What does 'Pre Testing' for fusion surgery entail?

oakleygirl

The mental test Shg is talking about is probably the MMPI (Minnesota Multiphasic Personality Inventory).
My physician required me to take it - costs $600 including interpretation. Not sure how they get some of that stuff from that test, but it was interesting! It is supposed to be a good predictor of surgery outcome.

Now for the bad news - my neuro told me 80% of fusion patients will tell you they would do it again. And, there is a percentage of the other 20% who were actually worse. We've all seen some of those people here on the board, and my heart goes out to them. Wonder what goes wrong to cause these failed surgeries?

O'Girl

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20 years intermittent back pain - no treatment sought
Nov 2001 - herniated disk - Right leg radiculopathy
Jan 2002 - Chiropractic care
Mar 2002 - MRI, X-Rays, Oral steroids
Apr 2002 - L4/L5 Microdiskectomy
Sept 2002 - PT, Oral steroids
Oct 2002 - MRI, Xrays - Failed Back Syndrome
Apr 2003 - TFESI, EMG, MRI
Diagnosis - DDD - foraminal narrowing, disk bulges, osteophytes, ligamentum flavum hypertrophy, active marrow edema, levoscoliosis, retrolisthesis, scar tissue encompassing L5 nerve root, disk height diminished, abnormal EMG results for left leg
Sept 2003 - Discogram with Xrays, CT Scan.
Oct 2003 - 2 level 360 degree fusion to be scheduled

MarianJ

Hello Shg,

I think that you worked your brain a little to hard today..lol.... I was referring to my blood donation prior to my surgery. Remember I already had my fusion. How could anyone forget my complaints.. lol...
Stop working so hard.....

Have a good night...

shg

O’Girl,

After I wrote it I realized I didn’t put what it was. Thank you for helping me out on this.

What goes wrong? Many things, poor MD skills, a doctor who isn’t aggressive enough and vice versa, really degenerated people who have gone too long before seeking this procedure, peoples bodies which you can’t control, than there are those things you can control: obesity, smoking, not listening to your doctor, stupid behavior, etc.

Also, that 20% figure is from some reports, others say it could be as low as 5 to 10% now. It’s all about perspective. Speaking of perspective, how many times have we heard a mother say, I’ll never have a baby again? Or heard someone who said, it was so painful when I had my nose job, knew/hip replacement and I wouldn’t do it again yet they’re better? Many of these studies looked at a 3-month to a 1-year time frame. The one’s that go further out have better stats than again, some don’t. We’re all individuals and we have to learn NOT to think so much about these stats but rather think about ourselves and what we can do to put ourselves in the “success” column.

SHG

MarianJ

Hello O'girl,

Here is an article that I saved when researching for my fusion surgery with infuse.

INFUSE Bone Graft contains recombinant human bone morphogenetic protein (rhBMP-2), the genetically engineered version of a naturally occurring protein that is capable of initiating bone growth, or bone regeneration, in specific, targeted areas in the spine. Approved for use with the LT-CAGE Lumbar Tapered Fusion Device, INFUSE Bone Graft is indicated to treat certain types of spinal degenerative disc disease, a common cause of low back pain. Using INFUSE Bone Graft with the LT-CAGE Device in spine surgery reduces the pain and complications associated with treating degenerative disc disease by eliminating the second surgery required to harvest bone from a patient's hip, as is done in traditional spinal fusion procedures.

Degenerative disc disease is a disorder of the spine that can be extremely painful and debilitating in patients who generally lead active lives. The disease occurs when discs in the spine are damaged. Pain emanates from the damaged discs themselves or is caused by the discs or bone impinging on nearby nerve roots or the spinal cord. By the age of 50, approximately 85 percent of the population will show evidence of disc degeneration.

Spinal fusion surgery is often the only effective method to treat degenerative disc disease. Spinal fusions essentially "weld" two or more vertebrae together to eliminate the pain caused by a damaged disc in the spine. To fuse the vertebrae together, surgeons traditionally insert pieces of the patient's own bone between the vertebrae to prompt the body to grow new bone. But implanting the bone chips actually requires two surgeries -- one to chip off small pieces of bone from around the patient's hip (autograft) and another to insert them in the spine. Studies have shown that the bone harvesting procedure can be more painful than the fusion itself, and nearly a third of patients experience some hip pain two years following surgery.


