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DR RX SPINAL FUSION T10-S1 or just L4-S1

Drs (3) Rx spinal fusion T10-S1 for pinched nerves, herniated disc, etc. in L3-S1 and scoliosis above those.  Most of my pain is lower back, sciatica down both legs, and pain down the outside of one leg.  Have had mostly successful cortisone injections for about 6 years, have had unsuccessful RFA.  I am 66 years old (too old for disc replacements) and have been on adequate pain medication for years, until the opiod crisis took most of that away.  (Totally discriminatory for responsible seniors).  Had a hip replacement 3 years ago which is doing well.  Dr says the larger fusion is the RX to take care of the L3-S1 problems and to straighten the deformity fusing up to T10.  He says if I go for the smaller fusion, the workload moves to above L3 and will probably put much more stress on the L3-T10, which will probably need to be fused at a later date.  My questions are in regards to the amout of loss of mobility by only fusing L4-S1, and then loss of mobility from the larger fusion.  Either one really freaks me out as I hear mostly horror stories about any fusion.  Also, concerns about personal care after surgery. (Especially if you c

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  • CParke - welcome to the forum!  I understand your concerns about fusion surgeries and the fact that people seem to be only too happy to share their 'horror stories'.  It was that fact alone that stopped me from telling anyone prior to my T9 - S1 fusion surgery 4 years ago at age 58.  I am definitely a success story. I had a 51 degree lumbar curve that was causing pain in my calf and numbness in my toes. My back symptoms were mostly a tired feeling, sometimes feeling like it was being compressed, but no real pain. But the pain in my calf made it impossible to stand for more than a couple minutes. Walking, even pacing back and forth, and sitting alleviated that pain. But it was getting worse. Saw an orthopedic spine surgeon and discovered a scoliosis that was not present 3 years earlier and likely had developed within the past 18 months. I didn't hesitate about surgery and 3 months later had my 10 level fusion surgery. Today I am back to living my life in pretty much the same way as before my surgery. Of course my flexibility is reduced but you just figure out different ways to do things. People looking at me would not know I have 10 levels of my spine fused. I have absolutely no regrets - just living my new normal.

  • https://forum.veritashealth.com/profile/179811/urbmshr. 

    Thank you so much for your feedback.  Thr conservative part of me feels I should do the smaller fusion but then do I want to chance having a 2nd fusion when I'm a few years older when it would be harder to recoup!  I'm 66 now.  Or am I better off with the  larger fusion and getting it all taken care of!  Big decision!  Also scary with the Covid19 thrown in right now! 

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  • Welcome CParke we’re glad you’re here!

    Fusion surgery is scary and you hear a lot of bad stories, I have had 2 lumbar fusion surgeries, 3 levels total and I consider both a success, I am fused L3-L5 and lost very little if any mobility.

    While you’re waiting for a reply to your first post, please take a few moments to review the Code of Conduct and FAQ section, located under Forum Tools. There you will find important information about posting in the forum and helpful tips for new members.

    Have you seen the Spinal Fusion Health Center on Spine-health? Spinal fusion surgery comes in many forms, and you’ll find a number of doctor-authored resources here, including Types of Spinal FusionPostoperative Care for Spinal Fusion Surgery, and tips to help Maximize the Ability to Heal After Spine Fusion Surgery. It’s a great resource for anyone considering spinal fusion. I hope you find it helpful.

    Again, welcome to the Veritas Health Forum.

    Chip 

    Veritas Health Forum Moderator

  • Thank you

  • https://forum.veritashealth.com/profile/179811/urbmshr.&nbsp

    Are you able to do much with your feet? I put cream on my feet daily, which my hubby could do. But I have a couple of bad toenails that I have to mess with almost every day, or they really hurt, and rough heels that I file everyday.  These aren't things he could do adequately!  I'm not so concerned that I wouldn't be able to tie my own shoes, but the thought of never being able to touch my feet again wouldn't be too good.  I know these things sound petty, but I'm a little OCD and anal about many things!

