 responded:
Hi Jayman - you have received a lot of good advice - but please do a lot of research before you decide to have surgery. I had my surgery in 2/08 - L5-S1 fusion - have plate and screws - this part of the surgery went fine. However I also had posterial tears in L4-5 that the surgeon said would not cause any problems - (the top of the plate is attached to the botton of L4-5) - so now I am having a lot of problems with that.

Recovery varies by person - so does pain relief - remember - the surgeon will state that they can repair/fix the dics issues but that they can hopefully reduce your pain by maybe 50%.

You asked what would happen if you don't have it done - well your bones could fuse by themselves and you could be in worse pain than you are now.

This is the same issues i'm having now with my L4-5 - it's been hurting me so bad since my surgery and really do not want to have another surgery.

Do all the research you can - start making a list of questions to ask the surgeon - I had a list of about 30 questions i had for my surgeon - didnt matter how ignorant the questions were i still asked.

Wish you luck - Joy
 
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MeMo3 responded:
Hi Jayman920!

Speaking from experience, I would tell you to do everything else possible to control your pain before you commit to surgery. Surgery is not a magic bullet, there are too many odds against it.

Wishing you strength in your decision making process and much success, whichever route you go.

MeMo
 
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brucekirs responded:
I have a long standing bad back. I have had 6 surgeries. My fourth was a fusion at L5-S1 with bone and fixtures in 1992. It was a tough surgery with a long recovery wearing a neck to waist brace for 23 hours.

After all those years I had to have 2 more surgeries over the last 2.5 years. I am not in pain in one leg whenever I stand or lie flat.

The orthopod says take out the old fusion (which is very hard after 17 years) and fuse three levels. My neurosurgeon (who has been my doctor for 5 out of 6 surgeries) wants me to try pain meds and a implantable nerve stimulizer which stops the pain from getting to the brain) before fusing three levels.

He says there is no other surgical solution since I have had so many. He told me some interesting things such a everyone's nerve degenerate over time, which is why elderly people have pain. He said because of my degenerating disc disease, my are probably degenrating faster.

I don't know what to do?

Anyone with experience in the stimulizer?
 
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Jof0808 responded:

I just had my L3-L-4-L5-S1 fused and a rods attached for support. My symptoms were the same as yours. I am 3 and a half weeks out from my surgery. You need to know that there are all type of little gadgets that you can purchase at a medical supply company that enables you to pick things up since you can not initially bend over, one to put on socks, long shoe horn, etc. At this point I am pain free, I am on the treadmill for 20 minutes and started three days prior to that at 10 minutes that exhausted me. My muscles were much weaker than I anticipated, but came to life very quickly. My back muscles get stiff and you will live with that until you strengthen them. On the other hand NO pain. I am currently sleeping in a recliner. Tried bed, but to sleep on my side and change the position, you have to roll and NOT twist your body. That is a NO No. Also, you can bend down at this time. I went back to the recliner because I knew my wife could not handle the rolling back and forth on my part. If you have a vacant bedroom, than that is an option. The beds in the other rooms for me are not an option. I am very conservative in my physical activity since it is my back and I know it controls my entire body flexibility. The healing process takes 3 months. So I am restricted to a treadmill, stationary bike and surface walking. Golf is 5 to 6 months away and fly fishing about 2 to 3 months, but someone will have to bend down and take my trout off the fly! Is it worth it? Tes, if not other options are not available and I tried all the other options from pain management, Chiro, PT, massage... The key is getiing a surgeon who has many years operating on difficult back/spine issues and then be conservative and patient in your rehab setting goals that require baby steps that in time progress into strides. Good luck!
 
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bj1208 replied to Jof0808's response:
Hi and welcome to the support group -

I just wanted to let you know that you are responding to posts that were done over 2 years ago -

I would like to say that I am very surprised that you are going thru physical therapy so soon -

I had a single fusion - Anterior Lumbar Fusion L5-S1 (done 2/2008) -

I don't know who informed you that healing process taking 3 months - this is not true as you can research fusion surgeries - especially multi level fusions - they can take up to a year to fuse or longer - I've spoke with several board members who have had multi level fusions and the fusions don't take - soon after surgery it is very, very easy to blow the fusion, thereby having to have another surgery -

Your back must first heal - this process can take from 6 months to a year let alone the fusion healing too -

I could not do any type of physical therapy until after my 6th month post op - I was one of a very few that fused 100% by my 6th week post op - but still that's too soon to do anything physical. I have what is called FAILED BACK SURGERY SYNDROME - basically there are several factors involved in back surgery; 1) the disc problem, 2) pain problems; 3) nerve root problems - so my operation took care of the disc problem but they could not do anything for the chronic low back pains or the nerve damage in both my legs - which is permanent. I did everything I was told to do and not do things to re-injure my back -

It's great that you are having good success with your back surgery, but we tend to not tell others how long recovery process is as we are all different and heal differently -

thanks for sharing - keep us informed - take care ^Joy^
 
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dianer01 replied to Jof0808's response:
Jof0808

As Joy said this post is 2 years old. If you look, I responded a few years ago. I indeed started out strong then had a set back about 3 months out. Do not over do it! You will be more misrable than if you take things slowly.

