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Old 02-27-2012, 06:27 AM   #1
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Fusion?

Short story, had a 11mm herniated disc L5-S1, discectomy and laminectomy done november 2010, had another MRI done august 2011 showing 3.5mm hernaition...So assuming did not fix the problem...With the herniation left the left lower leg partially numb, from foot to knee...Have no dorsal flexion...Nerve damage seams to be permanent, but is not main concern...Have done at least 100 pt sessions, Still experience low back pain...Had 2 transforamal injections done in november 2011 and a medial branch block, results showing pain not coming from facet joint...Drs want proceed today to do more injections to see if they will help, but did not receive any relief from previous 2...Mentioned doing a fusion of the one level and getting a discogram, but drs seem to want to approach with more injections to see if they will help..I hurt my back by lifting a heavy object in a squat position and twisted at the same time ...It is a work comp claim, and insurance company not giving any problems with authorizing everything thus so far...Tired of taking medication for low back pain Kadian 60mg a day, 30mg oxycodone a day, lunesta for sleep(was taking ambien), was taking lyrica for nerve pain now taking cimbalta which is very similar...Nerve meds making me have bad memory loss...Want to get input from others with experience on what you would recommend to do next....Thanks for all your help...Want to get back to everyday life and do things I love to do...unfortunately it is still painfull in the low back, can sit , stand, move, and for no reason will act up and cause pain. After the MRI done in august of 2011 it still shows a herniation of 3.5 mm...Dont know if this is best course of action, but willing to do anything for the pain to be lessened. Thank you for your input

 
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Old 02-27-2012, 09:33 AM   #2
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Re: Fusion?

Have you asked about having a second discectomy to resolve the remaining herniation? It is always better to leave fusion as the last resort and to give everything else a good try first.

 
Old 02-27-2012, 04:52 PM   #3
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Re: Fusion?

I agree try a second discectomy and maybe get a second opinion. A fusion will take you out for at least 6 months vs.6 weeks for another discectomy.

 
Old 02-27-2012, 08:24 PM   #4
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Re: Fusion?

[QUOTE=timeload;4935576]I agree try a second discectomy and maybe get a second opinion. A fusion will take you out for at least 6 months vs.6 weeks for another discectomy.[/QUOTE]

Thank you for the advice, will suggest it to spine surgeon and other drs to see what they think what success rate may be...

 
Old 03-03-2012, 09:41 AM   #5
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Re: Fusion?

Hello,

I know how you feel and I totally feel for you. I am a 40 old mother of 2 boys ages 4 and 8. I work full time and have been in pain for about a good 6 years. I have had nerve blocks, injections, pill, chiropractors, Upper Cervical doctors...you name it. In April of 2010 on my way home from work I took myself to the ER and begged the doctor to find someone to help me with the pain down my left and right legs. He gave me some pain meds and a Doctors name. I made an appt with the back surgeon and he sent me for an MRI. I had DDD at L5 SI and a large bulging disc that was crushing my sciatic nerve. I had a laminectomy on May 3rd 2010. I was only out of work for 2 weeks and I was pain free for a little over a year. I was pretty happy.

Out of no where the pain came back but it was all in my lower back now. No leg pain.
He did another MRI and said the disc had clasped my spine was not stable. He told me he could do another laminectomy but most likely I would be back in a year or two and have to get a fusion. I did not want 3 surgeries on my back. I went to see another doctor for a second opinion and he told me not to get the fusion. I was out of my mind with stress and did not know what to do.

I finally made the decision to go ahead with the fusion. I knew I did not want to live my life in constant pain so I had to give it a try. I was in pain already so I figured what do I have to lose?

I just had my fusion done on Feb 20th 2012. They also cut away more of the disc that started to bulge out again. I have 3 incisions and 29 staples in my back. I do NOT have the same pain that I did before the operation. I just have pain from the incision and the staples. The staples are coming out on Tuesday and I canít wait. I still have a lot of healing to do for the bone to grow and fuse but I am very very happy with the results so far.