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  • CParke - these things are not petty at all. It's amazing how the little things suddenly become the big things when you are unable to do them.  I'll be honest, doing anything with my feet is challenging and it is because my spine is now rigid in the area that needs to bend to reach those faraway toes.  I used a sock aid (which was my favorite tool) and elastic shoelaces for my tennis shoes for a couple years just because it was easier. I am fiercely independent and did not want to have to rely on anyone for getting dressed or any other basic need. That independence thing is both a blessing and a curse. I completely understand your concern with your toenails and I'm thinking it will be difficult with either of the fusions you are considering. Right now I have a pretty good routine. I put my foot up on a stool that is about 30" tall and bend the other knee as needed to get low enough to reach my toes. Sounds kind of weird but that is what I do. Maybe practice ways now to find something that works for you. Have your husband watch to see if you are keeping your back straight. I did find it easier to put my foot up on the 30" stool when my hamstrings were flexible and when I had lost some of my belly weight. Again, if you practice this now you will discover what your limitations are. Maybe pedicures on a regular basis are in your future - that might be nice.

  • https://forum.veritashealth.com/profile/179811/urbmshr

    Great info, thank you so much. I had to use all the same things when I had hip replacement 3 years ago as I couldn't get to my feet then either.  I used the sock helper, the elastic laces, a grabber tool,, potty seat lift, walker, cane, a tool with a hook,, a long handled back scrubber, etc.  It's funny though, I don't remember my feet things being such an issue then.  I'm sure most of my concentration was on just getting from point A to B!  This was a good reminder how our priorities change and how we do manage to manage.  I was able to handle my own potty wiping personal hygiene after the hip surgery.  Reading that's not possible after this surgery?   

  • CParke - I had no trouble taking care of my own potty hygiene. The only thing I absolutely needed help with was for bandage changes. Those were daily for the first two weeks. I also wanted to comment on small vs long fusion. This option was not presented to me as I believe the only goal in my surgery was to stop and correct the curve which was moving fast. And even though I had an excellent recovery with very little pain I wouldn't want to have another spine surgery if the adjacent segments begin to weaken. I am happy to have 10 levels 'locked down' to reduce the added load on the above vertebrae. I remember the surgeon saying to not wait "too long" because by the time I decide to have the surgery they may not be able to do it due to soft bones, other age related health issues, worsening conditions with my spine etc.. One and done would be my motto.

  • https://forum.veritashealth.com/profile/179811/urbmshr

    I really appreciate your input.   I tried to put foot on a stool approx 28 inches tall and I could reach my foot!  Now I  just have to get limber enough  and do it with a straight back.  I'm currently doing PT and we're adding more leg strengthing exercises.  We're doing core also.  I'm trying to lose some weight and get the rest of my body in the best shape I can before surgery.  I figure it can only help.  I had complications when I had hip replaced 3 yrs ago.  I was in ICU for a week and lost all muscle mass. It sucked as I had to go to rehab and my recovery took a long time.  Did PT for almost 2 yrs.  It' works pretty good now.  I only have pain at incision, scar tissue.  You'll never know how much help you are to me.  I'm very happy someone told me about these fourms.  Hopefully you don't mind if I  keep asking questions.  Thanks much.

  • CParke - ask away, I'm happy to help.  :)

  • Hi, CParke - 

    Welcome to our forum family! I wanted to chime in because I had a T10-S1 fusion in 2017, and now - after much time, work, patience, struggle, more patience, more time, and much help from my wonderful PT and my friends - I am back to feeling GOOD, which I never thought would happen. So it is possible! I was a serious cyclist before my back pain took me away from riding, and then discovered that my scoliosis had increased to 50 degrees...so I had to have the fusion surgery to decrease the pain and prevent further curvature. It was really, really hard, I cannot lie - but I had so many wonderful people helping me through the most difficult months (the ones following the surgery) that I was able to heal and work on regaining strength and my new mobility. I have good days and bad, frustrations and successes...and I'm learning to follow a sort of mantra that life, like a hike in the mountains, is "a little up, a little down." And that's just how everything is, I'm finding. I'm almost 58, so no spring chicken, but I'm REALLY glad I had the fusion done. I have all kinds of pointers fo how to prepare for surgery (pre- and post-) if you have specific questions. Please feel free to ask ask ask - that's why we're here! Wishing you the best of luck with your decision. 

    -MorningGirl 

  • https://forum.veritashealth.com/profile/174849/MorningGirl

    Thank you sio much for sharing your story with me. Being 66, I'm no spring chicken either!  Hearing other peeps experiences really helps me to not freak out so much!   I have lots of questions (of course!)  How long did you have to wear a brace?  To be blunt, were you able to wipe your own ass?  When I sleep, I really twist, turn and bend.  I don't "logroll", I lift up my upper half, twist, and turn over in place.  I'm sure that is a NO after this surgery!  I would love to hear any/all pointers both pre and post.  You can't give me too much info.  Give me all the nitty-gritty.  I'm one of those people who needs to plan for all these things.  I think it helps keep me from stressing out! Thanks again.

