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    debating whether to have the spinal fusion
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    abbey123 posted:
    Hello,all.My Dr. is recommending I have a spinal fusion on L4/5 and a laiminectomy.I have been in severe pain for years so I went to a neurosurgeon,who ordered a MRI-hence the suggestion for surgery.My question is--does anyone know of good results?I have been researching this and I can't believe the horror stories! I would also like to know how much this surgery costs.My ins. will not pay on any problems with my back.I would appreciate any advice anyone can give me.
     
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    cweinbl responded:
    Spine surgery has a success rate of 80% for improved function, but only 50% for improved pain (http://www.painphysicianjournal.com/2009/july/2009;12;699-802.pdf ). In other words, having less pain after fusion surgery is just a crap shoot. You run the risk of permanent nerve damage from the surgery (like me) and you WILL generate plenty of fibrosis (scar tissue) after the surgery (like me). Scarring can also impinge a spinal nerve root, creating just as much pain as before. Even if the surgery is successful, you could end up with more pain from implanted metal hardware impinging your nearby tissues. More about that later.

    If you have collapsed vertebra and/or spinal instability, then you might have little choice. If you do not have instability or collapsed vertebra, and a surgeon recommended fusion, I would get a second and third opinion. In fact, I did.

    What you can do is find the best spine surgeon in your region. A spine surgeon is a neurosurgeon or orthopedic surgeon who has completed a fellowship in spine surgery and devotes his or her entire practice to trauma and disorders of the spine. Spine surgeons possess the latest research and techniques. They are far more experienced and talented than a standard orthopedic surgeon or neurosurgeon. Spine surgeons can often be located at or near teaching hospitals. Having gone through all of this myself, I would not allow anyone to touch my spine if they have not completed a fellowship in spine surgery (I don't care how many thousands of surgeries they claim to have performed).

    The other thing that you can do is research the different spinal fusion techniques. For example, today's spine surgeons prefer to use rods, pins, cages and screws to fuse a spine. Metal hardware provides instant stability, without the need to wait months for a bone graft to grow and solidify. But, implanted metal hardware has been known to impinge tissues, including ligaments, connective tissue, fibrosis and even nerve roots. This "new" pain can be as disabling as the pre-fusion discomfort.

    The more traditional type of fusion requires a bone graft from your hip or from a cadaver. In this method, it can take up to six months for the fusion to become as hard as any other bone in your body. So, the recovery could be longer. However, this method implants no metal hardware. There is no chance of tissue impingement.

    Only after conducting research can you adequately discuss with your spine surgeon your preferred method of fusion. This should be a frank and honest discussion with the surgeon. You have the right to demand whichever type you prefer. Frankly, after hearing some horror stories about patients whose implanted hardware impinged nearby tissue, I think that I would request the older, more traditional (bone graft) fusion. But, that's just me. And, I've had four failed spine surgeries.

    Whatever you decide to do, do it with the piece of mind of knowing that you conducted plenty of research, that you met with at least one spine surgeon and that you are pleased with your choice of technique. If you have any questions, I can be reached at [email protected] .
     
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    Mizjoyb replied to 5yearsofpain's response:
    I too have had a good bit of back pain and had a discectomy laminectomy on L5/S1 several years ago. Was wonderful for about 2 years, much less pain and then I re-injured my back. I did not want to do surgery again as I also have generative disc disease. I did the injections again and they did not help. My doctor did a lot of research and then referred me to a chiropractor for IDD therapy. www.iddtherapy.com has a lot of good information. I've been out of treatment for over a year and have about 90% of my life back. It's a wonderful thing. I still need an adjustment here or there but overall I'm doing great now.
     
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    nmm3327 replied to donna53058's response:
    I have had three back surgeries, fushions, lots of screws, plates & it's still hurting. Also had 5 dics in my nect fused last fall & just had a CT to see why it hurts so badly. Can't have an MRI 'cause I have a pace maker. I had the CT 2 weeks ago Wed & the dr still hasn't called me. Have called so many times to leave message. Al of this is so frustating. I'm too old for all of this!!
     
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    cathpat56 replied to cweinbl's response:
    Hi
    I've had 4 major spine surgeries, all including laminnectomy and fusions, I am in such awful pain with a diagnosis of Failed Back Surgery Syndrome.Also during my 3rd surgery they put in a Harrigington Rod which causes even worse problems.I know there may be no alternatives but in my advice would be to hold out as long as possible before undergoing spinal fusions
     
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    BarbJoG responded:
    I had fusion of L4/5 and a laminectomy in June 2005. I had dealt with it for 5 years prior to that with chiropractic, massage, pain meds, muscle relaxers, exercise, therapy, heat, ice, TENS unit. Standing was my biggest problem, pain wise. But the pain exploded on me Feb. 2005. In April I had an MRI and a Milogram. It showed that the mild herniation that I had been diagnosed with in 2000 was now severe. I couldn't vacuum, cook, or grocery shop. The pain was the worst I had ever experienced. I had pain relief within a few days post-surgery. My neurosurgeon said I didn't need PT, to just start walking. Things were OK for 2-3 years. Now, I am dealing with a mild herniation above my fusion and bone spurs forming on a lot of the other vertabrae. Surgery for one problem does not make arthritis or other problems of the spine go away - it just corrects that one problem. I wouldn't hesitate to do it again if I ever experienced the kind of pain I had in 2005. I had insurance so I am not quite sure of the total cost, but with hospital, specialists and surgeons, etc. I'm sure it was thousands and maybe tens of thousands of dollars. Talk to your hospital and doctor for an estimate.
    It wouldn't hurt to get second and third opinions. Take test results already done with you. Have you looked into chiropractic? It can't hurt to try, but you have to give it a couple of months to possibly see affects.
    Good luck.
    Barb2787
     
