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lubear2003 01-08-2013 06:29 AM

Lumbar Fusion Question
 
How many levels in a lumbar fusion include 8 screws? My Neurosurgeon briefly explained that if he does this surgery, it would include 8 screws. I see him for follow-up on 1/15. I currently have issues from L3/L4 to L5-S1 (Lesser extent at L3/L4), with severe nerve compression at the neural foramen at L5/S1. I have increased, and long standing weakness & pain in my lower extremities & have been doing various conservative treatments for the last 3+ months, to no avail.

Thank you for your help.

Christie

teteri66 01-08-2013 11:14 AM

Re: Lumbar Fusion Question
 
I suppose it could depend on how it is done (from the front, back or side) but generally I would say eight screws would be a three level fusion.

I hope you are getting more than one opinion and seeing an orthopedic spine surgeon in addition to a neurosurgeon before proceeding. You want to make as sure as you can that you are having the appropriate surgery for your problems, no more and no less.

RTgirl2011 01-08-2013 12:18 PM

Re: Lumbar Fusion Question
 
If you are having a PLIF eight screws would be three levels. Your doctor should go over that with you before your surgery.

workinmom572 01-09-2013 09:01 PM

Re: Lumbar Fusion Question
 
Yep, sounds like a 3 level fusion to me too. I had a double fusion and I have six screws. He showed me a model of a spine and it had rods and screws on it so I could really see.

Also ask what they plan to use either artificial or your own bone from your hip, etc. Find out EVERYTHING they will use and put into your body before it's done so you can research it all before hand. Good luck with everything.

lubear2003 01-10-2013 05:13 AM

Re: Lumbar Fusion Question
 
[QUOTE=teteri66;5114065]I suppose it could depend on how it is done (from the front, back or side) but generally I would say eight screws would be a three level fusion.

I hope you are getting more than one opinion and seeing an orthopedic spine surgeon in addition to a neurosurgeon before proceeding. You want to make as sure as you can that you are having the appropriate surgery for your problems, no more and no less.[/QUOTE]

I spoke to my Primary Care Physician yesterday about the referral for 2nd opinion. He is referring me to a fellowship trained neurosurgeon with the Neuroscience Clinic at Stanford. He received the report from the local Neurosurgeon, and confirmed it is a 3-level fusion (L3-S1) that is being recommended. He's going to put a rush on the referral, so I can be seen within 2 weeks, and will review both opinions with me before I proceed. He agreed that surgery is inevitable, and will have to be done in order to improve my quality of life. So now, I wait.

Teteri, Thank you for your advice and support. I know I've said it more than once ..."You are a great help"!

lubear2003 01-10-2013 05:21 AM

Re: Lumbar Fusion Question
 
[QUOTE=workinmom572;5114851]Yep, sounds like a 3 level fusion to me too. I had a double fusion and I have six screws. He showed me a model of a spine and it had rods and screws on it so I could really see.

Also ask what they plan to use either artificial or your own bone from your hip, etc. Find out EVERYTHING they will use and put into your body before it's done so you can research it all before hand. Good luck with everything.[/QUOTE]

Thank you! I'm going to make several notes of questions & concerns to prepare for any future appointments I have. I appreciate all of the feedback I receive here. It helps so much!

ddm13 01-10-2013 07:42 AM

Re: Lumbar Fusion Question
 
I am going to my orthopedic surgeon tomorrow (1/11) to get an opinion on my lumbar back pain. My pain doc has suggested that the orthodoc might recommend either a discectomny with a laminectomy but most likely a lumbar fusion. I believe my issues are in the same as yours. Do you have any suggestions for questions to ask the doc tomorrow from your experience. Also, if I find I need the fusion, I might have other questions would you be willing to help me with thost questions about the surgery, and post-surgery. I appreciate your help.

teteri66 01-10-2013 09:56 AM

Re: Lumbar Fusion Question
 
There are many people on this board who have had lumbar fusions and will help you with questions. Take some time today reading up on lumbar fusions. There are many sites where you can find good information on this topic....

At this point, you want to find out a diagnosis, what is causing your pain and what does the surgeon propose doing about it. You do not need to know details about what type of fusion is being proposed at this point. You want to know if a discectomy will resolve the issues, as you always want the least amount of surgery that will handle the problem.

If the surgeon begins the conversation by saying a discectomy is not appropriate for your problems and that you need a fusion, you can ask why that is the case. Then since you will know a little bit about the fusion procedure, you can ask how many levels are needed, how he intends to approach the area (from the front, back or side), what he intends to use for the bone graft and how long you can anticipate being laid up.

But do a little reading today so you will understand the difference between a discectomy, laminectomy (which is often done with a discectomy to make more room for the nerve that is being compressed) and a fusion. You may see PLIF, ALIF TLIF and XLIF...these are all fusions, differing in the way the surgeon approaches the spine...you just need to know the basics about why a fusion is done and what its purpose is...not details at this point.

ddm13 01-10-2013 03:01 PM

Re: Lumbar Fusion Question
 
Thank you for the information. I have been researching both surgeries and will make sure I bring my questions with me. I did have cervical fusion with this doctor in 5/2009 so I do have an idea how he is during preliminary visits. Having said that, one of my concerns is whether he will be the only one operating or will he have a fellow helping him. Can I request that only he does the surgery? I've read that it is extremely important to have the ortho doc with the experience to do the fusion...thoughts?

workinmom572 01-10-2013 04:08 PM

Re: Lumbar Fusion Question
 
I had a neurosurgeon who did my double lumbar fusion along with his assistant, and a big team of others. It's not possible in my opinion for any surgeon to do major surgery like a fusion without more hands. And mine took 6 hours to complete.
My Doctor and I discussed the pro's and con's of surgery: pro: I'll have a much better quality of life, cons: I wont be able to lift more than 10 lbs again, thus, can't return to my job. Of course he couldn't guarantee anything, but he said he felt that he had a really high chance of reducing my pain, which he did. Ask realistically what your full recovery time "should" be also, if you will have to wear a brace or not, will he have you begin PT at all, etc. Good luck!!


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