  • Good morning! I'm happy to share about my own experience - of course, everybody's is going to be different, but there are things I wish I'd been prepared for before going into it! In any case, here's what I can tell you about mine: I didn't have to wear a brace afterwards -- they put two titanium rods (with screws) on either side of my newly-rearranged spine, grafts placed between vertebrae, and I just started using a walker basically the day after the surgery. It was slow going for a LONG time - at first, I went only from hospital bed to bathroom and back (and yes, I could do all the bathrooming on my own as long as there was a raised toilet seat. What I couldn't do alone was shower, or semi-shower, as I couldn't get the sutures wet...my mother had to help me with that for a few weeks). I was in the hospital for 7 days after the first (posterior) surgery - the big one, where they put the grafts and rods in - and when I went to my parents' house to recover I kept working on walking, at first just down to the end of the driveway and back, and eventually down to the stop sign and back (it took about 6 weeks to get to the stop-sign point). After the second (anterior) surgery, where they put a few more grafts in down in the sacral area, I only stayed in the hospital for a couple of days. That surgery seemed minor compared to the posterior one!

    So I guess I'd say that these are my pointers:

    -Be sure to have a bed rail (they will show you how to use it!), shower chair/stool, raised toilet seat, a decent walker, and a bunch of "grabbers" (you won't be able to pick anything up off the floor) for post-op. You might also want some kind of little bag that you can sling over your shoulder to keep your phone and other small items in...I found that I wasn't able to put stuff on the walker tray without its falling off, and I used that bag ALL THE TIME to keep necessities with me.

    -If you can, get an attachment for the walker that will hold a bottle of water, because you'll want to stay hydrated, and fetching water will NOT be on your docket until you are more mobile. Also, there are other walker gizmos that you can look at online - see what you think you'll want.

    -At home, lift all rugs from the floor, if you can - the walker won't go over even thin throw rugs (wall-to-wall carpet is okay)

    -If you are recovering at home or anywhere other than a rehab (I did not go to rehab), have someone help with organizing your meds regimen, getting the visiting nurse/PT/OT scheduled, preparing all meals, and setting up everything you're going to need in the room that you spend the most time in. 

    -Once home, you may need a low footstool to put your feet on when you are sitting in a chair. I had footstools in three locations so that I had more than one option for a sitting spot (it got boring pretty fast!)

    I'm gonna stop there. There's more, but I don't want to overwhelm you, and I think this covers the basics as far as I'm remembering them at the moment. If I think of anything else important, I'll write some more. Best of luck to you as you move toward whatever surgery you end up having! 

  • Thanks much for the info.  I'm  leaning toward the T10-S1 route at this point. Kind of a one and done!  I was reviewing my MRI from 2019 info and remembered I have herniated disc at L1-L3 as well as L4-S1.   Most of my pain is in my legs which L4-S1 are responsible for.  So that's why I was going to consider just doing the L4- S1. But now remembering that L1-L3 is herniated, etc.,  plus the scoliosis,  it sounds like the T10-S1 is the route to go. Next Wednesday the 15th,  I'm having a CT scan, Bone density, and a scoliosis xray.  After Dr sees more about what my spine really looks likes he can probably explain the reason for the large fusion.  I'm a very visual thinker so seeing the films will help.  I'm very leary about going into any hospital with the Covid.  I don't think you can have anyone visit, and I feel that I won't get as good of care as the medical staff is spread so thin at all the hospitals.  I think our hospital has only 5 cases.  Our county has 195 cases, which isn't bad. My plan is to have the surgery in the fall after the weather cools off.  The problem with that timing is that in another 3 months the Covid could be alot worse in this county.  It was 103 today.  I live in northern Ca in Redding.  Do you mind if I ask where you live?  

  • I'm in CT, where we're on the edge COVID-wise (too many people here think it's over, for some insane reason)...Sounds like your county is in MUCH better shape than ours! It definitely is hard to plan a surgery with this going on, but if the benefits outweigh the risks, then it's gonna be okay. We can't predict the future, is all I know! 

    I agree that seeing your imaging will help you decide what you want to do and when. And your surgeon should also, I hope, be helpful to you in the decision-making process. Keep me posted as things progress - it's great that you've found this forum, as it's a great source for information and support!

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