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whats the truth folks ???



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  • Tony,

    Fusions as you know work for some, and not for others; or there are after surgery complications that are rare. My first fusion 'gave me back' my life, no question. I wasn't 'major' educated on 'adjacent level failures, but even if I where, I would still have had the surgery. Everything has risks, right? My last one, not so good - more intervention coming for that mess. In hind site, I still would have underwent my last surgery - (lol) but would have insisted on a plate not my 'wing.' :)

    From what I've seen of your posts Tony, "internally" I think you know what you need to do. I truly hope that the discogram results are such that this experienced surgeon can bring you back to some sort of normalcy. You and I both know, NO surgery is a guarantee, but with what all you have been going through, your choices are getting "easier" (hate that word) to make? Please let us know how it goes. You're really good people Tony. **HUGZ** :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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  • Here is how it is -- you know i've been there and am living it every minute. YOU WILL NEVER BE THE SAME AS YOU WERE WHEN YOU WERE A YOUNG MAN. You need to accept that -- right now. You are a miserable bag of pain at the moment -- yes, you are -- I know -- I've been there. You will have the surgery and the first few days you'll think - this isn't so bad, I think I'm going to be okay. Then you will have days of searing pain again. You will have stiffness and soreness and burning down your legs again and you'll think "why did I do this to myself? I'm so miserable. Why didn't I listen to those who said multi-level fusions were not a good idea?" Then after about 18 months to 2 years (yes, it REALLY takes that long), you will think - "hey! I feel really pretty good!" This is the most DANGEROUS time. This is when you decide you can lift that load of gravel in the wheelbarrow to take it into the back yard. You can split wood if you want from a felled tree. NO YOU CAN'T. You must accept, before you head into a multi-level fusion, that your spine is not normal. Yes, they can fix it for you. Yes, in time the pain will be much relieved. But, you will never go back to doing all you did before. If you do try that, you will damage the discs at other levels. The fused part of your spine with be a fulcrum against which you can damage all your other discs. Resign yourself to a limited physical life, but one without the excruciating pain your are now experiencing. Know that you can have relief, but you must always guard your spine. I really believe you'll be fine. I am -- as long as I make myself realize that I have to take care of my back.
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • After a fusion there will be certain things you won't be able to do again. In my case though, I couldn't do them before because of the chornic back pain - so I'm not too bothered that I can't do certain things now, 6 weeks after a 2-level fusion.

    I'm not sure I agree with the notion that having a fusion always puts added stress on the discs above and below and therefore it seems that people have gone on to have further fusions at adjacent levels. The reason I say this is because when I first hurt my back 5 years ago, it was confirmed at the time through MRI that L5-S1 was the only disc causing the pain.

    After loads of treatment, 2 discectomies etc. (you know what I've had Tony), when I eventually had the discogram before surgery, it confirmed that two discs were pain generators - hence the 2 level fusion 6 weeks ago. What I'm trying to say, and probably not explaining myself very well, is that I ended up with a 2 level fusion when I thought I was going to have a one level.

    Suppose I had a one level fusion up to 5 years ago - then experienced chronic back pain again and had to have another level fused, I would have automatically thought that the first fusion had done the damage. When in fact it was degenetive changes that would have happened anyway - do you see what I mean?

    It may be that at some point in the future I MAY experience further back pain and may need further surgery, who knows - but I firmly believe now that these changes could have happened anyway and may be nothing to do with the surgery I've just had.

    The most important lesson I have learned over the years is that I did not (and would not) do anything to make my back worse. I may decline to do some social activities if I feel it would compromise my back - but I would have done that anyway because of the resulting pain it would give me - I know there are certain things that I won't do again, but to be quite honest, at 53 would I honestly expect to be doing things now that I could do when I was 20 - I don't think so. And I'm more than happy with that.

    If I continue to be protective of my back I don't see why I cannot enjoy life to the fullest of my current abilities. If my circumstances change, they might have changed anyway. The most important thing about having the surgery is that I DO NOT HAVE THE SAME BACK PAIN AS I'VE HAD FOR THE PAST 5 YEARS - AND THAT'S A SUCCESSFUL OUTCOME as far as I'm concerned.

    There are no guarantees and I think you've voiced what everyone facing surgery feels. Your specialist, I'm sure, wouldn't offer any surgery unless he thought you had a good chance of experiencing a better quality of life afterwards.

    It's a decision I also agonised over - but ultimately what kept me going was positive thinking. To be able to fly long-haul to visit my daughter who now works in the USA - all I need now is to be able to try and save the money to get there (which is difficult now I'm on half pay at work!). There are pro's and con's with everything, but I couldn't carry on the way I was. Working was becoming such an issue that, in the end, if I didn't have the surgery it would have affected my ability to do my job. I'm seeing the Occupational Health peeps this Friday who will determine if I'm fit enough to return to work in a months' time - but to be honest, if I'm not, I'm not going to worry because I know I WILL be fit enough to do something else perhaps.

    If I don't do anything stupid, then the surgery would have given me the chance to have options that perhaps I wouldn't have had before.

    It's not long now till you have the discogram - everything seems to depend on the results of this. With your faith in your surgeon, I'm sure whatever the outcome, he will advise and reassure you so that whatever decision you make (and you seem to favour surgery if it is offered) you'll be a 'patient' patient - knowing that for a time you will need the help and support of your lovely wife and family. Accept it with the good grace that it is given and when you're able, you will hopefully be in a position later on to help them if ever they need it in the future.

