Lumbar interbody fusion

[Smitty33]

Wondering if anyone has had back surgery? Had an appointment with surgeon yesterday and surgical option I have is removal of my bottom 3 disks and fusion. Been suffering with this for 20+ years and just about had it with it. Been to multiple docs and chiropractors over this time frame and have tried every option except of surgery or heavy narcotic pain killers and am leaning heavy on the surgery option just wondered if anyone else has been through this and how they feel it helped or hurt them. THANKS!!!

[piedlover79]

I haven't had the surgery but I work as an occupational therapist for patients who have had fusions and I'd say a soild 9 out of 10 are happy they did it and wish they'd done it sooner rather than later. The few that don't get relief tend to be medically complicated in other ways. Just do your homework on your surgeon and his outcomes and the hospital's infection rate. There are website that are government sponsored that will give you all those numbers.

[blue roses]

In 1974 at 24 years old, i fell and cracked 2 discs in my lower spine. The discs traveled into the spinal collom, pinching the syatic nerve. When i started losing feeling in my foot and right leg they x-rayed at the hospital, and found the damage. I had emergency sergury the next day. They removed the 2 discs and fused the spine. I am walking today because of that sergury, and am pain free to this day. My case was very severe and i could have been paralized if i had waited longer. I still have a drop foot and wear a brace on it, but the pain is totally gone. I know sergury is scary, but so is being in constant pain. I would really sit and talk to the doctors, and have them list the pros, and cons, including the risks involved especialy if you have other medical issues. hope this helps, good luck

[Smitty33]

Thank you very much guys for the info!! Exactly the feedback I was hoping for.

[Reinz]

I've had disc problems as long as I can remember. I now have three lower herniated discs and am disabled. I can walk, not run. I can only stand or sit for 15-20 minutes at a time.

I've seen dozens of doctors and surgeons over many years. They all gave me the same advice, if I can walk fine and or without too much pain, DO NOT get surgery. That has been my yardstick to go by even though some days are unbearable. But I can still walk ok.

My current back doctor tells me that there are promising procedures coming here that are working in Europe for 3 levels of discs, but not approved yet. The newer two level procedures (nonfusing) are approved and working well.

For me, I'm waiting on the new 3-level nonfusing procedure. Each back patient has unique circumstances and criteria.

Best of luck with your decision.

[Stingray74]

I'm right there with you, Smitty. I'm in my early 40's and have had serious back issues since my early 20's. I have degenerative disk disease, two herniated disks, and really bad stenosis at L4, L5, and S1. I've been to at least 10 different surgeons over the past 20 years and have more MRI's in my filing cabinet than I can count. For years, I've had minor sciatica in my left leg, but severe lower back pain, impacting all aspects of my life. The lower back pain is a constant "pinch and burn" that never seems to go away. Definitely gets worse when I left something too heavy, or twist and bend too much. I've never taken any narcotic for the pain as that's a road I don't want to go down at all.

5 years ago I finally decided to have a minor back procedure to try to help with the sciatica and possibly help with the stenosis. I had a micro procedure at L4, L5. Essentially, he went in and trimmed the bone hitting the sciatic nerve, and left me with a tiny 1" scar. It worked very well.....for about 2 months. The sciatica came back worse than before, and the lower back pain never went away. I've just lived with it since then and definitely notice that the more I move, the better I feel. I walk 4 to 5 nights a week to keep the pain in check. If I stop walking for a few days, the pain becomes really bad....can't sleep, sit, stand.....laying flat on my living room floor seems to help. Things got so bad around Christmas 2015, that I scheduled appointments with two surgeons for opinions. Got a fresh MRI and saw them both for their opinions, not telling either of them I saw the other. They both said I need a three layer fusion to stabilize things.

