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Old 11-22-2005, 03:40 PM   #1
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I need help deciding about fusion surgery

Thank you all for your advice. I have had back problems for almost 2 years. I have been to 3 different therapists, I have had 2 pain blocks, a series of MRIs, x rays,nothing has helped yet. I saw a Dr. Zogby in Syracuse, NY. He is a sepcialist in this field. I also went to another orhro. who basically said the same thing. I have a stress fracture in L5 and DR. Zogby said PT or pain blocks will not help a fracture. I am a very phyical person, I own a carpet cleaning business, I play golf,softball,and I'm a long time bodybuilder. Lifting weights is my life. I have set 2 state bench press records. Even with my back as bad as it is I still go to the gym every day, I just alter my routine due to my back. I am scared to death of this fusion surgery. My DR said my only limitations would be running long distances and bending to touch my toes. I would love to hear from people that have had this surgery and the out come. Again thank you all for your responses.

 
Old 11-22-2005, 04:49 PM   #2
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Re: I need help deciding about fusion surgery

Think very carefully before undertaking spinal fusion. There is a percentage of patients who end up with failed back syndome. Others start to have a domino effect on the levels above and below the fusion causing more problems down the road. Get a second opinion and make sure you have all the information you need to make an informed decision. Is there a possiblity of your stress fracture healing and how severely handicapped are you. Personally I did not have fusion surgery until I was bedridden most of the time.
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Old 11-22-2005, 05:57 PM   #3
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Smile Re: I need help deciding about fusion surgery

Well you seem very active, as am I. I didnt see your other posts yet, so i didnt catch your age. I am 20 and Ive had pain for 5 years. You seem to have the exact same problems as I have. I am a hardcore gymnast and cheerleader, but I remained cheerleading and tumbling for 5 years, then the pain became too bad and I knew surgery was next. I dont recommend waiting 5 years.My pain management doctor used painkillers and procedures. I had the nerve blocks, epidural injections, facet joint injections, and nothing worked because my problems were bone, not nerve. As is yours. I didnt have a fracture but a disease that made my spine fuse, my problem was only the back part of my spine fused and not the front so the bone on bone made any movement of the spine hurt. I had the spine fusion T10-L1 3 weeks and 1 day ago. And so far the pain seems better. I still have some aching pain in my lower back but im hoping thats just from the trauma of surgery. I wont tell you it didnt hurt, the incision pain is bad but once the first week is behind you its better. I still have to deal with the fact that this surgery may not work, and I may need more surgeries in the future, but sometimes you have to trust the doctors and hope everything works out. I cant tell you to definitely do it, or not to do it. But this message board has helped me a lot, so listen to the advice and facts and that should help you make up your mind. Keep the Faith!

Ash

 
Old 11-23-2005, 07:05 AM   #4
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Re: I need help deciding about fusion surgery

Splitter,
I can honestly tell you If it hurts bad enough, you'll know if you want a fusion. I had my spine slip forward ( spondylosisthesis ) at work. I was in terrible pain.I did every thing the doc ask. I ended up doin a fusion in April 2004 . Did therapy in pain for almost a year in a half. My pain was still there. My doc said nothing wrong, Did a second opinion. The new doc said I never healed. Out came rods and screws and in with new . They put a spacer in between my L4-L5 in Oct of this year and Im walking and doin stuff already. I just have to be careful no bending or twisting or lifting. 5 weeks and Im great....Its your choice. Im only 40yrs old.

 
Old 11-23-2005, 03:18 PM   #5
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Re: I need help deciding about fusion surgery

You may also want to look into a procedure called Vertebroplasty before agreeing to a fusion, I have heard this procedure has worked well for people with stress or compression fractures, and the plus is that it's less invasive than a fusion.

I'm not positive if Orthopedic doctors perform this type of surgery or not, If I recall correctly, I think the procedure is done by either a pain management doctor or an interventional radiologist. I would look into Dr. Yuan, Dr. Eng, or Dr. Holsapple (all at SUNY Upstate/ Harrison Center) I've heard good things about them and believe they do perform Vertebroplasty.

I would do anything in your power to avoid a fusion if at all possible, especially given the fact that you are so active.

Good luck.

Last edited by My Back Hurts; 11-23-2005 at 04:01 PM.