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    vardag responded:
    Hi. Whenever I hear these days of someone suffering from lower back and leg pain I feel I must tell them about Neurofencine. I know how bad this pain can be. I suffered from radiating back pain down my right leg and toes as a result of a herniated lumbar disc. My doctor recommended surgery, but I decided against it. After several weeks on various pain medications which did not help much, a friend of mine who did undergo surgery like you are describing, recommended that I try Neurofencine, a new health supplement that is helping her. I began taking Neurofencine (bought it online) and after a couple of days it helped my pain and I continue to take it. I really think you should try it.
    Iris
     
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    cohengirl replied to cweinbl's response:
    Hi there, just read thru all of your stories, wow! this is great. thank you . first, how sad is it that many of us still cannot afford health insurance which always pisses me off. Come on Obama, it's time already!! I am so sorry Joy that you are suffering, it is so difficult. I know. i myself am experiencing back pain since early 2009. All due to a herniated disc with shooting pain from the butt down the r. leg. I have been to many different orthopedic doctors because i wanted to see what each would say about my condition. Because of my age no one really wanted to do surgery but recommended the steroid injections. I tried one in Nov 2009. that didnt' help at all. I tried Celebrex and some other pain killers. my friend also gave me some Vicadon that made me sick. Beginning of this year i finally decided to go to the doctor who had done great work for a couple of my friends. this doctor i was told, would cost me $325. up front for the consultation visit. So I went only to find out from him - that my back would not have the outpatient surgery my friends had. Due to a multitude of other spinal problems i have, spinal stenosis, major scoliosis, and sciatica, herniated disc, i would have the spine fusion surgery, with the inplant of donor bone and a metal plate and 4 wks recovery at minimum. That was depressing. I dont even know what i did or how i got a herniated disc. Just good ol wear and tear. He referred me to a surgeon who could do the steroid injections. The first injection was great. the pain really diminished and i could actually walk without my sciatica flairing up. I had another injection 4 or so wks later, they say to do them close together. My body had a very bad reaction to that one. The next morning i woke with cramps so bad i called 911. I think it was just gas or something but i have experienced some tremendous shifts in my body due to the steroids. I am not sure i want to do anymore of those, but i dont want to have the surgery either. I will say that i have definitely stopped having to use the ibuprofren so much. After the second injection i began physical therapy. I have been doing for the last 4 wks. My body is getting a bit stronger but sometimes it just starts to hurt and not want to move. The one thing about the steroid injections is it did alleviate the major part of the pain. i can function, i still feel uncomfortableness where the disc is but this is way better. Now as i come to an end with my Physical Therapy, i am determined to keep going with a home program strengthening the necessary muscles. I know it is difficult to endure but know that there is a reason for this and that you can overcome, no matter what!! stay positive, because your spiritual wellbeing will promote a healthier body. and listen to your body. trust yourself. Only you know what your body needs. with regards to finances, you have to be responsible for your life, so do what you can do. many doctors will give discounts if you pay cash, making payment plan. It's just so weird when one day your healthy and then suddenly you're not!! My best to all of you and Joy, you will be alright. Believe you are going to find the right doctors and keep searching till you have.
     
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    Vicki4650 replied to bj1208's response:
    I also had surgery on my back in 2000 L5S1with screws --cage--and metal plate. My pain is different after surgery numbness in my right leg I see a pain management Dr. who gives me epadurals and trigger points 4 times a year--be careful having surgery there is always side effect of some kind sometime the result is worse the orginal problem
     
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    cyboren responded:
    we just got home today from my husband having a fusion at L4-L5. He had the surgery on tuesday. He has alot of pain right now from the incision when moving from one position to the next, but walking does help reliev the pain. He is on percocet now, which he is extremely suprised is actually relieving the pain, because it never even touched the pain prior to the surgery. We are still in the early stages of recovery but have high hopes. We do know that the radiating pain in the upper back and down the left leg are gone, so if you have a surgeon you feel you can trust, and has good reviews with I would go for it. We do have insurance but I do know that the surgeon fees are approx 12,500 and the hospital stay, 2 night in our case was about 14,000. I'm not sure if either of those include anethesia. I'm sure it is expensive to anyone whether they have insurance, money or neither, but if it works It may be worth it to you. The cost for us out of pocket was about 1,200, which was well worth it. We spent 4 times that last year in copays.
     
