advertisement
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

The main site has all the formal medical articles and videos for you to research on.
advertisement

Deciding on surgery-L4/L5 PLIF fusion

Hi everyone,

This is my first post, although I've been reading for some time. I'm trying to decide on fusion. My low back pain started in January 2013 and quickly progressed to severe nerve pain down my right leg into my toes. I finally went to my regular doc and he ordered an MRI. The MRI showed a large fragment impinging on the nerve root at L4/L5 and spondyolisthesis and my doc referred me to a neurosurgeon. Turned out to be a large synovial cyst. Had surgery to remove it and all pain was gone. About a month later the pain returned but this time on the left side. I was referred to a pain doc. I've had several epidural and SI injections over the past year or so and 2 rounds of physical therapy without any success. Pain doc ordered another MRI this past July and referred me back to my neurosurgeon stating I had failed conservative treatment. My spondyolisthesis is a little worse than it was a year ago and I have some scar tissue or the possible return of another cyst. My neurosurgeon suggested fusion but also said to hold off on surgery as long as I can. I have good days and bad but the bad outweigh the good. I'm usually much better in the morning and as the day wears on the pain gets progressively worse. By the time my kids are in bed I'm done and on the heating pad the rest of the night. I have bad muscle spasms and nerve pain in my left hip going down my left leg. It's so bad sometimes just switching my weight from one foot to the other is agonizing. I'm 37 next month, have 3 kids under 6, and am sick of living like this. Everything revolves around my back pain. However, I do have good days and on those days I wonder why I'm considering surgery. I don't know what to do. I'm terrified of making it worse or surgery not fixing the problem. Sorry for the book! I don't even know if this makes sense. I'm just rambling and I feel like my family is sick of listening to it. Any advice would be appreciated!! Thank you. : )
Teresa
37 years old
DDD at L4/L5/S1
Spondylolisthesis
Lamenectomy to remove synovial cyst March 2013
TLIF at L4/L5 March 10, 2015
advertisement
1

Comments

  • Thank you for the info Sandi!

    I would love to hear from anyone with a similar situation and what made you decide to have or not have a fusion.
    Teresa
    37 years old
    DDD at L4/L5/S1
    Spondylolisthesis
    Lamenectomy to remove synovial cyst March 2013
    TLIF at L4/L5 March 10, 2015
  • I would weight all my options before I have surgery, you will need a great support system, without it things can be extremely difficult. My Doctors were very infomativeon what I can expect, and the rough times my recovery will be. Pain can change your personality and sometimes the medications can make things worst if you abuse it. Remember your PAIN will not go away after your surgery, recovery takes time and I would read others post from people who are going through, the same problems you are. Be encourage at those who help you with kind words and support.
    My best advice is to stay positive, and remember you are going to have a lot of bad days(painful), which can be expected. My surgery was 9/8/2014, I had lumbar laminectomies L4, L5, S1 L4 Gill procedure, L4-L5 Fusion with autograft and allograft. The pain at times can take a toll, but I remind myself this is going to take time to heal and I have to stay strong, I know it is easy to say but there are a lot of us out there with this issue and we have to be brave. Don't feel bad when you get emotional upset, just remember you have inner strength that will prevail. I always come back to this forum for support when I am in extreme pain and look for encouragement from others who had this procedure. My recovery is a long way down the road, and I have had more bad days than good(still waiting)days.
    Ronald J. Geron
  • advertisement
  • PeggyMcPPeggyMc Glendora, CaPosts: 16
    Hi Teresa, what a situation - 3 little ones and back problems! A couple of things come to mind. When you had your first MRI, did they see anything other than the spondylosthesis or cyst , like a bad disc? One month after you had the cyst removed, you started with pain on the other side, did you ever experience the pain here before? Before a year and a half ago? Did you hurt yourself within the last year?
    If I were you , I would definitely get a second opinion with another Neuro. I would also ask your regular doctor (or ortho, whomever you trust) if you could try a steroid pack like Medrol or Decadron. I would also get a Velcro soft, back brace for some support. The heating pad is awesome. I know from lots of experience !
    I am thinking that after only a year and a half of pain, a fusion is a BIG surgery to jump to. Of course, I'm not a doc, I only am a patient. I struggled off and on for 20 years before I had my first surgery and that was not a fusion. It was a lamenectomy, discomectomy. Then I had a fusion a couple years after that. Now I'm recovering from my 3rd and 4th fusion surgery. (ALIF PLIF 360). I'm 52 years old.
    I'm so sorry you are going through this and I hope you get some really good advice. You will get great support here ,on this forum, but like Ron said, you will need lots of support at home. I mean LOTS!
    Please keep us posted! Peggy
  • t1018rosstt1018ross Posts: 20
    edited 09/25/2014 - 2:08 PM
    Thank you Ron and Peggy for your response. Fortunately, I do have a wonderful support system. Most of my family lives close by and all have offered help. I forgot to mention that I also have DDD at L4/L5 and L5/S1. The back pain is not as bad as the nerve pain. Right now it's in both hips and going down both legs to my knees with lots of muscle spasms. One of my reasons for not wanting to wait is I feel like I'm missing out on so much with my kids. I should be able to play with them in the backyard, not be stuck in a chair. The pain makes me grumpy and short with them. I completely agree about pain changing your personality.

