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DDD above fusion

Hi everyone,

I had fusion l5-S1 in 2015 and had discography before surgery and it showed the disc was grade 4 degenerated and caused pain when pressurized. It also showed L4-L5 was grade 2 degenerated but didn’t cause pain when pressurized and since there was no pain my surgeon didn’t want to fuse it too. He did say it will probably start giving me problems in like 5 years or so. This past year my back pain has gotten progressively worse and am in constant pain. I am waiting for my workers comp insurance to schedule my appointment to go back. Has anyone else had the level above go out too or had a similar situation with DDD? Thanks for any input 

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Comments

  • needabreaknneedabreak Posts: 10
    edited 08/04/2019 - 10:56 AM

    I think this is very common. I haven't had a fusion, but I have various levels of degeneration on s1-l3 and the surgeon said I'd probably need a 3 level fusion at some point. I don't know the grades but L3-l4 is not quite as degenerated as the other two, and I'm only getting pain from l4-l5 due to a hernia pressing on a nerve.  But when the surgeon looked at it, he said I would probably need a three level fusion at some point because even though you'd think I could get away fusing only l4-s1 (since l3l4 isn't that bad), a fusion right below an already degenerating disc would fast track it's degeneration. Thing is, everything I've read says that more than a one or two level fusion for ddd is a very controversial procedure. 

    I'm really hoping to avoid this as long as humanly possible and just keep the pain manageable with drugs and therapy.

    What I've been curious about is suppose you just go for the multi-level fusion, and you just keep adding fusions to it as the discs above degenerate- one level every 10 years or so. What's the most levels anyone's ever had fused for this? I know people with scoliosis get some very long fusions, anyone ever get a long one for ddd built up over decades?

  • I had my first fusion on L5 in 2015, L3-L4 were recommended at the same time because of DDD, doctor made the statement that if he did all 3 levels I would probably not be able to continue working, I talked him into just doing l5, 1 year and 3 months later he did the other 2 levels, I went back to work after 8 weeks, moral of the story for me, do what the doctor says.

    Chip 

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  • Thanks for the responses. Break I to am worried about each level above going one after another. My aunts neighbor just had his fourth fusion done after starting with L5-S1 and working up. Good news for me is my L3-L4 is in really good shape. Luckily I got a really well respected surgeon thru workers comp which isn’t always the case and do trust his opinion. One other thing I have is a knot in the muscle on the lower back just to the right of my spine. It’s the size of a golf ball cut in half. I’ve had it for a few years and get sharp shooting pains to it and spasms around it. Only info I can find about it is it could be a trigger point? Any other ideas? Thanks 

  • needabreaknneedabreak Posts: 10
    edited 08/08/2019 - 2:38 PM

    I mentioned fusion to my pain management specialist because my surgeon had indicated I might need one in the not to distant future. She strongly advocated exhausting all other options first and getting a minimum of 2 opinions first, almost to the point of saying just don't do it. It struck me as an interesting perspective, because as a pain management specialist she's the one who sees people when the fusions don't work so well. So I'd recommend not only getting multiple opinions but getting multiple opinions from multiple kinds of specialists.

  • Anytime there is a fusion the discs above and below take the brunt of the work until they just wear themselves out. After 7 surgeries (starting in 1987, 2 in 2005, 3 in 2015 and 1 in 2016) I am currently fused from T2-S1. Scoliosis started it all, years later dealt with kyphosis, and now dealing with lordosis in my neck secondary to my kyphosis...and a host of issues with my SI joints degenerating and bursitis in both my hips, and my curvy neck. Research adjacent segment disease. 

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