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lumbar fusion- does it work?

fredffred Posts: 1
edited 06/11/2012 - 8:47 AM in Chronic Pain
I am a 47 yo male I had discectomy/laminectomy at L5/S1 about 5 mos. ago. I am still expieriencing moderate to severe lower back pain, at this point they are telling me that a fusion or pain managagement are my only options. What I want is to be able to return to work, relativly pain free. I trully don't see imagining my pain isn't there to be a realistic option for returning to work, that may work for times around the house, when I can sit and relax. What I would like is any opinions regarding the fusion surg. If the general opinion is whether is is worth the risks,I feel if theres a chance I can be better maybe I should go through with it. Thanks for any info


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  • Have you done ALL of the conservative management steps?

    Fusion works sometimes- I believe I've read that depending on the doctor it can be as low as 50% or as high as 80% (is that about right? feel free to correct). The problem being that no doctor admits to being the 50% doctor, of course.

    But when you've done the physical therapy, the injections, the minimally invasive procedures, etc- what other choice DO you have? Just be sure to get a great surgeon!

    Also, make sure to see surgeons who offer other options, such as disk replacement and other high-tech stuff. Not that you would choose those things, but it's always best to investigate all of your choices.
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  • Welcome to Spine-Health. You'll find a lot of great articles on this site as well as some amazing videos (animated, so not gross). Check out the fusion ones, it might make you feel better.

    I had a lumbar fusion this past January on L4/5 and I can say that I'm much better than I was before. I still have problems if I walk too much or stand too long, but that doesn't compare to the fact that I couldn't stand for 10 minutes without major pain before the surgery. I also feel myself improving as time goes by, although you definitely can't measure improvement in days, just weeks and months.

    Tony and HB are right when they say make sure you have a great surgeon. Many of us here would suggest that you find a fellowship-trained spine surgeon, ortho or neuro, but one that only specializes in spine surgery.

    Good luck on your decision. I consider both of mine a success, for what it's worth.

  • Welcome to Spine Health Fred,

    My 2 level PLIF was great for me. I had a lot of instability and anything less than fusion would have been a waste of money.

    What are the tests that you have undergone? Can you get a second opinion?

    I will tell you that while my lumbar spine feels great. My neck went south (was always bad) about a year after the Lumbar Fusion. Now the neck feels great and I am fighting Thoracic Spine problems (car accident made worse)...

    Good luck,


  • Hi. First of all it is too soon for you to do anything. After a laminectomy you need time to heal, about a year. If you were having lots of nerve pain prior to the surgery the nerve needs to re-generate and heal. You will still have nerve pain for awhile after surgery.

    Now saying that if you still have pain after a year..then in my should try everything else first (epidurals, etc) before getting surgery. After my laminectomy I had two good years, re-herniated and then after a year of conservative treatment tried a non-invasive laser disectomy. It did nothing for me so my next move is Fusion which I think I am going to get done in December. If you are only 1 level I think you can also look a disc replacement.

    Just my 2 cents. Good luck.

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  • Hubby had fusion at the end of June. He is 66 and is doing really well. He walks daily, has started PT and is driving and puttering around in his garage. He is trying not to do anything he shouldn't but is in no pain whatsoever and, if he never gets back to complete normal, that is enough. But I think they are all right when they say you have to do the work and he has been faithful.
  • Fred,
    I would always go down the pain management aspect prior to any invasive surgery and only acknowledge that a fusion was necessary when the evidence and rounded opinion envisaged that, as the best and proportional option.

    Relative to the amount of fusions done statistically is may well have a good success rate and some here, myself included a fusion did not work for me, I would never use that as a measure of the overall potential and we as individuals have to decide what is the most beneficial decision give all the evidence and our current condition rather than the perception of how it may develop.

    It was suggested to me many years ago that fusions either work or do not which seems logical and if we are unfortunate to be in the latter group that distinction between hype and hope is harder to differentiate as time continues. What are your alternatives, if it is you that is in the minority then no amount of others success would reflect a positive outcome for you, even if only 5% are failures, that is of no comfort if it happens to be you. We all needed to be initially positive and taking that leap of faith into the unknown is always problematic and a question of time and hope.

    We all want to be back to normal and return to the person we once were, although evidence and experience here infers ongoing problems those who had success have the opportunity to move on.

    Take care and good luck.

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