 
Old 11-23-2005, 04:59 PM   #6
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Re: I need help deciding about fusion surgery

Splitter,

Sorry to hear that you are experiencing problems which raise the possiblity of fusion. I'm probably one of the more experienced people with fusions, as I have had four fusions, 8 spine surgeries plus all the many, many tests. I've been paralyzed temporarily, and I am a very active female.

Haven't been on the boards much lates, due to a major MVA which has caused more back problems, or I would have responded sooner, but I do have a few suggestions or recommendations for you, based on my experiences.

First, let me say that if you are still lifing and working with carpet laying, please do tons of research on the artifical disc replacements and consider that before fusion. Fusion can be done later IF that didn't work, but I've talked with a number of individuals and when only 1-2 levels is involved, this has great success with returning an individual to "normal". With ADR's you would still have full flexibility, and according to many doctors, you would not be as likely to have further herniations or needs for additional fusions, because with the ADR you do not have additional stress on the levels immediately above and below the fused area. Not all doctor's agree that the fusion adds stress.

Now, as you should know, I am NOT against fusion, as it was the best choice for me at the time and it has worked for me. But, as with any surgery, you need to know all the pro's and cons and what else is available, and not all doctors will discuss other options, especially if they do not do the other procedures. That is why we research, to make us our own best advocates.

So, at the top of these threads is a post by Bionic Witch about New Info. It has the address of one of several excellent web sites, and that one is Spine Universe. On it, you can see various procedures, such the ADR, the fusion and DYNSES, which is a flexible fusion. I would recommend you research all three of these.

Also, do research on Clinical trials. Various sites list which ones are on-going, which have been complete, and the locations of all. You might find one in your area, and clinical trials can be very beneficial and don't cost you.

Most important, beyond your own research is having the right doctor, and in the case when you are considering fusion, I highly recommend that you have a true spine specialist and not a general ortho or general neuro surgeon. The difference, if you are not familiar, is that although the doc may be ortho or neuro surgeon, the true spine specialist will have completed a major spine fellowship. You will want them to have done at least a year, and preferably a two year spine fellowship, and then you want them to be doing nothing but spines at least 75 to 100% of their practice time. Those who are not dedicated to the spine will not be up on the newest and greatest techniques, and even if now doing some of those in effect for a year or more, are not as trained and experienced. You see, when a new technique is developed, the companies will go to the specialists and they will be trained first, will be more involved in the development and testing, and by far, they will seek out more training faster.

WIth my first several surgeries I was using general ortho and general neuro surgeons, and as far as I knew, they were the "experts". It wasn't until I became paralyzed and they "didn't feel it was prudent to talk" that I found out that there actually were doc's more specialized in the spine itself.

When I did this and then searched out these spine specialists (I have a post "how to find a spine specialist in your area" in case you aren't familiar with how to do this), I took all my records and all films and test results for 2nd opinions. I let them know all the information even if I felt it was negative for me. Thankfully my insurance company will pay for as many 2nd opinions as I felt I needed to go to, but it would have been worth it to pay out of pocket, if necessary. I found that even with spine specialists, there is a great variety in ways they practice, so you want to make a list of questions you want to ask, so you can ask the same thing of all doctors.

I found that some didn't do their own comprehensive exam, instead taking the prior doctor's diagnosis. I knew that diagnosis, but wanted to know what their own diagnosis was. Some didn't look at the films, taking a glance at the radiolgists reports, some used PM's instead of treating for pain themselves, some treated for pain from beginning to end, while others may cut off meds 5-6 weeks post op, no matter your condition, some would answer questions while others zipped in and out and didn't want to deal with informed patients. On the 9th doc I found one who said he indeed was a spine doc, but with all my major conditions he would not touch my back, but had a partner who had done nothing but spines for more than a dozen years, and wanted me to see him. That was the doc who fit all my criteria, who spent more than 2 hrs going through the films, did the comprehensive exam, and who was willing to discuss ALL the options and the why/why not other techniques were appropriate for my situation.

Thanks to this true spine specialist, I am walking, I am active in maintaining my home and yard, can care for an ill parent, and this is in spite of all the surgeries and other complications of health and the fact that I now have 10 levels of my spine fused! Granted, you don't want more levels, you don't want multiple surgeries, but if fusion is the only answer, the best answer for you, you do want to have the best possible doctor to treat you.

