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PAINFUL DDD, 35 years old, Dr. says no to fusion.



  • Considering a fusion at any age is a big undertaking. The decision for a 35 year-old to have a fusion has long-term consequences. That is, a fusion limits motion in the segments fused. More loading and pressure is inevitably put on the discs/joints above or below a fusion.

    So, if you have degenerative disc changes at L4-5 and L5-S1 and have those segments fused, then at some point there surely will be issues at L3-4 and levels above the fusion.

    Additionally, where there was not a clear response to the discogram I wonder what the likelihood that a fusion would fully address your pain. There certainly would not be a guarantee that you pain would be better.

    I think it is worth revisiting your physical therapy and exercise interventions. It sounds like you have tried a lot of things but I would find a good McKenzie trained PT and see if you can make progress from that angle. It would be worth exhausting nonsurgical options before thinking about a multilevel fusion at your age.
  • I agree with RETIREDBOSN. I see it time and time again with people that have one surgery inevtibaly have lots more surgery waiting for them down the line. I hear a lot of people say they wish they never had the first surgery.
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  • I had a fusion surgery at 34 due to DDD. I am 40 now and the 2 discs above the fusion have herniated and slipped forward because of the original fusion. Doctors dont want to do another fusion on me now either. I am in soo much pain all of the time and I have tried and done everything there is out there. It has not gotten better. I new when I woke up that it did not fix my problem. Please get several opinions and make this your last option. Be ready for the consequences because it might not be the answer. I just had a dorsal column stimulator implanted and it doesnt even control the pain in my legs, knees and feet, much less my back. I really feel for you because I have been there and I would do anything to have made different decisions back then. God Bless you and I hope that you get the relief you are looking for.
  • I am 40, been dealing with a herniated disk at L5-S1 for 8 years, had a Laminectomy 2 years ago didn't help. The doctor said I was too young to have a fusion at 38 and I didn't want to have one. Now 2 years later still in pain L5-S1 now has DDD and I saw another doctor one of the best in Atlanta and he said fusion so I'm getting it done on Feb 5th. My insurance will not cover a ADR but they will cover the fusion and my doctor said he's seen a lot of ADRs fail. Just like everybody else said get a 2nd opinion.

    I've been thinking a lot about this, I just think its strange, when I was 38 I was too young to get a fusion, but now I'm 40 and their like we'll get it now before you get older, your not getting any younger.
  • I got hurt on the job in 2007, had several months of meds, PT, and even 1 injection which I had a reaction to. I then after being sent to my 3rd surgoen thanks to workman's comp finally had an L4-L5 microdecompression surgery. I felt good after that for a while, 1 1/2 years later I was admitted to the hospital for iv pump pain management after just fixing my hair for work. About a year after that I had another flare up but only for 2-3 weeks. Now it's been 10 weeks and I can barely sleep. I was taking almost 12mg of dilaudid and 2 advil pm just to sleep but it stopped working so I stopped taking it. My surgeon from 2007 recomended now with the new advances that I do a 2 level L3-L5 fusion. Well according to my workmans comp insurance he is no longer on their board. That was 2 weeks ago. I'm waiting for them to send me to another dr and do a new MRI. They said they needed last years records first. Nice of them while I sit here in pain... My lawyer re-opened the case and if we don't get an appt in 10 days he's making a motion to the court to continue treatment. I was really secure and comfortable with my surgeon and now I'm scared having to see a new one. He was saying with the advances he would definately consider me a candidate at just 31. He said he uses cages with a protien sponge to stimulate bone growth instead of a bone graft. Anyone else heard of that??
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  • I understand your concerns with multiple surgeries, etc. But for example I fell off a roof ten years ago, fractured a vertebrae and have never been the same since. I have spent TEN years with back pain. I haven't been able to play with my kids, play softball like I did in high school or play any sports competitively. I have gained 70 pounds too. Its awful. I have had it. I have had enough. I want at least a "chance" of being in less pain. I think once every conservative option is worn out and several years have passed, your age should not be as much of an issue. Thats just my opinion, I'm not a doctor (but I am a lawyer) ;-) (which of course has nothing to do with it) But it interferes with my ability to do my job and my job is hard to do on Percoset.
  • Anonymous said:
    I am 35 years old and have had lower back pain for about 10 years now...diagnosed with DDD 8 years ago. My pain has gotten to where it's constant...can't bend over, stand...walking is a chore! I had my first lumbar epidural, it lasted for 3 days now the pain is back. My Dr. said there is "no way in hell" he'd do a spinal fusion on someone my age. Anyone else been told that? Spinal fusion that bad?
  • yes, fusion in the continental us is not recommended.
    they are using new technology in europe for ten years now and waiting for our FDA to approve here. the problem being you will be doing a fusion every two to three years because the surrounding bone will eventually degenerate, once you are engaged to this type of surgery consider yourself married to it for life, i am personally waiting for the FDA to approve the method they use in europe currently.
  • I am somewhat like you...I compression fractured my lumbar vertebrates about 10 years ago. I am now suffering with DDD, still loose bone fragments, and the apparently "new" osteoarthritis is making bulging disks, herniate. S1 absolutely does not move. I am also a recent widow with 3 children...and I am so devoted to finding any way possible to improve what I have. I would like to hear from others like us, because it really is hard to have THIS back and try to keep up. Expectations people have of you at this age are very high...they look at me like I am nuts...then see the latest MRI and they are truly shocked. I have seen MRIs of people much older and they look sooo much better than mine. I do not feel sorry for myself and I don't live off pain meds...but I understand feeling under pressure to "perform" and you can't.
  • im not exactly the same case, but i have DDD at t9-10 & t10-11 and they wont do fusions either. on that note, im barely 20 years old. diagnosed at 19, and the first dr. i went to said no dr. would even give me an injection, much less a fusion. i am in extreme pain all day every day with absolutely no relief ever. i have had 3 injections, none of which helped even for a day. age for some reason is a big factor. which i dont understand AT ALL. might as well do it when we're young and can bounce back and BEFORE we become immobile from pain. there are already days where i cannot move without excrutiating pain and tears, and im 20. dr.s are nuts.
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