I have read a lot about fusions and honestly I don't know what they are? Can someone let me know?

From what I understand, they are going to take out the offending discs, put in rods and/or screws with cages, make a bone paste out of your bone (taken from your hip or illiac) and mix it with cadavear bone and then put it in the space and hope that it fuses. You will lose range of movement. The percentage of failed back surgery is high. The percentage of people who don't fuse is high. It should be a last resort.

With all due respect, Betty, this is far from what I know about fusions.

Kelly,

I had a fusion due to a collapsed disc 9 weeks ago. The dr went in through the front, removed the disc and placed 2 titanium cages. No screws or rods, in my case... The cages were filled with artificial bone graft material, called Infuse (sp?) and no bone graft material from my hip or iliac. The success rate with my type of fusion is extremely high! Over 95% is what my dr told me. There are a few things that will affect the bone graft materials' success of fusion, like taking Ibuprofen, Aleve or certain other inflammatory meds.

Of course, I plan to stay away from those meds in hopes that I am in the 95%. My pain before surgery was unbearable and no way to live. My pain level now is very low and sometimes zero. I still have some pain most days, but it is nothing compared to my pre-surgery pain.

I did loose range of motion... about 3%. Not even noticable to me on a daily basis.

I'd do it again in a minute. No regrets here. That's not to say I will never have back problems for the rest of my life but for now, I'm so much better.

A fusion was exactly what I needed. I agree, it's not for everyone but it truly can help some and improve their quality of life.

Please read all you can to learn about fusions. And if you're faced with a decision, please make it according to your own personal situation, not what people on these boards advise you to do.

These boards are a great place to hear about others experiences, but ultimately, it's your body and YOUR decision.

God bless,
Elaine

Aloha Kelly, :wave:

I also have to take issue with injuredbetty's statistics. I don't know where she may have gotten her figures but in my opinion I think she has sorely misstated the facts and has done an unfortunate disservice to people such as yourself who is trying to make an informed decision whether or not to go forward with a surgical procedure whatever it may be to relieve pain and or other symptoms which are preventing them from enjoying life.

There is an enormous amount of credible information on back surgery on the internet, and unfortunately, there is also a lot of questionable information floating around cyberspace also, usually in places such as health boards, chat rooms and newsgroups from emotional people who have had surgery that have more often than not, not been helped by their surgeries for one reason or another (It is my opinion that these people are the exception rather than the rule). But don't let this discourage you from visiting these places as they do have a lot to offer, be it a sounding board, support, encouragement, personal stories, etc, etc. all of which will give you more than enough information and inspiration to make a very informed decision, discussion is a good thing, especially when you are discussing this with people who have actually been up close and personal with it.

As Elaine stated it is ultimately your decision. So if you haven't done so already, go to your favorite search engine and do a search on back surgery success rates and see what comes up, you will more than likely know which sites are credible and which ones aren't.

I hate to plagiarize but I’m going to anyway. Below, I have cut and pasted some paragraphs from a website with info that may help. And a lot of it is only relative as everyone’s personal situation is different and even though you may have the exact same symptoms, diagnosis and procedure as someone here, you may have a totally different recovery and outcome.

So gather as much information as you can about the symptoms you are experiencing and discuss it with you surgeon and ask a lot of questions (some of which are at the bottom of this post).

As you will see, the success rates are fairly high, although some people may say that the failure rates are also high. I hate to do a J.Kerry and Flip Flop (did I say that? :D ) but I will have to agree, anything above a 1% failure rate IS too high, but again it is all relative, and you have to assess your quality of life now, versus what you may achieve with surgery. Needless to say, you should always exhaust all conservative treatments first before you even consider surgical intervention. Good Luck with your quest for success.

From a WebSite:

Very few people require back surgery - about one in every hundred that will attend an out patients clinic or hospital. Such surgery is only essential when there are extreme symptoms such as a paralysis of the bladder and bowel or loss of power to a foot.

The most common spinal procedures
Wherever possible try to ensure you are referred to an orthopedic or neurosurgeon who regularly performs spinal surgery. There are three basic types of back surgery:

1. Discectomy - this operation Involves removal of part of the intervertebral disc and c an be done by a variety of techniques including open incision, microdiscectomy (which may allow a smaller incision as the surgeon uses an operating microscope) keyhole or endoscopic techniques. Each method has its pros and cons.

2. Decompression techniques involve removing any tissue that is compressing the nerve, e.g. disc, scar tissue, bony spurs (also known as osteophytes.)

3. Stabilization/Fusion - this is more extensive surgery. Two or more adjacent vertebrae are fixed together, either rigidly or flexibly, to try and give the spine more stability. The operation involves decompressing any nerves involved. For a 'rigid fusion', bone is taken from the pelvis to place between the vertebrae. 'Flexible stabilization' does not involve bone grafting. However, there are several procedures that involve using instrumentation (screws, plates, rods). Your surgeon will explain which technique is most appropriate for your situation.

Success rates
Success rates for these procedures are only just being collected in this country so there is limited information about their success, it is also, however difficult to determine "success". Is it that you wake up with no pain? or remain pain free for one or more years after the operation?
As with any surgical intervention there are risks. Anesthetic drugs carry certain problems and operator error can cause difficulties (such as a dural perforation - where the membrane covering the nerve is nicked, leading to a leak of the fluid bathing the nerve, or damage to the nerve itself and there is a risk of infection. The incidence of any of these is very low, but they should all be discussed prior to signing a consent form for any surgical procedure.