INFUSE Bone Graft eliminates the painful harvesting surgery because it contains rhBMP-2, which induces the body to grow its own bone where it is needed. Discovered and developed by Wyeth (NYSE: WYE), rhBMP-2 is manufactured in its Andover, Mass., biopharmaceutical facility.

To use INFUSE Bone Graft, surgeons reconstitute the rhBMP-2 powder with supplied sterile water and then apply it to collagen sponges. The sponges are inserted inside each of two LT-CAGE Lumbar Tapered Fusion Devices, which are then implanted between the vertebrae. The thimble-like cages stabilize the spine while it is fusing and also maintain the proper height between the vertebrae. The tapered design of the cage is intended to help restore the natural curvature (lordosis) between vertebrae in the spine, as compared to traditional cylindrical cages.

"The FDA approval of INFUSE Bone Graft represents a new approach to the treatment of low back pain and is a major advance in traditional spine surgery," said Kenneth Burkus, M.D., an orthopedic surgeon at the Hughston Clinic in Columbus, Ga., who participated in numerous clinical trials and has the most clinical experience in the world with the product. "The combination of a biological product with a medical device, intended to effectively fuse vertebrae in the spine, is a significant step for orthopedic and neurosurgical procedures for both physicians and patients. Spine surgeries with INFUSE® Bone Graft and the LT-CAGE® Device will be quicker, less expensive and, more importantly, less painful for the patient."

Take Care.

MarianJ

Hello Isillyme,

I really hate to hear that you as well as Brooke will be home alone most of the time. I really wish you had someone to help you along. Maybe the case worker might suggest you also staying in the hospital a little while longer. I had my husband and teenage children to help me and they still asking me in the hospital if I was interested in going into Rehab. I told them no way I am going home. After a couple of days home, I wished that I had gone into Rehab, but that's only my experience. Things would have been so much easier for me if I had a hospital bed. But we are all different and you are also having the prodisc surgery.

I really wish you the best of luck.

MarianJ

Hello Camelia,

Prior to my surgery I had chronic back pain. I had pain in the right buttock area and it was a very sharp pain. I had pain all the way down the back of my right leg and my two little toes. I had the sciatica severely and I was tripping all the time. After I had my discogram I had begun to use a quad cane and was dragging my leg and could barely walk at any distance. The pain kept me up for many hours during the night and the pain meds weren't working as well. This all was from only one disc. Occasionally my back would go completely out and it basically crippled me from the other disc. The last time that happened I really needed a wheelchair. That would last about a week. Their wasn't a prescribed pain med that could alleviate that pain. I would end up in the ER. I do not have spondy like you. I have DDD, lordosis, disc deformity, and stenosis.
My surgeon had changed my surgery date to a sooner one as I was progressively getting worse at a very fast rate. I haven't posted this before because it is very embarrassing but oh well, I even started to lose my bladder. I had also suffered for so many years and my nerves were being damaged. My neuro did explain to me what may happen if I did not agree to the surgery. He also told me that their was no way of knowing if the nerves would heal or if they would be permanently damaged.

The pain I now have is not the same pain as prior to surgery. The back pain is different and is finally starting to lessen. The buttock pain is worse. I have pain in not one but both legs and feet. This could also be the nerves waking up and hopefully repairing themselves. Also have muscle pain but I am hoping this will go away as this is from the surgery. I have also started a thread called swollen legs and feet. I may have other medical conditions contributing to my leg pain. Recently they have found that I have anemia and I have to have all sorts of testing. I also have pitting edema and the causes for this are being ruled out with other testing. My neuro has said that my swelling is not related to my spine. But he also sent me to have a CT Scan which was yesterday. To soon for me to say if my surgery is a success or not. Fusion does take from 3 months till a year and sometimes longer. If I completely fuse within that time and my spine is stable the doctor's will consider my fusion a success. Even if I still suffer with muscle or nerve pain. I pray everyday.