    Ron, wow you've definitely been through it! Praying you'll begin to have more good days than bad and a good recovery.
    Peggy, if you don't mind me asking, are the 3rd and 4th fusion a result from having the others? I know that having a fusion can cause stress on the the discs above and below.
    Teresa
    37 years old
    DDD at L4/L5/S1
    Spondylolisthesis
    Lamenectomy to remove synovial cyst March 2013
    TLIF at L4/L5 March 10, 2015
  • Oh and no, I never had the pain on the left side before I had get cyst out and I haven't hurt myself. Not sure what even caused all of this. I have twin boys and I'm sure the pregnancy didn't help anything! I also had to have a c-section with them and my physical therapist said that having my abdominal muscles cut weakened them which may also have contributed to the problem.
    Teresa
    37 years old
    DDD at L4/L5/S1
    Spondylolisthesis
    Lamenectomy to remove synovial cyst March 2013
    TLIF at L4/L5 March 10, 2015
  • advertisement
  • Hi Teresa,
    I hate that you are going through this and having to make this decision. I had the ALIF surgery last Sept. on the L5 S1 and have never gotten out of pain since. I have DDD and my L5 disc had collapsed, so 2 different neuro surgeons recommended the fusion. I had numerous injections as well as physical therapy, and nothing helped, so I decided to move forward with the fusion. Unfortunately for me, it did not solve the problem and I am still in terrible pain. After more injections and physical therapy this year, my surgeon has now diagnosed me with SI joint dysfunction and I am awaiting another surgery on Oct. 6th to have the SI joints fused too.

    I know everyone is not the same, and only your surgeon can help you make this decision, but I am with Peggy (we became friends on this site) and recommend that you get a second opinion and ask about doing the steroid pack first. It is a huge surgery, so please believe me and Peggy, when we say, there are NO guarantees that this surgery will make the difference.
    I am praying now, that if this SI fusion surgery gets approved for me, that it will be the end to this pain, but again, no one can guarantee it will work.

    It's great that you have the help you would need at home if you do proceed, that is key to recovering from a fusion. Please just make sure it truly is the disc that needs replaced before moving forward. I don't know that Peggy or I would have done anything different with having the surgery, but just go slow and seek another opinion if you can.
    Good luck and please keep us all posted as to your decision.
  • Thank you for the advice! That's exactly what I'm afraid of, the surgery not fixing the problem. My neurosurgeon doesn't think a myelogram or discogram is necessary to determine if that disc is the culprit. Did any of you have either one of those done?I'm definitely leaning toward getting a second opinion, although I do trust my current doctor completely. He's not pushing this on me, in fact, he told me to wait as long as possible. I wish there was some diagnostic test that would tell exactly what is causing pain! I hope your SI fusion is approved and provides some relief. This pain is no joke. As far as the steroids go, my doc prescribed a Medrol dose pack before I had the synovial cyst removed and it really helped. But you can't stay on steroids long term right?
    Teresa
    37 years old
    DDD at L4/L5/S1
    Spondylolisthesis
    Lamenectomy to remove synovial cyst March 2013
    TLIF at L4/L5 March 10, 2015
  • The user and all related content has been deleted.
  • t1018ross said:
    Hi everyone,