BTW, I did try to get the newer ADR's now that they are doing those with fusion, but because I needed so many levels, he fact that my tendons and other support systems had already failed, and the fact that my vertebrae had slipped and I was at high risk for soon becoming a quadraplegic, it would not work, but at least my spine specialist discussed the options and drew me pictures of why this had to be.

Hope you will be your own best advocate, and search out more options and discuss them with your doc if they are a spine specialist, and if not, please consider getting other opinions, especially from true spine specialists.

Best Wishes!!!!

 
Old 12-02-2005, 08:38 AM   #7
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Re: I need help deciding about fusion surgery

How did your fusion surgery go? Mine is set for Dec. 15 I believe I have no other choice at this time, my back pain is constant 24-7.

 
Old 12-02-2005, 12:19 PM   #8
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Re: I need help deciding about fusion surgery

Splitter,

My fusions, even the 10 level done last December, has gone great. I have a wonderful spine specialist, and although we worked to try for the artifical disc this last time, as FDA had then approved doing some disc replacement with fusions, my back was so deterioated that it was not possible. I returned to many normal activities at 3 months post op, and was back in full swing except for not being allowed to ride my mower, at 7 months. As I was in a severe MVA 3 weeks ago and sustained some additional injury to my spine, that is going to have to wait a bit longer now, but certainly not as a result of the fusion.

As you are still young enough to work, that is why I suggested that you investigate the artifical discs. Individuals I've met with who had the ADR's have been so pleased, and they were able to return to their routines and work. I know that the ADR was a much better success for a roofer than a fusion would have been. Besides, some doc's say that a fusion puts additional stress on otehr levels, so that you will eventually have more problems. That's not agreed upon by all docs, and let's face it, that even if it were, it still is the only answer for some of us in order to keep our sanity and live part of our time without pain. But, the big thing is that a general ortho or general neuro surgeon is not likely to give you that option, as the true spine specialists are the ones most trained and experienced with the ADRs at this time, so for the ortho's and neuro's fusion is the only option they themselves can or will offer a patient.

ADR's were not even near approval when I had my first 3 level fusion, but were gaining light when my first fusion was broken and had to be redone. They were more acknowledged by the time I had the next 3 level fusion, but still insurance companies weren't even considering it. Many still resist, but some will pay for them if the doctor will justify it. Certainly, if it is approached as saving money in the long run, especially if it will negate more surgeries when some doc's say that fusions will cause more problems and the need for more fusion surgery, then some insurance companies apply common sense and approve the surgery. Some doc's however, do not push and will just go along with the insurance companies.

You are evidently a good bit younger than I, and being able to work X number of years longer was not a consideration for me. Had I been younger, I know that just getting out of pain would have been just part of any decision process, as I had been the round of fighting forced disability retirement when in my late 20's and I crushed my arm. It would have put me far below poverty levels today had I not been able to work and take a normal retirement. As my back problems started after retirement, my decisions were based on pain levels and the fact that I was temporarily paralyzed once and facing permanent paralyzation last Dec.

Just be certain that you have explored and asked questions about the various options. If not artifical disc, have you spoken with your spine specialist about why a fixed fusion which could give you some limitations in movement, versus a flexible fusion called Dynesys? As I've often said, we are our own best advocate, and if we do not defend ourselves and do all we can for ourselves, then no one else is responsible. The doctor's, the nurses, friends and family do not have to live the pain, the limitations, the suffering, and all the rough times back problems can bring, and we cannot hold them responsible for not telling us of all the different options out there. The're humans, they have their own limits on knowledge and skills, so we have to seek out information so that we are indeed our own best advocate and make the best choices that we possibly can.

Hope your surgery and recovery go very well. Know you will be looking forward to a better year ahead.

 
Old 12-17-2005, 08:21 PM   #9
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Re: I need help deciding about fusion surgery

check out this hospital and send them your MRis they fixed me up .im 8 weeks post op and ready to go back to a very physical job...running jackhammer,backhoes etc.just get the opinion they are agressive in treating people and dont look to take the easy way out and have you go through multiply procedures.I avoided fussion on 2 levels ,http://getadr.com/

 
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