Re: xlif for L4-L5 plif for L5-S1
If you have the opportunity, you might also want to get an evaluation by an orthopedic spine surgeon. Their fellowship training is almost identical to that of the neurosurgeon's but they sometimes have a slightly different approach.
Do you have the radiology report from your MRI?
Have you gone through all the conservative treatments without success? Fusion is a big surgery that for all intents and purposes is life-changing. It should not be undertaken unless there are no other options.
An annular tear of the disc is a rip in the outer layer (annulus fibrosis) of the disc. The disc is composed of two parts: a soft, gel-like inner that is called the nucleus, and the outer part of the disc is often compared to the belt on a radial tire. It is a tough layer made of concentric layers of collagen that circle the nucleus. There are no nerve fibers in the nucleus, but some of the outer layers contain them, and thus can be very painful when torn. When the tear goes all the way from the nucleus to the outer edge, the matter of the nucleus can leak out. If this material comes in contact with a spinal nerve, it can also cause pain from a chemical reaction that occurs.
Annular tears can and do heal without surgical intervention, but many times there are other issues that require surgery, so it is taken care of at the same time.
You also said you were given a diagnosis of [B]spondylosis with myelopathy.[/B]. Was this on the written report? Spondylosis is degenerative disease of the spine (arthritis). It often comes as the spine ages. The term "myelopathy" is usually used in relation to the cervical spine. It is a degeneration of the spinal cord. It is not usually used in the lumbar region since the spinal cord runs from the top of the spine down to about the L1 level. It ends at the conus medullaris and from there on down to the sacrum, there is a thick bundle of nerves that early scientists thought resembled a horse's tail, thus its name, cauda equina. These nerves continue on down to the sacrum where it branches into two and forms the large sciatic nerves that go into each leg.
Myelopathy, at least in its most common usage, refers to the spinal cord (the area above L1-2) compression. In the area above the conus medullaris, it can result in paralysis. Below this level, I think your doctor is probably referring to stenosis. This may be the recommendation for the fusion, more than just the annular tear.
The spondylosis refers to spinal degeneration...so the doctor must feel that fusing the spine with halt the degeneration at these two segments.
If the post doesn't make sense, it is because our cable went out last night while I was writing this...so there has been a big lapse between when I started this and finished it...sorry.