    This is my first post, although I've been reading for some time. I'm trying to decide on fusion. My low back pain started in January 2013 and quickly progressed to severe nerve pain down my right leg into my toes. I finally went to my regular doc and he ordered an MRI. The MRI showed a large fragment impinging on the nerve root at L4/L5 and spondyolisthesis and my doc referred me to a neurosurgeon. Turned out to be a large synovial cyst. Had surgery to remove it and all pain was gone. About a month later the pain returned but this time on the left side. I was referred to a pain doc. I've had several epidural and SI injections over the past year or so and 2 rounds of physical therapy without any success. Pain doc ordered another MRI this past July and referred me back to my neurosurgeon stating I had failed conservative treatment. My spondyolisthesis is a little worse than it was a year ago and I have some scar tissue or the possible return of another cyst. My neurosurgeon suggested fusion but also said to hold off on surgery as long as I can. I have good days and bad but the bad outweigh the good. I'm usually much better in the morning and as the day wears on the pain gets progressively worse. By the time my kids are in bed I'm done and on the heating pad the rest of the night. I have bad muscle spasms and nerve pain in my left hip going down my left leg. It's so bad sometimes just switching my weight from one foot to the other is agonizing. I'm 37 next month, have 3 kids under 6, and am sick of living like this. Everything revolves around my back pain. However, I do have good days and on those days I wonder why I'm considering surgery. I don't know what to do. I'm terrified of making it worse or surgery not fixing the problem. Sorry for the book! I don't even know if this makes sense. I'm just rambling and I feel like my family is sick of listening to it. Any advice would be appreciated!! Thank you. : )
    Hi, As the other post's suggest, I would do your research and find the very best Orthopedic / Spine Surgeon available in your area.
    I consulted with 4 Surgeons, within the last 4 years, before I felt comfortable preceding with the surgery. It is a big deal, so write down your questions , concerns etc. ahead of time so as not to miss anything. I might add that my first MRI showing an issue in the lumbar area was back in 2002. From 2002 until March of this year, I did everything possible to avoid surgery i.e. Chiropractic , Decompression Machines & Core Strengthening. However,after these non-evasive techniques were exhausted, I concluded that surgery was my final option. I too had good and bad days regarding pain prior to surgery.
    My status currently is pretty good. I'm walking 2 + mile per day with very slight discomfort . My pain level overall is about a 2-3 on a scale of 1-10. After my 5 week post op appointment I was back to driving. I'm now scheduled to return to work on 10-13. Based on my progress, this seems plausible.
    I think one of biggest challenges with this type of procedure isn't so much the surgery as is the sedentary life style your thrust into. This because other than walking, your not doing a lot physically. I'm hoping it's all worth it in the long run as only time will tell. However, at this juncture it looks positive. I hope some of the information helps. Good luck to you with your potential upcoming procedure!
    Regards
    Bilateral L5 spondylolysis L5 with grade I anterolisthesis L5-S1.
    Stable multilevel degenerative spondylosis contributing to mild canal
    narrowing L2-3 and L3-4.
    360 ALIF & PLIF L-4 - S-1 on 8/11/14
    Regards
    Eric
  • I'm 45 and had a L4-5 discectomy in May 14. Pain returned with a vengeance as the disc is collapsing and crushing the nerve roots without morphine if I stand for more than ten minutes I'm crying with pain. I'm having the surgery to prevent further / permanent damage. If the pain is less, that's a bonus.

    Steve
    L5-S1 herniation. Both knee meniscus tear. L4-5 herniation - 2 x nerve block injections. L4-5 discectomy. L1-2 nerve block injection. L4-5 reherniation - TLIF fusion. 2016: L1-2 and L5-S1 retrolistheses and multiple facet joint degeneration.
advertisement
Sign In or Join Us to comment.