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Impending L4/5 fusion surgery.

Scott in the UKSScott in the UK Posts: 136
edited 06/11/2012 - 8:46 AM in Lower Back Pain
In February this year I had Percudyn Stabilisation Surgery at L4/5 and after a few months it became apparent that there was a problem again.
I revisited my surgeon for a follow up and had an x-ray taken prior to the consultation.
During the appointment I told the surgeon that the pain was returning and I wasn't happy.He stated that according to the x-ray it seemed as if one of my implants appeared to have retracted a little.
Following a CT scan and a Bone scan over the following three weeks I received a letter stating that after seeing the other scans it was confirmed.
My surgeon is now suggesting fusion of L4/5 following the removal of my implants and I have an appointment to discuss this on September 9th 2010.

What should I expect if I have the surgery as far as recovery times etc,pain levels etc,etc.

Can anyone think of questions I should be asking my surgeon at the consultation next month ?



  • i had an l4/5 fusion on january 6 and i consider mine a success, although i still have stiffness and pain in the back area. mine was for stenosis, facet problems and spondylolisthesis, so i don't know if recovery from l4/5 fusion for disc problems is different than what i had fusion for.

    but in any case, it's considered major surgery and you can expect a fairly long recovery, although like jelly said, it really varies from patient to patient.

    i've included two links below, one is 38 questions to ask your surgeon before having back surgery:

    and the other is preparing to meet with a spine surgeon or specialist:

    these come out of the sh faq section.

    the questions jelly suggest are good ones, but i think it's fruitless to ask the surgeon how long your recovery is expected to be (just my personal opinion). it really is what it is and although you'll get an answer, it might make you worry if it's taking longer or if it's shorter.

    i've read that generally you feel better at 6 months and back to normal at a year. i can't tell you if that's true, but that's the normal expectation.

    take care, scott and please update us on your appointment.

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  • Firstly, each person has a different experience of recovery from lumbar fusion surgery.

    Some have a really difficult time and others (like me) are surprised and very relieved to find that it wasn't as bad as they feared.

    I went into surgery prepared for the worst but hopeful for the best.
    I got lucky!
    I have been told by several medical people, that my recovery was amazing, and they think that all the walking and exercise I was doing before surgery, to try and avoid it, helped with my recovery.

    It has still been hard at times and very long!

    There is a thread on here of questions to ask your surgeon.
    Some things that come to my mind are:

    Will you have to wear a brace?
    What access will he use - posterior (back), anterior (front) or side?
    What type of bone graft will he use? (autograft, allograft or synthetic, BMP type)
    What post surgical restrictions will you have while you are recovering?
    How long does he think it will take to recover? (Often surgeons are very optimistic here - mine said 3 months, but I was warned it was likely to be more like 6 months. Actually at 3 months I have been pretty much recovered, from the worst of it. :-))

    I'm sure that others will have other ideas.

    I suggest that you do go well prepared for your appointment, with questions written down. It is so easy to get distracted by something said, and then forget the questions that you wanted to get answered.
  • nearly 4 weeks ago and I definitely feel it's been successful. The pain I had in my back totally disappeared immediately after the surgery was done - and has continued to stay away, thank G-d.

    I had a fusion at L5-S1 and L4-L5 and although I'm left with pain if I sit for too long, which I'm told is due to the dynamics of my back being changed during surgery and post operative swelling - and residual discomfort in my legs from time-to-time (if I overdue it too much) - on the whole I'm delighted with the result.

    Everyone has different reasons for back pain obviously and some outcomes will therefore be different, but on the whole, I think if you can improve your core strength, get as fit as you can within your physical limits, have a good support network and have trust in your surgeon there's no reason why your outcome can't be a good one.

    Like someone else said above, I was expecting the absolute worse after surgery, but with the right pain medication and good physio, I was walking up/down stairs the very next day, which really surprised me.

    Here in the UK they don't tend to use a brace - I think that sounds extremely uncomfortable and restricting and there's no reason why you cannot move more naturally with your physio's guidance. I am not able to bend, lift, twist, push or pull (although I don't know for how long - probably until the fusion has been successful I guess?) and do try to protect myself from doing so as I don't want to compromise the good work of the surgeons.

    The reason I had the fusion was because of degenerating disc disease, facet joint osteoarthritis and right foraminal stenosis - the surgery sorted it ALL out in one go as far as I am aware.

    You will have loads of questions - I asked about 30 when I went for pre-assessment! (and alot of the questions under FAQ were extremely helpful). Also, the surgeons showed me exactly what my problems were on the MRI and what the surgery aimed to achieve. They also said how many procedures they'd done over the last 15 years and what the expected success rate was (but I do appreciate you cannot always take this as read because everyone's experience is different).

    I also attended a spinal support group in York which was invaluable as the people there had gone through very similar procedures over different lengths of time and were able to answer lots of my other questions. They were very reassuring and the surgeon attends these sessions as well. Their next one is on Saturday 25 September at 10.00am - if anyone would like more information on this group, send me a PM and I'll happily give you all the details OK?

    Find out as much as you can and what you might need to do in the meantime to improve the outcome, if indeed you are a suitable candidate for such surgery. Also ask the surgeons what you need to do immediately after surgery to help yourself and when you can expect to drive/work again etc.

    There's probably lots of things I've forgotten to say, but I've been sitting for too long already (browsing!) and need to go and lie down!!!!

    Please let us know how you get on OK?

    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • Hi Sue and others,

    First of all thanks for your replies and I can only apologise for not replying sooner.
    I forgot to 'tick' the box asking to be notified of any posts on my thread.
    I've got my 'Pre-Surgery Appointment' tomorrow to take bloods etc and make sure I'm fit for surgery.This usually means that surgery happens within a month of this appointment but I haven't got the appointment yet.
    The list of questions to ask will hopefully prove very helpful so thanks for that.
    I just want something done now but it's a viscious circle.I was always really fit and teaching judo as well as working in a prison,but now I've managed to put on almost 2½ stones in weight due to inactivity so I'll be starting post surgery with a hill to climb.
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  • scott , watch out for that elusive op date ,
    I had my pre ops in may , but wasnt given a date , Like you I thought it would be within a few weeks ,
    i only just got my date last week ,
    Its still within the 18 week policy !!
    So you could wait 18 weeks for your op date !!!
  • Blimey Jamie,
    That sounds a bit crap to say the least.
    I went to Coventry this morning(70+ miles)for my pre-op checks and I found out that there is a surgery due to take place on October 19th but there are 3 other people waiting for the same procedure as me so it all depends who the surgeon thinks is most urgent.

    Fingers crossed.
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  • is that you guys/gals in the UK get all your pre-op bloodwork and checks done and then wait for months after that for surgery. In the healthcare system I use, 30 days is the maximum amount of time your pre-op stuff is valid for. If it goes to 31 days, it all has to be reaccomplished before the surgery can take place.

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