I would suggest making a list of all your question's prior to your doctor's appointment. I always forget to ask something. I even made a list but the only problem was I forgot it....lol

Have a good night.

StillWater

Are psychological tests prior to the surgery common?

Tomorrow, you said you had wished you had a hospital bed at home. Did others of you feel that way, too?

StillWater

shg

Still,

The tests are common.

SHG

camelia

this posting is for all - but especially those amongst us who get 'bored at night & can't sleep', the constantly 'curious' & those who've been through the 'dark years'
I 've been corresponding for 10 years with my husband's 1st wife - we come from similar white bread backgrounds but are very different, she communicates with 'the other side' I don't, she isn't materialistic - I am, she's very bright - I'm just average but we share a son & daughter - have lots to write about & we've both thought our letters would make a great book but neither of us have had the time to do it
my point here is:
Some of the threads on this board have been quite inspiring & could possibly contribute towards a novel - for romantic think Brigitte Jones Diaries, for informative think Numb Toes & other Woes - (hope this isn't advertising)
The internet is such an amazing thing allowing us to communicate & support each other without ever meeting - I hope this idea doesnt offend anyone as obviously none of us want to be taken advantage of or hurt in any way but permissions could be asked for, postings could be changed & names too if necessary - anyway that's my 2 cents - you can thank me in the acknowledgements!
C

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Spondylolisthesis at L5S1 = nerve impingement = pain in legs & feet
Laminectomy April 21, 2004

shg

C...

Lets get this book started now and put the proceeds towards something like a Healthboards.com Positive Fusions Reunion Party..

SHG

MarianJ

Hello Camelia,

I agree with you about the internet being amazing. I prefer to be on my PC rather than any television show, and that makes my husband very happy as he has the remote control all to himself...lol

As for the book, sounds terrific, but you will also have to include, "The Misery of Recovery," with Sean's Positive fusion Reunion.

Take Care.

MarianJ

Hello Camelia,

I agree with you about the internet being amazing. I prefer to be on my PC rather than any television show, and that makes my husband very happy as he has the remote control all to himself...lol

As for the book, sounds terrific, but you will also have to include, "The Misery of Recovery," with Sean's Positive fusion Reunion.

Take Care.

isillyme

Hi Shg
I am having one level done, and this will be done at the L4-5 area. I was told that I will have a 2 to 3 inch surgical site, so that won't be so bad. Clay is about 10 miles north of Syracuse, and my surgery will be done by Dr. Yuan. He is top surgeon in the country and I was told by many people that I have a great surgeon. Dr. Yuan is trying to save the other 2 discs that are torn, so hopefully having the PRODISC surgery done will help the other ones. I will be at the university hospital in Syracuse. I can't believe the October 9 is just a few days away now. When the surgery was first scheduled in July I was like you know October is so far away, and now I am like it's here. I will look at the good fusion board, and I am remaining positive that this will work for me.

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canadate for the prodisc surgery. have herniated disc at L4-5 also have tears in L3-4,and
L5-S1. Had the IDET in January 2000 at
L4-5 level. Have nerve blocks under sedation at C5-6 and C6-7 also have swelling in the nerve that supplies down both arms and hands. May have 3 buldging discs in the cervical region as well. due to have the prodisc surgery for the lumbar in October. Have tried everything for lumbar nothing has worked, including significant weight loss.

__________________
I had the prodisc surgery at level L4-5 on October 9,2003. I have L3-4 and L5S1 starting to go bad... but will look into that in the future. Epideral blocks are helping.

isillyme

Hi Tomorrow
I will be seeing my ortho's nurse practioner on monday so I will be asking many questions to her, and explain to her that I will be home alone most of the time. Then perhaps I can still plan on things. I am hoping that I won't have to be at the hospital too long, but if I have to in order to have a successful surgery then I will do it.
Thank you all for your posts and kind words, it gives me a huge inspiration to keep going, and I hope what information I have will be passed to all of you as well. Have a great weekend. [img]http://www.healthboards.com/ubb/love1.gif[/img]

__________________
I had the prodisc surgery at level L4-5 on October 9,2003. I have L3-4 and L5S1 starting to go bad... but will look into that in the future. Epideral blocks are helping.