I finally am feeling like my old self again and the thing I notice the most is that I am no longer walk around with that painful grimace on my face 24/7. You will have many people tell you to do this or do that or you crazy if you do or you nuts if you donít. It will consume you. You are young and have a lot of life to live so make your decision based off of what you feel. I figured I was in pain now so if it didnít work I would be the same.
I had to give it a shot and so far soo good. I wish you luck and feel free to reach out to me if you need someone to talk to.

 
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Old 03-03-2012, 10:00 AM   #6
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Re: Fusion?

I reread your first post and just wanted to add that I can tell you from experience that you should not conclude that whatever nerve damage you have is permanent. It may turn out to be, but at this point it is worth proceeding with some sort of surgery to decompress the nerve...and worry about what is permanent, or not, at a future time.

When I still had sciatic type pain after my first surgery ever, a one level fusion at L4-L5, almost everyone I met with told my I most likely had permanent nerve damage. Because nothing appeared to be compressed and my MRI "looked great" the assumption was that it had to be permanent nerve damage.

I was told to look into a neurostimulator to help with the pain. Eventually I was able to prove that I still had instability in my spine, eventually had another fusion, on either side of the L4-L5 which had healed nicely. I am 21 months out now and I am still seeing improvement in those nerves that were supposedly permanently damaged. I imagine my toes will never recover 100% but I have much more feeling in them than I used to, and I just realized the other day that I no longer have feet that ALWAYS require socks to keep from feeling like they are freezing.

I would agree with you that if several injections have had no effect, there is no point in trying more. I'm wondering if you have consulted with an orthopedic spine surgeon for a "second" opinion?

 
Old 03-03-2012, 01:53 PM   #7
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Re: Fusion?

Hi,
I'm kind of in the same boat as you are now, and will be right along side of CBarrett1971. I am 39 years old, active, have kids 5 and 8, and I can't live with daily pain anymore. I had L5-S1 hemi-laminectomy and microdiscetomy back in 2003 and had great success. The leg and toe pain I had endured for 2 years was gone. I had tried PT, epidural steroid injections, chiro, discogram, and finally had surgery and have never regretted it. Now, I've been having horrible low back pain (no leg pain) for months now, and decided to get a MRI last October. It shows there is no disc at L5-S1 and at some points the vertebrae are bone on bone. I get low back spasms that stop me in my tracks, and have low back pain frequently. I have been doing PT since October, but it hasn't gotten rid of the pain or made it any better. I'm stronger, though, because the PT is all weight lifting, and I have noticed that I can do things like sit and lift laundry and vacuum without as much initial pain, but it always catches up with me. I do the PT 3x/week, and I do cycle classes 2 -3x/week. I'm planning on having surgery in July when the kids are out of school.

I saw a ortho spine surgeon who thinks that a L5-S1 fusion is necessary to get rid of my pain. He told me that no injections, PT or chiro care would ever fix my problem... so fusion it is. Problem now is which surgeon to go with. I have a second opinion with a neurosurgeon next week, and I am also getting my records to my surgeon from 2003 so I can see him as well. The surgeon who did my lami is very good, and it would be great to have him do the fusion.

It sounds like you need a fusion, too. L5-S1 is the ideal level to fuse since it doesn't change the body mechanics as it sits deep in the pelvis, and I read somewhere that L4-L5 will not necessarily be stressed if you're careful, called adjacent segment disease.

Now, there is a compound called BMP (Bone Morphogenic Protein) out there that is made by Medtronic, and I encourage you to ask the surgeon if s/he plans on using it. There are horror stories out there with its use, and I for one will not let the surgeon use it. It increases the rate of fusion, but can also cause a lot of inflammation, infections, and some say cancer. Yikes. A friend had a L5-S1 fusion done last November and just had his 4th (!) surgery this week to fix all the complications that the BMP created.

Good luck!
__________________
L5-S1 hemilami w/ microdiscectomy 2/18/03 - right leg pain gone
Successful chiropractic care 2005-2011
Daily low back pain and HORRIBLE spasms since 2011
L5-S1 ALIF 6/30/12 - back pain is GONE!

 
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