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Old 04-09-2011, 11:38 PM   #1
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schedule l5-s1 fusion surgery for may 5th, starting to doubt my decision. please help

ill try to make this as short as possible, i suffer from a herniated disc at the l5s1 and have been for around four years. in the last year or so it has gotten worse, at its worst my pain was at a 9-10 on a scale of 1 to 10. on most days it is around a 5-6 although that is with percocet and muscle relaxers. well i figured i was a candidate for micro surgery, went and seen a local surgeon and he said he recommended major surgery and to remove the disc and put rods in. needless to say i was shocked. i am 28 years old and just did not see that coming at all. i thought about it for a month or so and scheduled the surgery yesterday for may fifth. but now i keep reading the failure rate of fusions and it just seems like a really risky operation. i did get a second opinion but it was not much help, he explained to me that i could do the small surgery but it may not get rid of all my pain. but from what im reading the major surgery might not either. most of my severe pain is in my left leg and buttocks area, also makes my hip really sore. but i do get back pain and stiffness. can someone please weigh in and give me your opinion. i just feel like maybe i should try micro surgery to see if it would help, it seems a lot less risky and a lot less time off work and life. this whole thing is keeping me up at night and making me anxious as can be through the day.

 
Old 04-09-2011, 11:58 PM   #2
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Re: schedule l5-s1 fusion surgery for may 5th, starting to doubt my decision. please

[QUOTE=jboyer1983;4726890]ill try to make this as short as possible, i suffer from a herniated disc at the l5s1 and have been for around four years. in the last year or so it has gotten worse, at its worst my pain was at a 9-10 on a scale of 1 to 10. on most days it is around a 5-6 although that is with percocet and muscle relaxers. well i figured i was a candidate for micro surgery, went and seen a local surgeon and he said he recommended major surgery and to remove the disc and put rods in. needless to say i was shocked. i am 28 years old and just did not see that coming at all. i thought about it for a month or so and scheduled the surgery yesterday for may fifth. but now i keep reading the failure rate of fusions and it just seems like a really risky operation. i did get a second opinion but it was not much help, he explained to me that i could do the small surgery but it may not get rid of all my pain. but from what im reading the major surgery might not either. most of my severe pain is in my left leg and buttocks area, also makes my hip really sore. but i do get back pain and stiffness. can someone please weigh in and give me your opinion. i just feel like maybe i should try micro surgery to see if it would help, it seems a lot less risky and a lot less time off work and life. this whole thing is keeping me up at night and making me anxious as can be through the day.[/QUOTE]
I had a similar situation fusion or not? I had to do it I could nt live with the pain any longer. I was over medicating myself, I started drinking and quit my job of well over 6 figures I lost my life in the pain. I said no to the fusion 2 x s and then my family had an intervention that led me to my fusion. I hope u make the right choice 4 urself. It was nt easy but living without pain is.

 
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Old 04-10-2011, 09:36 AM   #3
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Re: schedule l5-s1 fusion surgery for may 5th, starting to doubt my decision. please

Welcome to the board. Since this disc has been a problem for over four years, it is probably time to consider some type of surgery. If you're having leg pain, there is probably nerve compression, and there is a limit to how long you can keep that nerve compressed without having it result in permanent nerve damage.

I don't know what type of doctors you have seen thus far...but the most important component to a successful outcome is the selection of your surgeon. Be sure you are going to a fellowship-trained spine specialist. This can be either an orthopedic spine surgeon or a neurosurgeon who devote the majority of their practice to issues of the neck and back. You do not want an orthopedic surgeon who does hip and knee replacements, or a neurosurgeon who prefers to do brain surgery!

Sometimes it is useful to see one from each specialty as they sometimes approach an issue from slightly different points of view.

I think you would find it helpful to get another opinion. This time before you go, do some research and be prepared with a list of questions so you can ask why a discectomy might not be appropriate for your problem, or why the doctor is recommending a fusion.

I would agree with you in that it is always a good idea to have the least amount of surgery that will resolve your "problem." You can always have the fusion if the smaller surgery doesn't work out. BUT obviously I am not a medical doctor and do not know any details of your situation...so there may be valid reasons why a fusion is being recommended.

Depending on what is wrong, you might be a candidate for artificial disc replacement....

Don't get hung up on the term "micro." Depending on your situation, both a fusion with hardware and a discectomy can be performed with a minimally invasive procedure. It just depends on whether your particular set of problems can be most successfully treated that way, or not...and only the surgeon can tell you this.

The primary reason for needing a fusion is when there already is instability in the spine, or the surgery the doctor will perform would created instability. For example, if so much bone has to be removed to decompress a nerve, a fusion becomes necessary...there are other reasons as well...but that is the most common one.

Just remember that you are not in a situation where this surgery is an emergency. You've had the bad disc for four years, so waiting a little long to make the right decision will not be a problem. I think you need more information before you will feel comfortable making a decision.

