What were your symtoms with needing a Laminectomy? I'll be having a fusion but the doctor said he will not do a laminectomy unless after I have a fusion I need one because of my symptoms not being alleviated by the fusion. I am unsure what he meant by which symptoms he would be referring to with needing a Laminectomy.

Harmony

Harmony- my doctor wanted to do a laminectomy before the fusion which is what we exactly did. He felt the lessor of the two surgeries was the way to go. In May 2006, he did a laminectomy for severe right leg pain that would not respond to other treatment. Every step I took sent shooting pains down my right leg. When I bent backward, it sent shooting pains down my leg. My pain prior to the laminectomy was 20% back 80% leg.

May, June, July - I had not symptoms - all was grand. August - I has a small flare up of sciatica. In September, I bent to load the dishwasher and BAM I fell to the floor in the most excrutiating pain I ever felt. It took me about 1/2hour to get off the floor. From that point on every time I turned, bent, or twisted the back began screaming something fierce. My pain at this point was probably 70% back 30% leg. I had epidurals and selective nerve block. After the selective nerve block the pain changed to 60% back 40% leg pain. Except now my pain became very crampy in nature and went thru my buttocks down the right thigh, down the back of the calf, down the right side of the foot into the toes. That I would feel like I needed to be scraped off the ceiling. Feb. 1st I had fusion.

Hope this helps you.

Thanks, yes, that helps! Sounds like the main difference then is more leg pain with a Laminectomy and more back pain with needing a fusion. My pain is mostly in my back, hips and buttocks. The pain is severe especially when standing and walking and feels like the nerves are severely pressed. I do have bone touching bone and my facet joints are bad. I do get pain in my legs and feet but not as much nor as severe and it does radiate to my legs.
My appt. to finalize my fusion is tomorrow so I'll find out more. I hope you're doing okay after your fusion. I have read your posts on it and you have been helpful in that too. Take care!

Harmony

Harmony -- my facet joints were extremely arthritic.

oh yeah! wow, just like mine. Did your dr. say the fusion should help the facet joints from pressing on your nerves since they are probably the main cause of pain? That's what I was told; also I couldn't have the ADR because the facet joints were too arthritic. Dumb question....what is a spacer? Is that different than a cage?

a spacer may be a piece of bone such as from a cadaver. a cage looks like a snack food combo. small with little protrusions from it. The cage is usually packed with bone scraped from your pevic area and packed around the cage to hold in place. I had a cage and laminectomy my first surgery but it never fused in place after a year. I changed surgerons and he tried to remove the cage but it would not come out. So he pushed it further in. used straps and screws on L4 and L5 to immobilize. It did not take away the pain.I now after 5 years of pain meds have tried a pain pump to kill the pain.Still not woirking so i need to take oral meds 20 mg twice a day of oxycontin. It helps some so that i can get around, but i still need to lay on the floor and not sit in chairs for more than an hour. Luckily my pain is greatly reduced when in a horizontal position. So sleeping is good. Surgeon says he could fuse more but i have scar tissue areound the nerves and more surgery would just cause more scarring. don't do any surgery unless you cannot stand the pain. ( REMOVED ) good luck

oh yeah! wow, just like mine. Did your dr. say the fusion should help the facet joints from pressing on your nerves since they are probably the main cause of pain? That's what I was told; also I couldn't have the ADR because the facet joints were too arthritic. Dumb question....what is a spacer? Is that different than a cage?

Yes the idea was for the fusion was to prevent the facet joints from crunching my sciatia nerve. Apparently I had to much motion after my laminectomy and the the nerves were getting hung up in the facet joints. My surgeon said my facet joints were outrageously big.

I was told the ADR was not possible for the same reason as your doctor cited to you.

They had to use my bone for my fusion because he could not safely implant a cage because of the size of the facet joints. Because of the amount of arthritis he did not need to take any bone from my hip or pelvis.

It sounds like our case is very similar to one another.

My surgeon did the laminectomy and decompressed the nerves but when he did that he made the spine unstable (to much motion) and they had to do the fusion.

Hindsight my surgeon feels he should have done the laminectomy and the fusion together but he wanted to start with the least invasive first.