Question about lumbar fusion

jaydar · 08-24-2006, 11:52 PM

I've been trying to wait intil multi-level adr are approved by FDA and doctors have had time to better perfect their technique....however it seems like that is years away.I've decided to go ahead with spinal fusion.
At issue discs are L3L4 which has already had micro-discectomy which according to Disco and mri has been a success.After that surgery I reinjured my back....mri's do show significant bulging at L3L4 and L4L5 and discogram shows a tear at L4L5(did not show with mri with conrast.MRI also shows ddd at L5S1.
The surgery my doctor wants to perform would be anterior.Not entirely sure which method will be used.I will consult with him next tuesday.
Anyway...I seem to have periods where I don't experience a lot of back pain...and periods where it is unbearable,even with strong meds.
I have at times lost control of bowels...been unable to sit,stand or lay down.....and these episodes have lasted months...I usually have these 2-3 times a year now for the last 4 years.
My question finally is this.
Does lumbar fusion resolve hip,groin,buttock,calf and shin,ankle and foot pain?
Even on my good days I can't walk far or do much of anythingie:yard work,grocery shopping,housecleaning.
After about 10 minutes my hip is bothering me and the pain seems to go down the hamstring almost to the knee and then moves to the outside of my knee to the calf and shin.The pain is usually a burning...but sometimes like electric shock.
The foot pain is usually like being stabbed with an icepick.
I'd just like to know if the risk of such a major surgery has much hope of relieving this pain.Or is fusion more so for the lumbar pain?
4 years of my life has been wasted and I'm not getting any younger.Almost 50 now and being unable to get any cardio type of excersize I am gaining more weight and developing a cholesterol and heart condition.
I'd like to be able to get to a point where I could at least walk a fair distance or ride a bicycle.
Any input as to whether or not going under the knife will help....or is the doctor just trying to make a quick 80-100 grand?
Getting desperate here.

Suzy-Q · 08-25-2006, 12:12 AM

Well Jaydar - that is a loaded question - will a fusion help you?
My research showed that leg and hip pain was more likely to be helped by a fusion than lumbar pain. But if reading this board counts, MANY people experience an onset or return of leg pain post-op. The thinking seems to be that this is likely due to 1 ) the effects of pre=op nerve comression and nerves post-op 'awakening', and 2 ) actual irratation/damage of nerves during the surgery and swelling compressing nerves post-operatively. The hope is that this post-op pain will resolve in time.
I think it is helpful to ask your doc to explain what exactly is causing your pain pre-op (to the best of her ability and in so far as the diagnostics and your symptoms allow) and to follow immediately by asking for a complete explanation of how a successful fusion will reduce or eliminate that pain.
A very intersting thing for me was how these questions landed on the various surgeon's I have met along my journey. Two have been frank and disclosed the fact that outcomes are very variable, most people experience some bumps along the raod to recovery and some - do not recover. I saw one guy who absolutley guaranteed that I would be 100% cured and would have 'zero' pain. I hopped away from that guy as fast I ever I could. Such a guarantee is just nuts and no competent person would make it - in my opinion.
I'm sure this isn't much help to you but that is one whopper of a question you have posed. I wish you well - Suzy-Q

settledintex · 08-25-2006, 08:13 AM

The pain you describe so well is the sciatic nerve. I felt like someone had a tool and was pulling the area between my big toes right off or like you said - stabbing in the foot. I had anterior/posterior surgery and that particular pain is gone. I still have troublewith nerve pain but in working with my PT we have started stretching the nerves very gently back out and the pain is greatly decreased. Lumbar Fusion is a huge operation. My doctor said he puts it up there with heart surgery-its that serious. His opinion was everything else was a proceedure, but this was an operation. We will have you lifted up in prayer as you make this decision.
-Michelle

jeanette44 · 08-25-2006, 02:49 PM

I don't know if this is something that would help you or not, but, there is a new FDA approved device (Nov05) that is for the lumbar area. Called X Stop implant. Mentioned in Sept issue of GoodHousekeeping mag. For ages 50 and up articles say. Medicare approved and said 80% of private insurance will pay for it because it's half of regular back surgery costs.
[removed] It is a minimal invasive 45 minute surgery using local anesthesic. It says it helps those who have lumbar spinal stenosis problems by putting this device in like a spacer, thereby lifting the pressure off of nerves.
Also, if it doesn't help, it can be removed....reversible..no harm done.(articles say) If you have symptoms like only being able to walk short distances and if walking sort of bend over helps and pain goes down your leg/hip and sitting down helps relieve pain. It might be something that would help you instead of surgery. They say on a website that about 600 doctors throughout the US have been trained to do this. I just heard about it this week and have started looking into it. Hopes this helps and good luck!!

jaydar · 08-30-2006, 03:08 AM

Just want to thank those that responded.
I consulted the surgeon today and it looks like we'll be doing 360 fusion with cadaver bone with protien in cage implants at 3 levels.L3-S1.
He say's there's likely to be 70% likelyhood that I will be satisfied with results.The fusion will be both anterior and posterior.I asked if I'd be laid up in that damn plastic corset I had used before and he said that there will be so much hardware that that will be unnecessary.I'll wear a cloth corset primarily I assume for the incision sites to heal up.
The doctor fully informed me of the potential risks which are many,but also assured me they are unlikely...si I said.."Let's do it...I don't care if I die on the table,I just need to see if I can regain some of my life back and be active again" he said"I've never lost a patient on the table yet...I don't plan to have you be the first"
So hopefully surgery will be in the near future,provided the insurance company doesn't play their usual stalling games.