Can anyone tell me how many microscopic decompression surgeries on the L5-S1 (removal of synovial cyst pressing against the nerve root) a person can have? And if a fusion of the L5-S1 would prevent the cysts from forming?
This is a question best posted to your surgeon. I suppose the answer would depend on the attitude of your surgeon and whether he is removing bone along with the cyst. If he feels the decompression is creating any spinal instability, then he would perform a fusion instead...I would think!
With discectomy, most surgeons do not like to repeat it too often, usually recommending a fusion on the third attempt. I'm sure there are exceptions, but the third time seems to be fairly common.
With each additional entry over the same incision, the risk of infection increases, as well as some other issues.
From what I could tell from doing a little online research, there is not definitive proof that fusion will stop the formation of synovial cysts. Some articles state that once there is not any movement at the facet joint, the synovial sac will not fill will fluid and a cyst will not form. But I found a comprehensive study from the NIH done over a study period of ten years that indicated there was no difference between those patients receiving fusion and those receiving decompression and removal of the cyst.
I hope your surgeon will be able to provide you with appropriate information, so you can make an informed decision. You may want to get more than one opinion since synovial cysts are not all that common in the spine.
Do your cysts press the nerve root creating pain down your leg and prevent you from living in a normal fashion due to the pain ?
My problem is that the synovial cysts start pressing against the nerve root and the pain gets so bad that it becomes unbearable and I cannot function. Thus the two surgeries which are not very invasive and takes about 4 weeks to recover. The problem is I cannot function or live in a normal fashion with the constant nerve root pain, that is the reason I am considering the 3rd decompression surgery(removal of cyst, fragments, etc pressing the nerve) and then perfomring the fusion at the same time, and that would restrict the movment of the joint, and the hopefully the cysts would not form anymore.
Best Regards,
DBKY
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