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    Michael66049 responded:
    21 yrs ago I had a "slipped disc" which pressed on my spinal cord at T8-9.A neurosurgeon removed the calcified disc, and all seemed fine. After some months of physical therapy, I could walk with a cane. I had no pain, just spasticity. So I got an implanted Medtronic pump to give me Baclofen intrathecally, to calm the jumping legs. It worked well. But then pain began, so morphine was added to the Baclofen, then Fentanyl--in my view a placebo--and finally Dilaudid (Hydromorphone) which made my pain go away completely for a while. But soon it was back to Percocet at least 2x daily. By 2000, 11 years after the original injury, I could no longer teach at my university and had to go on Disability. 9 years after my pump was replaced in 1999, that model was recalled and I got a new one at Medicare's expense. Unfortunately the implant surgeon didn't know what he was doing, and the pump started delivering its contents directly into my flesh, rather than through the catheter into my spine. This put me in a coma for 3 weeks, and many people thought I would not survive. But one day I woke up and asked what was going on. Since then, I've been taking oral Baclofen (which does not keep my legs from jumping) and Percocet, which does about as good a job of controlling pain as the pump did. I've lost so much muscle tone, though, that I'm stuck in a wheelchair. Because of rotator cuff surgery, I even have to use an electric wheelchair at home. But my wife says I'm much sharper and less forgetful without the pump.
    I've considered more surgery and spinal fusion, but reading the stories on this site has made me very skeptical. I'm going to wait until something better comes along; I know that plenty of research is going into this for the aging Baby Boomers. I'm slightly older than they are, but what's done for them might benefit me.
     
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    painbeenandseen responded:
    Dear abbey123
    I am sorry to hear of your predicaments.
    The stories are true.
    Surgery should avoided if possible.
    The problems with all pain treatments (including surgery) is that there is an inadequate diagnostic workup to pinpoint the source of your recurring pain like spasms, stiffness pain down the leg.
    That is why 'failed back surgery exists.
    Or failed treatments due to treating the presenting condition such as muscle spasm which is a secondary condition with the root causes being ignored or missed out.

    I would suggest consulting a pain sepcialist who is a interventionist (one who does diagnostic blocks to identify root causes) and consider facet jopints and sacro-iliac joints as the possible causes.
    if this is so then consider pulsed radfreuqency neuroablation
    It certainly is cheaper than surgery
     
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    catmom999 replied to RMS1970's response:
    I had the same exact surgery as Rich December 2003 in the exact same place!. I was hurt in a horse riding accident when I was 13 and had the surgery when I was 38. I waited so long to have surgery because I was told the success rate was only 15% so I didn't want to chance it. My ortho at the time told me to never have a fusion. The procedure has come a long way since then. I am thankful I had the surgery. The recovery was difficult and I had a lot of pain until I had the hardware removed 3 years after the surgery. I've been pain free ever since. The procedure was considered experimental at the time and my insurance didn't want to cover it but after a fight they covered the $260,000. my advice is to make sure you have a very good surgeon if you decide to have surgery. My surgeon had never performed this procedure before me but I did research and had total faith in him.

    I wish you the best in your search for a pain free life,

    Carrie
     
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    vesuvius13 responded:
    I have had two successful fusions and would have them again. They are difficult surgeries and recovery isn't easy but many people have good results from them. I will point out though that like any surgery the results can be worse than the pain you had before surgery.
     
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    dfoskey1 responded:
    Hi Abby,

    I have had low back pain for 25 yrs or so. I had heart valve surgery in 2007, and my back pain seemed to worsen. I was refered to a neaurosurgeon. At first he did MRI's of my whole spine because of pain in multiple locations. I had ignored the pain all that time, because I was younger and stronger (dunmer). He said I had 2 ruptured at C3, C4 and 2 at I think S3, and S4. He also saw damage at L-2,3,4. It took me 3 years to get the cardiologist to sign off on the surgury, because of the blood thinner from the valve surgery. He suggested doing C3 and C4 disk replacement and a fusion at C-2,3,4. He said it would take the pressure off of the nerve bundle. I was a little apprehensive, since I had not really had pain at cervical area. The pain was intense in my low back. I ageed and did everything he asked of me. It was done in jan 2010. It reduced my overall pain level from a 7-8, to a 3-4. Now I only have to use 1 or 2 pain pills a day, compared to 4 or 5 before. It worked exactly like he said, and the pain is managable now.

    As far as cost, I have good insurance. It appears to be in the $80,000 range. IT WAS WORTH EVERY PENNIE!!! I know it is not the same for everyone, because our bodies are so different. It looks like I may end up with around $1500 out of pocket. I know the other areas are going to need to be repaired someday, but I am going to live with it for as long as possible.

    I hope this helps, and good luck to you.
     
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    Colleen003 responded:
    abbey, I had a failed spinal fusion surgery in 2003. I was told by my pain management Dr. ,after the failed surgery ,that the reason I had the surgery to begin with was NOT to relieve pain, which was my reason for having the surgery. I was told by 3 different Dr's orthopedic surgeons and neuro surgeons that it would relieve pain. The pain management Dr. said I was misled. The reason for the surgery was to stablize my spine NOT to relieve pain. If this is the only reason you are seeking this surgery DON"T DO IT!!


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