Spinal Fusion?

Here is my brief history. Now 48, I have had a bad back for almost 20 years. In the early stages, episodes would be confined to one to three days at a time, but would getter better with rest. As time went by episodes were more frequent, and took longer to recover from. Then about 6 years ago, I had my first traumatic (prolapsed disc) episode when bending to put on a sock, then another 6 months later getting out of the car. I was diagnosed with degenerative disc disorder. In addition to these more traumatic pain episodes when it was so bad I had to call an ambulance because I couldn't move, the general level of day to day pain increased as well.

Eventually I was persuaded that I needed a spinal fusion at S1 because the disc was badly worn, and had a wallace ligament fitted to L3/4 L4/5 to support these two further worn discs. One year post op, I had another traumatic episode getting out of the car. I have subsequently had the two discs L3/4 L4/5 replaced with artificial discs. This seemed to help for 9 months post op but by 12 months post op the general level of pain and discomfort had returned to such an extent that I have not been able to work for the last 15 months. My pain is mercifully contained to my lower back, with no leg pain.

I was a bit like you with two small children, and my quality of life was suffering, I thought at my age, I wanted to at least give myself a chance of getting this fixed, but it hasn't worked. Would I have had so much surgery, if I new what I new now.

This is the big unknown. Would I have been better off, or am I still better off now than I would without surgery. The answer is you just wont no. Talk to a surgeon and they will advise surgery, talk to an osteopath and they will advise against.

My advise would be that surgery should be an absolutely last option when everything else has failed, then you might as well give it a go. You maybe lucky or like some people who find surgery to be the best thing that they could have done. If you have one bad disc and the others are fine, then you could be Ok, or if like me, spinal fusion just put more pressure on my other bad discs, it may not help.

I wish there was an easy answer, but I'm afraid there isn't, everyone is different, everyone has a different view on this. If you do opt for surgery make sure you find out as much as you can about who will be conducting the surgery, how many ops he/she has performed, and what are their sucess rates.

Good Luck

Thanks for your advice. I have only one disc bothering me now. I don't want to have surgery but have noticed the pain slowly progressing as you did to more days of the week, month, etc. I know the one doctor who recommended fusion has a good reputation and lots of experience. He was very confident that this could help. Although everything I have read shows that more than one level of fusion is exponentially less successful, and could place more pressure/stress on the other discs. Do you or anybody else know if just letting it go will cause any kind of permanent nerve damage?

I do get pain down the back of my right leg. I have tried conservative approachs. PT is helpful, but not enough. Anti inflamatories helped but seemed to help less and less the longer I took them. Also I do not want to take them long term due to the stomach problems etc that can come with them. I have not had bowel or bladder problems. What type of problems can this cause?

If you had impingement on the nerves which control bowel or bladder functioning, then doctors get nervous.

You could ask your surgeon for a conservative trial of injections followed by PT. That might help a lot moer than PT alone.

The first thing my Dr. asked is if I had any injections. I anwered no he said good do not get them. I don't know why and didn't ask. I know a few people personally that have had injections and they don't seem to last long.

Wow, that is a strange response from a doctor. Well, I am not looking at your MRI, so maybe he knows something I don't. And, of course, I am not a doctor either. We send a lot of patients for injections. They do not last forever, you are correct. The reason we do them is so that patients can have a period of pain relief during which they can attempt to rehab the injury themselves. A lot of docs order the injections and nothingelse, but I hav found that with PT after, they are much more effective. That's really all the advice I can give from way over here where I am. I really hope you can find a solution that works for you! Best of luck!

Dschorsch....Listen to Sillyakchick. She has a vast amount of back pain information and all of it is on target. As a person who has had a long history of back pain and a variety of injections, I am also surprised that your Dr. didn't recommend injections.

She is right, they don't last forever but, for a measured time, they can be a good pain relief option. They allow you to try other things for long-term relief like phys. therapy, exercise, etc.

She is also correct about the importance of nerve involvement. I have that in three discs and numbness in both legs and feet. I have had a nerve conduction test, which tells which of your nerves are involved and where they are. Numbness anywhere else (bowels, kidneys, etc.) ratches up the importance for doctors because of bodily function involvement.

I really agree with Sillyakchick aqbout surgery of any type, especially fusions. Surgery should be a last resort as you go through the steps to solving your pain and numbness. I might even consult another doctor, maybe an osteopath like she suggested, so you can get another opinion about the injections and manipulation of the spine. Believe me, you are just starting out, so research all the options she mentioned.

There is also non-invasive laser surgery offered in Florida that promises complete pain reduction by deadening the nerves around the facets on the discs. These laser procedures are not cheap, however, and the clinics do not take all insurance plans. We are talking $10,000-20,000 out-of-pocket if you get to that point in your treatment. I'm considering the laser option myself.

Good luck with your search.

Hi SillyaChick:
"If you had loss of function of your foot (foot drop)" Good information, would you explain drop foot a bit more? Do you have drop foot, if you can't walk on your toes and your foot (heel) drops to the floor? This was one test way . . . back that I performed in the doctor's office. My right foot couldn't keep on it's toes. My left foot was o.k. Is this serious damage about which to be concerned? Do or did you also post on Spinehealth? Why do I think I remember seeing your name?
Thanks.
C