 
Old 04-10-2011, 12:18 PM   #4
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Re: schedule l5-s1 fusion surgery for may 5th, starting to doubt my decision. please

I totally agree with Teton's response. The smaller the surgery the better. There is no going back after having a fusion and at 28 you are pretty young.

A lot of the posters on here are recent surgical patients and the proof of a fusions success is not in the short term but rather the long term. All too often a few years down the road fusion patients end up with the pain back again. A fusion puts more stress on the levels above it and so sometimes a domino effect starts as the levels above degenerate because of the added stress.

You are right to be concerned and unless there is a valid reason for not having a lesser surgery you are wise to pursue other surgical options.

Get another opinion and don't even think about having a fusion unless you are very sure in your own mind that this is the choice that you wish to make. Best to make an informed decision weighing the up and down sides. Go to the doctor prepared with a list of questions. There is no emergency here so take your time to get the answers.
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Old 04-10-2011, 12:35 PM   #5
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Re: schedule l5-s1 fusion surgery for may 5th, starting to doubt my decision. please

Hi, and welcome to the board. I also agree with Tetonteri in ALL that she said. You have time to get more opinions and I think you should, and I also think that since you have the opinion of a neurosurgeon, you should see an orthopedic spine specialist to see if they might have a different approach.

Having the "smallest" or least invasive surgery is something we all wish for, but sometimes it isn't feasible as it could cause instability of the spine. This is why getting another couple of opinions is important. It will reassure you, if indeed, spinal fusion is recommended. Seeing more doctors will also allow you to have a choice in the surgeon you pick, because that is an important part of success....having faith in your doctor.

It's always a hard decision, and I wish you the best in that. Please stay in touch and let us know how you are doing and what you decide.

Carol
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Old 04-11-2011, 12:39 AM   #6
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Re: schedule l5-s1 fusion surgery for may 5th, starting to doubt my decision. please

I also was ready for surgery when I had it as I had bad leg symptoms after 8 years of chronic lower back pain, but I did see 3 surgeons beforehand and ended up going with the last even though I had excepted the first ones diagnosis. The surgeon I went with had told me he was going to do a double disc replacement but when he went in he found L5-S1 was much worse than he thought and hence he his decision change to a L5-S1 fusion and he left L4-5. This was anterior as I was happier not to have any scaring on my back and against the spine, and I was very happy with the results. The cut was a lot like a c-section across under my belly button. He put in a plate with 3 big screws and a wedge shaped implant attached to it by an alan key type screw. I think it had an artificial bone growth material within it. The surgical site healed quite well (12 staples). Sorry about the explanation but that is the only way I can explain it. My leg and butt symptoms were gone immediately after surgery.
But as mentioned earlier the recovery is slow and I am not expecting to do any full time work for at least the first 12 months as I can feel that things are not healed yet and it has been almost 5 months now. The bone takes at least 12 months to grow and longer to harden. But in a few months I could maybe do some part time work. At the moment I still don't sit for more than 30 minutes. I walk every day and do physio exercises and stretches. Also I get tired easily and need to rest during the day.
So for me the surgery was essential and I am pleased with the results but everyone is different. And surgeons all have different techniques. Mine specialised in the surgery he did on me but was more expensive than all the others. He was a neurosurgeon. I had seen 6 surgeons all up but 2 ortho and one neuro just before the surgery offering different techniques. It was worth every cent I paid to find the right doctor.
Good luck with the surgery. (Ask lots of questions)
Allan
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Old 04-11-2011, 07:27 PM   #7
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Re: schedule l5-s1 fusion surgery for may 5th, starting to doubt my decision. please

Although I have a wealth of problems due to lax ligaments and tendons, hence many surgeries, each spine surgery I've done has helped.

I agree that you can see if you are a candidate for microsurgery or something less invasive, but you may not be. Does your current doctor do that type of surgery? If so what was the reasoning for you not being a candidate? If there's something in your tests, symptoms, etc that tells this surgeon that a fusion is needed, it may be something to consider. You can always call and ask to speak to the surgeon's medical assistant, physicians assistant , or nurse to request the ask the doctor why you would not be a candidate for some other type of surgery. Please don't assume that everyone is a candidate for a less invasive surgery. It does work for some, but some get frustrated that they need further surgery later on (in some instances).

Depending on what your CT and/or MRI is showing, if you have little to no disc space and the vertebrae aren't lined up correctly then fusion may be is the right course. Sometimes less invasive surgeries work to remove the portion of a disc impinging on a nerve, but if that's not the problem then there may be no less invasive option. Do you have a copy of your test results?

If the fusion is L5-S1 you won't feel much difference in your functionality (as long as you don't plan on aggressive sports, etc). I had my L5-S1 done very young and I was back to normal activity in 8 wk.
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Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
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