It is now 3 1/2 years from my L3-s1 fusion and I am still doing well but you don't go from fusion to completely healed in a few weeks, the whole process takes time and be sure to take yours.

my best to you

di
 
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KarenB1033 replied to dianer01's response:
Diane

I am encouraged by your outcome. My doctor is talking about fusing L3/L4 on me and will most likely have to fuse all the way down to S1. I am almost bone on bone at L3/L4 and L4/L5, so the likelihood is there. He won't know for certain until he gets in there to see how L5/S1 is doing. I have other issues with my lumbar spine and mid spine (mild scoliosis and rotation of the vertebrae is the above noted areas. There is also displacement of the vertebrae at L3/L4). As of now I have chronic sciatic nerve impingement on the left and acute on the right with no nerve damage in either leg. My goal is to have this repaired before I completely lose the rest of my discs to avoid permanent nerve damage in my lower extremities.

I am a physically active person and am curious, if you don't mind me asking, how old you were when you had your surgery. I am 48 and flat out tired of the back pain and limitations I have with my present condition.

Thank you for any input.

Karen
 
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bj1208 replied to KarenB1033's response:
Hi Karen - welcome to the support group -

Diane has not been on the board in a couple of weeks so am not sure if she is not doing well or just busy with family -

I can tell you from my experience (see my responses above) I was 47 when I had my L5-S1 fusion - I'm 50 now -

I know that you are looking at having the fusion surgery - but would encourage you to get another opinion or two - from either Orthopedic Spine Specialist or Neurosurgeon Spine Specialist -

This way you know exactly what your options are -

I do have a question for you - How did they determine if there was or was not any nerve damage in your legs? Did they do the EMG WITH Nerve Conduction Test? Most times, MRI's CT Scans or even Myelograms do not show if there is any nerve damage -

When I first went to a Pain Management clinic they did this test and found that I had nerve damage in my left leg and mild nerve damage in my right leg. All my MRI's CT Scans and Myelograms did not show this but did show the severity of my disc - at this they should have suggested surgery but I was sent from one Pain Clinic to another - each one saying they could take care of the pain in my back - it wasn't until after my surgery and seeing a Physiatrist Pain Clinic that I found out I was pretty much allergic to steroid injections and pain injections don't work - all treatments before and after surgery have failed. I have more pain now than before my surgery and the nerve damage in both legs is worse than first detected. I now have to have the EMG Nerve Conduction Test done each year to check to see if there are more problems - I just had it done a month ago and now it's showing L4-5 disc is pressing on a nerve root - so will be having an MRI done to see how bad my disc has changed.

So I would stress getting more opinions to make sure of all your options. As most of the members of the board would agree - Once you have the surgery there is no going back to redo it - And there is no guarantee that back surgery will reduce any pains - my surgeon stated he could fix the L5-S1 disc with a fusion but said there was a 50/50 chance of reducing the pains - I've been to too many physical therapist only to find that the strengthening exercises increase my pain levels with no known cause except chronic back pains -

Everyone is different and recovers different - so please get a couple more opinions before deciding on surgery -

take care - Joy
 
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dianer01 replied to bj1208's response:
I'm Here!

Thanks Joy! Life has been crazy, I am back in school, been working overtime and going on long walks with the dogs on the weekends.

KarenB:

Be sure you are going into the surgery for the right reasons, there is no guarantee the surgery will relieve pain. Your first goal is stabilizing your spine and if you are out of pain, you are lucky! I did not have any nerve conduction tests before my surgeries but we knew there was damage by the numbness and weekness. Turns out much of it was permanant.

For many years I have had issues with sciatica and ruptured disks, only I had powered my way through it. In 2007 I woke up on a Saturday morning with a familiar pain in my butt and by Wednesday I couldn't pick up my right leg or hobble more than a few steps. I was 45, active but not in good shape and about 60 lbs overweight. My doctor sent me for an mri and they sent me directly to the hospital for a laminectomy and diskectomy. Wow! Amazing relief but then 3 months later I had lost about 30 lbs and started walking daily for exercise and ruptured 3 more disks. I was working with a neurosurgeon and that was when we decided on the fusion. It took me a good year to recover and I questioned my choice many times but at this point I think I made the right choice.

Write down your questions, and keep asking questions until you have the answers you need. Do not hesitate to get a second opinion either. Please remember if you choose the surgery and it does not get you out of pain you cannot go back. There are no do-overs in back surgery.

my very best to you!
 
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8screws2rods responded:
Hi Jay, I had my 5th back surgery on 9 August which was an L3-S1 fusion to stabilize the spondylolisthesis that had developed at L5, decompression, herniated disk L3-L4, and bone graft. As all have suggested so far, do your on-line research. Knowing exactly what was going to happen and how it would be done was a tremendous stress reliever. Of the 5, this was by far the most extensive. It is indeed, major surgery. I was up walking by early evening the day of surgery. I am completely pain free from the problems caused by the conditions I stated previously. I had not been able to stand up straight for over a year and I can now do that with no radicular pain. I am very tender and sore around the incision but that is to be expected. I take Oxycodone every 4-6 hours as needed which has been about three times a day. It has only been 4 days since surgery so more to follow.
 
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bj1208 replied to 8screws2rods's response:
hi 8screws2rods - welcome to the support group -

you are answering a post from Jay from over 2 years ago - unfortunately, we have not heard from Jay since then - we do wish Jay well -

we do encourage you to continue posting to let us know how u are doing - I hope and pray that you continue to heal fast and well -

take care - Joy


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