Your expectations
It is very important to have realistic expectations of what surgery can do for you. You may not be relieved of all your pain; although a straightforward discectomy for a disc prolapse is about 80-90% successful in resolving most of your leg symptoms, but your back pain may still persist to some extent.
If your operation is a stabilization or fusion mainly for back pain, the outcome is usually less certain. There is a 60-80% chance of substantially relieving the pain, a 10-20% chance of staying the same and 10-20% risk of being worse or needing further surgery. You may not be completely pain-free afterwards, but you may find that your pain eases down to an ache, leaving you feeling able to do much more.

Always discuss these matters in detail with your surgeon so that you know what to expect and how to give your operation the best chance of success.

Questions to ask your Surgeon
· What kind of back operation are you proposing to do?
· Do I have signs of nerve or nerve root damage?
· Are the symptoms that I have directly related to the nerve compression?
· What are my chances of good pain relief if I opt for a surgical intervention?
· What might happen if I do not consent to surgery?
· Are there any alternatives to conventional surgery that I could try?
· How many of these procedures have you performed?
· If you do not do these procedures would you refer me to a surgeon who does?
· What are the possible risks or complications of this type of surgery?
· How long will I be in hospital?
· What follow up physiotherapy should I receive, and how long after the operation should it start?
· When will I be able to return to work?
· Do you have written patient guidelines for me to follow after the operation?
· When will I be able to resume normal activities e.g. driving, carrying loads, sporting activities, sex?


I hope that this wasn't too much, and once again, I wish you much success.

God Bless :angel:

Carl

P.S. Positive Attitude! Positive Attitude! And Oh, by the way...have a Positive Attitude!

There are different methods that are used and a lot depends on how extensive the fusion needs to be. For example, a one level fusion often can be done without metal rods or screws, using only a cage and bone. My first fusion, one level, was totally successful and only 2 MVA's were my undoing.

Fusion should, of course, be the last resort, but sometimes they are absolutely necessary. Do as much reading about the surgery as you can...just type fusion surgery into your web browser and you will come up with more websites than you can read, lol.

Educating yourself is a sure way to help yourself both in understanding and in recovery.

Carol

I take no offence to the posts as I can only speak from experience. Well, or lack there of as my husband chose not to do it. He injured his neck and saw the doctor. The Neurologist told him to have the bone spur out that was causing him pain. It was formed because of repetitive motion and an injury where two discs were herniated in his neck. The Neurologist said that he didn't need fusion and that discs herniate and if you have every disc fused as it did herniate you would be one long fusion if you lived out your natural life. He didn't seem to think that the herniations needed to be addressed much further than knowing that they were there. It was the bone spur that needed to be taken out. He was sent to a Neurosurgeon. She thought that he needed fusion because, hey, the discs are herniated and even though they are not causing pain now, as long as she was in there taking out a bone spur, why not do a fusion.

She would have removed the two discs, put in two cages, screws, bone paste that was a mix from him and a cadaver. He was told that the success rate of the fusion is not as high as they would like but WAY higher with the neck than the lower back. Both the Neurologist and the Neurosurgeon quoted the same thing. Lower backs are hard to repair because you have so much depending on them. Your neck only has your head. Your lower back is kind of the center of it all. They both quoted very low statistics of success rates for recovery of the lower back through surgery. There is a lot of things that you can do before even thinking about fusion.

I came home from his appointment with the Neuro and spent days and days researching fusion. The range of motion that he would have lost was that he would never be able to tilt his neck back again. The would not have had the same movement from side to side. He would have not been able to touch his chin to his chest. That is too limited for him. The doctor told us that once he was fused that the discs above and below the fusion would herniated, eventually, as they would be the new shock absorbers. It would place a greater stress on them then before and he would end up with more fusions. This didn't sound good to us at all.

I would say that if you are in a lot of pain and you truely believe that fusion is the only way then that is a personal choice.

My brother fell off of the top of the double Ferris Wheel when he was working for the carnival back in the early seventies. They put a rod in his back. He had it out this last year. His back aches, but he is fine. No pain pills. Through a program of exercise, stretches, and keeping good health, he healed his back. When he had a rod he couldn't bend. Now he bends and works. All things are possible.

He did what he did because he broke his back. I forget how many places it was broken but he was in a full body cast and then one of those contraptions that cover your torso for a long time.

I have a question, after fusion, if it fails, then what? What do you do when the pain is still there? What are the statistics on FBSS?

I have been reading a lot of material on the lower back. I can't find anywhere, where doctors are not involved, where the statistics are as good as the ones that someone quoted here. I would tend to believe that if I was surfing a site that involved doctors that their statistics would be a bit scewed. I am glad that my husband's doctor gave him the straight scoop on the reality of what would and would not happen.

Thank you all for your quick replies. I have several disc problems and also a 5mm x 15 mm piece of broken bone in my lower spine L4-L5. I am going to be seeing an OS soon and just hear so much about fusions wanted some information. I don't know if it would be an option with my problems.
Again thanks to you all.

Kellyp,
Just wanted to say good luck with the OS, and keep us posted! There are lots of great, supportive people on this board who have been through similar situations, so come here anytime you have questions or even just want to vent! Hope you feel less pain every day!

Jessie

Kelly,
I am in total agreement with Carl. I am 7 weeks post op from a 3 level APLIF fusion with cadaever bone milled discs, BMP, pedicle screws and rods. I am doing great! I go back to work next week, I've been working around the house the last few weeks, driving, and today, I'm helping my husband paint and sand in our living room.

I also had a harrington rod fusion 22 years ago, and it was the best decision I ever made. I had a 49 degree curve in my upper back from scoliosis and was in pain constantly. I was 22 years old then. The surgery was a success and still is!

If you have disc problems, then perhaps ADR is worth getting, I know I would explore that option. But that was not my problem and would not have helped me in the least.

As everyone has said, do your homework, but please, consider the source.
Good luck to you. I hope you find relief from your pain.

Julie