    I know you're worried about 'personal cares' etc. but that's what family is for. Maybe, Social Services could offer a care package from a male assistant for a short period of time until you are able to do things independently - could you contact them to discuss your concerns first and see what action you may need to take (if that is an option)?

    I hope I'm managing to explain myself properly Tony.
    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 !!
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  • I so relate to Linda...and she is certainly the voice of reason!!

    For me, the decision to have surgery was fairly clear. I was in terrible pain; my legs were numb. I could not continue to work at my job...I was...disabled.

    I was going down fast, and the fusion seemed like the only option to become "well" again. I had to take the chance since I did not see much hope without surgery.

    Now...what is "wellness". It certainly isn't what it was 5 years ago for me. I had to have endoscopic surgery last week because of the scar tissue, and have to have it again in 2 weeks, then maybe one more time. I have to wear a bone stimulator, since there was little fusion noted on my 6 month xray. That was 3 months I'm in limbo for now.

    So, I've had a few wrinkles in the recovery, but I will not look back. As Linda said...the is a long road. I'm still hopeful that I will go on to fuse, and maybe in 6-9 months I will have a similar story as Linda to tell...

    Take care,


  • Hi Straker,

    Sorry to hear your news. It has been a while since I have been on here and I was sorry to see you are still having troubles.

    As you may re-call (or not) I had a PLIF followed by 2nd TLIF next level a year later. Like others have said, I am a success in so far as lower spine finally stable, I'd say my original pains are "gone" (mostly) but I was one of the complications persons (migrated cage crushed L5 and was left for 6 months) and now my pain has been replaced by iatrogenic pain / nerve pain and mechanical pain. Am I worse off? No, not really. I have traded one pain for the other. Do I regret my surgeries? No, I was desperate (and prepared to die.I had reached the end of my rope, as it was then.)

    If you are desperate and can embrace the risks (you should discuss them with your doc and consider what that mean long term) then I think you know what you need to do. If you have doubts, you need to soul search. Is this the right time for you?

    Yes this is a HUGE surgery, huge risks but many people do regain a quality of life post surgery. Hope Straker. I wish you the best in what ever you decide.
  • I believe that both have valid arguments. Sue, I am inclined to agree with you however with a twist that leads into the mechanics of it all that Bkins explained. It being that the adjacent disc would have eventually failed, however the fusion just accelerated the process.

    Kind of like having a defect in the sidewall of your car tire. You may never know it exists if you always drive around town. However if you place additional load on it by traveling many miles on a bumpy road, it reaches a point where it can no longer handle the added stress and it blows.

    Most surgeons will tell you that they try to do only the very minimum that is needed to stabilize the spine. If the adjacent level is found to be holding its own at the time, they will gamble and leave it be, in hopes that the patient will get a few more years without it being a problem. It seems that very few surgeons will do "preventative maintenance" when it comes to the spine.

    Tony, I hope you get to a point where you are able to get some sleep. One thing that I have done to help alleviate my fears, is to write them down. Write them out in exactly the words that they create inside my mind. I then go back and read what I wrote down, and it somehow no longer has as strong of a hold on me. It's not something I would write to share with others, but the gut wrenching reality that I have inside, that needs to be let out.

  • I've read most of this, been a while since I had time to come visit.

    Anyway, I agree with many and "C" in particular as to not being able to deal with the what ifs should I turn down a possible improvement. I would forever be wondering what if. My wife and I did the very same questions when I underwent my second arthroscopic procedure. Knowing that if he found the dead bone had softened the cartilage the I would wake up with a partial shoulder replacement and months to years of recovery time. Yeah, you guessed it, of course here I sit 2.5 years later, with the titanium cap and? yeah, my shoulder still hurts. Do I regret the procedure? No, I fully believe that I would be far worse if I had not had it done. Not only would my shoulder hurt, it would not function properly on top of it.

    I try to look at it this way, when my Bi-polar depression lets me. I try to compare my now to my just before surgery days. NOT to the days before the accident! Most of us don't ever get those days back.

    I bought a T-shirt while on vacation, it says "Scars are tattoos with better stories" (not realy helpful I know, I just needed a new T-shirt! :D )

  • SueD said:

    I'm not sure I agree with the notion that having a fusion always puts added stress on the discs above and below and therefore it seems that people have gone on to have further fusions at adjacent levels.

    Let me throw a theory out here.

    The reason that I believe, and has been explained to me by two different surgeons, that the upper and lower discs are at more risk after having a fusion is that those areas, the upper and lower discs, have to carry the load that the fusion area previously carried. It is really just basic mechanics.

    Think of what a pryamid looks like with a very wide bottom and a very small top. The reason for the wide bottom is to be able to carry the load of everything up top. As you go up to the top less and less downward force is present and therefore less size and width is needed to support the load.

    Our spines are much the same in that the top, cervical area, is much smaller in size then the lower lumbar areas. The one big difference here is that our spines in order to be able to move have a disc between each level. When you take out a disc and fuse two levels together you are creating more load on both the top and bottom adjacent levels. The added load that is now not being cushioned by the area(s) in which a fusion took place gets transfered to the lower adjacent level mostly but some also gets transfered to the above level as well. All discs in our backs were designed to carry a certain amount of weight, or load, and when discs are taken out that load has to go somewhere. If you look at the discs between each level in a spine you will see that they not only are bigger in height, and wider in width as you go from the cervical area down to the lumbar area.

    Does that make any sense?

    Anyway, from a engineering standpoint it makes sense. A fusion will always add more loads to adjacent areas that were not designed for it. This may or may not create more problems as it in a large part depends on the health of the adjacent disc's. You and everybody else are wise to protect your back from further loads once you know there is a problem.
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