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omabluebird · 04-17-2012, 08:32 AM

I am a newbie to this site. I am an active grandmother who will be 70 next month. I have had some back pain and a lot of leg pain for several years. I had 3 epidurals a year apart and they helped up until last November. At that point the leg pain got so severe that the pain doctor told me he can't help me anymore. So I went to a spine center at a major university hospital an hour away. They ordered new xrays and a new MRI since it had been 4 years since the last one.

I had a follow up appointment with my spine (orthopedic) surgeon yesterday. To say the least I am stunned. He wants to do a complete lumbar fusion. If I understood right (and I just realized I will have to clarify this) he would fuse L1/L2-L4/5 and stabilize with rods and screws. I have severe disc degeneration and basically the centeral canal space at L4/L5 is almost completely closed. I could clearly see it on the MRI. I also have some scoliosis and level 1 spondylolisthesis at L4/L5
I went to the appointment ready to schedule surgery, and I knew it would be a multilevel surgery but I was stunned that it will be so extensive. At his suggestion I will make an appointment with a scoliosis surgeon in his group. Tomorrow I have an appointment with my PCP and plan to get other opinions.

I live half way between Des Moines and Iowa City, Iowa so all of these appointments involve an hour drive.

Meanwhile my leg and buttock nerve pain is pretty severe. I cannot twist or make sudden movements without having shooting pains. I am taking gabapentin and tylenol, and I have a few vicodin which I reserve for really bad nights.

teteri66 · 04-17-2012, 11:17 AM

It is always a shock when you learn you are headed for a multi-level fusion. You will want to take your time in reaching a decision on the surgeon and just how much needs to be done.

When I first began my journey in the wonderful world of spine problems, I thought I had a minor ailment, so was shocked when the first spine surgeon I went to said fusion. But then it got more interesting: several surgeons indicated they would do a one level fusion at L4-L5. Then I went to another surgeon who said he would do a minimum of 3 and up to 5 levels. I was stunned. I thought that was overkill, and went with a one level fusion, figuring I could always add on if the one level did not resolve my pain.(It did not. I am now fused from L3 to S1 and feel great.)

So you may find that another spine specialist will feel that you do not need that much surgery. It is important to get several opinions. The success rate for multi-level fusions is quite a bit less than for one or even two levels.

So, do your homework. You may end up with the first surgeon, but at least you'll know you made a decision rather than blindly believing whatever the first surgeon tells you.

omabluebird · 04-18-2012, 03:11 PM

A couple of clarifications are in order. I saw my pcp today and he clarified a lot of things for me. (Not that my surgeon didn't give me the information, I could just communicate with my PCP better after mulling over the surgeon visit.

I do not have severe disc degeneration. I have facet hypertrophy so severe at L4L5 that the central canal is basically nonexistent. The other lumbar facet joints are also compromised to a certain extent.

PCP said not to bother going to any other spine surgeons within the state as where I went is the best there is. He thinks I should wait to see the scoliosis surgeon (can't get in until June 22). If that doctor thinks I should have surgery to correct that issue, it would mean fusing L1-S1. If the first surgeon does it he would only (only!!!) do L1-L5.

So I think that the major issue is L4L5 but he thinks that he needs to stabilize the spine above it (as it is deteriorating). But that would not address the instability at L5-S1. So my question is has anyone had that type of fusion for scoliosis (as an adult?)

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