L5/S1 Fusion Surgery - Sooner or Later? - Back Problems Message Board

ColoradoEd · 02-12-2007, 01:53 PM

Greetings folks. This is my first post.

I just found out that I have a grade 2 spondylo at L5/S1 with severe (8/10 according to my ortho surgeon) foraminal stenosis call caused due to bilateral congenital pars defect. Flexion and extension x-rays show pretty good stabilty. MRI shows that L5/S1 disc is shot, but L4/L5 looks pretty good.

Right now my pain level is generally a zero, although with activity climbs to a 2 or 3. No radicular symptoms or pain right now. I take no pain meds and have been treating for the last 6 weeks with chiropractic and acupuncture.

I am a 45 year old male am used to a very active lifestyle (running, skiing, weightlifting, heavy backpacking, etc).

Naturally, I am freaked out about this recent discovery - especially where this anatomy was probably there my entire life.

I am not sure whether I should go conservative, limit my activities and prolong what I believe to be the inevitable surgery or do I just bite the bullet now, when symptoms are still relatively mild and fix this anatomical problem.

I'm seeing the most conservative ortho in town and he said that I am a surgical candidate. At this point, I am leaning toward surgery sooner rather than later.

Whattya think?

sheri42 · 02-12-2007, 05:29 PM

Hello,
I received almost your same diagnoses 10 years ago at age 25, except, my L-4 was good and I was grade 1. In 10 years I slipped to grade 2 and L-4 is shot.
I was able to wait for 10 years and the technology in the 10 years I waited is incredible and not even comparable to 10 years ago. I had an L-4 to S-1 fusion 1 year ago, and I am doing as well as you are now.

I would wait until your quality of life is effected. Maybe that will never be the case. Even if you do eventually have to get a fusion, everyday that you make it without one is another day of spinal technology development.
Take Care
Sheri

ms_west · 02-12-2007, 07:31 PM

Welcome to the board!

I agree with Sheri - unless your pain drastically affects the quality of your life, you are miserable, or it is a matter of medical emergency, I would hold off as long as possible on surgery. I would think that most surgeons would not consider it at this point in your back journey.

I had a fusion 25 years ago and I lived 22 years pain free. However, it weakened the next level up, and I just had a fusion less than 2 weeks ago. I have been told that it is normal for a fusion to weaken the next level up and I can expect to have another fusion in my lifetime. I am praying that this will give me another 20 years of pain free or near pain free years.

I am telling you this because I want you to be aware that not all surgery is a cure all, it can led to further surgery down the road.

yvette777 · 02-12-2007, 08:40 PM

I would say later, if this isn't affecting the quality of your life and the pain isn't that big of a deal, I would completely wait. Medical techonolgy keeps advancing so far. I would do the best to stay actively in shape and keep your core as strong as possible. It supports everything. With the stenosis, well in my case let me tell you my experience is leg and foot pain and burning..i don't think that part causes pain in the back as much...could be wrong. i attribute my back pain to the disc and spondy.

I would read up on it so that you understand fully whats going on. And make sure you NEVER LOOSE YOUR MEDICAL INSURANCE because you will be deemed uninsurable. And make sure just to cover your but you have disabilty pay lol. Well those things would have been really nice at this point in my life. Rather have them and don't need them, then need them and not have them.

Good luck

Porter107 · 02-12-2007, 10:23 PM

I have to agree with everyone else here. I was told 5 years ago that I was a candidate for fusion, but I decided to wait until I could not take the pain anymore and unlike your pain leve now, mine was 7 to 10 daily when I decided it was time for the surgery. If you are not experiancing pain that is affecting you quality of life, wait. I dont believe there is any reason to rush into a surgery just because your Doc believes your a candidate for it. Of course I am not a DR so I dont know if waiting would cause any further damage. Fusion surgery is major surgery requiring a long painful recovery with physical limitations.
Why are you leaning toward surgery sooner anyway?
Again, if you can wait to have surgery especially if your not having any pain, wait. Good luck to you whatever you decide and welcome to the board!

Porter