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  • Xlif fusion L3 L4

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    Old 04-06-2013, 09:15 PM   #1
    runiac2
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    Xlif fusion L3 L4

    I have sufferedfrom lower back pain most of my adult life. As a runner I assumed it was just part of the soreness of running.

    Last year I started noticing odd sensationsin my legs, mostly theright leg when running. Over the course of about two months this progressed to the point where my foot and really my entire lower right leg sort of let go atthe point in my stride where I was bringing that leg forward which caused my foot scrape the ground with every runing step.

    An MRI revealed disc dessication at L3 and L4 and L4 and L5 as well as stenosis. I have xonsulted with three surgeons. One wanted to do a laminectomy at L4/L5 only. One wanted to do a laminectomy at l3/l4 and l4/l5. The surgeon I feel most comfortable with says an Xlif fusion at L3/L4 will solve the problem of the foot drop and address the back pain. He says a laminectomy will not help my back pain.

    I finally gave up hobbling through running ten days ago. I now only cycle but am getting in at least two hours a day on the bike. My back pain is usually pretty bad and my right leg still sort of drops alittle even when walking. I will sometimes also feel a sort of heaviness and fatigue like feeling in my buttocks. My right knee always hurts. I had arthritis in this knee but the pain is a bit different from that. The surgeon says the fusion will elimnate my symptomsand allow me to run and walk normally again.

    As I read the threads on this forum and when I google anything involving spinal fusion it seems everyone has radiating leg pain not just some muscle weakness or fatigue. This makes me wonder ( and ask for advice) concerning my situation.

    How can I be sure this back issue is really the source of my deficits and will things likely get progressively worse if I decide not to do the fusion? Are the risks of surgery worth the potential gain?

    Any input is appreciated

     
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    Old 04-08-2013, 11:50 AM   #2
    teteri66
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    Re: Xlif fusion L3 L4

    I'm positive I responded to your thread last evening, but since it isn't here I will try again.

    First, it doesn't sound like you are at the point where you are ready to commit to surgery, particularly a fusion. You are correct in that surgeries like laminectomy and fusion are often more successful dealing with leg pain than with back pain. Second, I am curious why the surgeon who suggested fusion is choosing L3-L4 rather than L4-L5. Obviously he has much more information to go on...but just from what you have described I would be concerned that the foot drop is stemming from the L4 or L5 nerve and that the L4-L5 segment needs to be addressed, too. Muscle weakness is a sign of spinal nerve compression just as much as tingling, numbness and shooting pain.

    Without more information from your MRI report, it is difficult to add much, but in general, it sounds like you need more information before you can proceed.

    Surgery for lumbar problems is almost always done as a last resort after the patient has tried all appropriate conservative treatment measures and they have failed.

    Have you been through a course of physical therapy and have you had any epidural steroid injections?

    Fusion is a surgery of last resort. Once the spine is fused the back is never the same. Some people don't realize that once they have spine surgery, the back will not end up in the same condition it was once in prior to onset of injury or pain. Fusions is done to stop spinal instability. It is not done for the purpose of pain relief.

    Disc dessication is a sign that there are degenerative changes going on in the discs. As we age the discs tend to lose moisture and flatten out. This can allow for more "play" between segments which makes the body think there is instability. To counter this, the body sends the message to grow more bone...and the result is little bony overgrowths like bone spurs. This can happen with the disc, the vertebra and the facet joint, resulting in an enlargement that can end up putting pressure on the nerves.

    I'm glad to hear you have stopped running, for now. I would advise you to discontinue running until you get your back issues resolved and you are healed. Otherwise, if you don't give your body the opportunity to heal, sometimes the pain and the back problems become chronic and you may have them all your life.

     
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