Meanwhile, one of the surgeons suggested a nerve block injection, which I had done about 6 years ago and it did nothing at all to help. I was hesitant, because they're expensive, even with excellent insurance. 1 month ago, I had the injection, and I'm feeling really good. The pinch is still there, but not nearly as bad as it was before. The sciatica has essentially disappeared, but it was never very painful. The serious pain is in the lower lumbar area. Granted, this shot is simply a temporary band-aid, but I'm taking advantage of it and trying to strengthen my core and do everything I can to avoid a fusion. One of the surgeons I met with operated on and fused my mom's spine 20 years ago. It took her a full three years to recover, and I remember her pain vividly as I was living with her at the time. She was up and walking instantly, and was functional in about a month, but it took three years for everything to settle and for her to be without major pain. She still has back pain to this day. Anyways, he told me that the spinal fusion is a 33/33/33%, meaning 33% get better, 33% get worse, and 33% have no change. He said this is documented by the Mayo clinic and any doctor that says differently is not giving the facts. So, based on the 33% of getting better, I'm holding off on any surgery until I'm stuck crawling on my hands and knees. So, I'm 66% het to stay the same or get worse....no thanks. Good luck to you.

[Smitty33]

I'm right there with you, Smitty. I'm in my early 40's and have had serious back issues since my early 20's. I have degenerative disk disease, two herniated disks, and really bad stenosis at L4, L5, and S1. I've been to at least 10 different surgeons over the past 20 years and have more MRI's in my filing cabinet than I can count. For years, I've had minor sciatica in my left leg, but severe lower back pain, impacting all aspects of my life. The lower back pain is a constant "pinch and burn" that never seems to go away. Definitely gets worse when I left something too heavy, or twist and bend too much. I've never taken any narcotic for the pain as that's a road I don't want to go down at all.

5 years ago I finally decided to have a minor back procedure to try to help with the sciatica and possibly help with the stenosis. I had a micro procedure at L4, L5. Essentially, he went in and trimmed the bone hitting the sciatic nerve, and left me with a tiny 1" scar. It worked very well.....for about 2 months. The sciatica came back worse than before, and the lower back pain never went away. I've just lived with it since then and definitely notice that the more I move, the better I feel. I walk 4 to 5 nights a week to keep the pain in check. If I stop walking for a few days, the pain becomes really bad....can't sleep, sit, stand.....laying flat on my living room floor seems to help. Things got so bad around Christmas 2015, that I scheduled appointments with two surgeons for opinions. Got a fresh MRI and saw them both for their opinions, not telling either of them I saw the other. They both said I need a three layer fusion to stabilize things.

Meanwhile, one of the surgeons suggested a nerve block injection, which I had done about 6 years ago and it did nothing at all to help. I was hesitant, because they're expensive, even with excellent insurance. 1 month ago, I had the injection, and I'm feeling really good. The pinch is still there, but not nearly as bad as it was before. The sciatica has essentially disappeared, but it was never very painful. The serious pain is in the lower lumbar area. Granted, this shot is simply a temporary band-aid, but I'm taking advantage of it and trying to strengthen my core and do everything I can to avoid a fusion. One of the surgeons I met with operated on and fused my mom's spine 20 years ago. It took her a full three years to recover, and I remember her pain vividly as I was living with her at the time. She was up and walking instantly, and was functional in about a month, but it took three years for everything to settle and for her to be without major pain. She still has back pain to this day. Anyways, he told me that the spinal fusion is a 33/33/33%, meaning 33% get better, 33% get worse, and 33% have no change. He said this is documented by the Mayo clinic and any doctor that says differently is not giving the facts. So, based on the 33% of getting better, I'm holding off on any surgery until I'm stuck crawling on my hands and knees. So, I'm 66% het to stay the same or get worse....no thanks. Good luck to you.

See I'm the opposite, I wish I could walk 4/5 days a week but walking just kills me. It's by far what messes me up the most and also my biggest aggrevation of it all.

[Jabberwocky Dragons]

The literature shows excellent results for lumbar spine fusion. 90%+ successful fusion rates are frequently reported in large randomized controlled trials and same with patient satisfaction. A three level fusion is more difficult than a one or two level but still shows decent success. The product and technique used will also play a role. My advice is to ask your surgeon for the name of the technique he would use and then Google it. Look for the studies and read the results. That will give you an idea of the typical success rates and patient satisfaction with that particular procedure.

I haven't had the surgery but I work as an occupational therapist for patients who have had fusions and I'd say a soild 9 out of 10 are happy they did it and wish they'd done it sooner rather than later. The few that don't get relief tend to be medically complicated in other ways. Just do your homework on your surgeon and his outcomes and the hospital's infection rate. There are website that are government sponsored that will give you all those numbers.

Right on. smoking has been shown to have a negative impact on healing.

Anyways, he told me that the spinal fusion is a 33/33/33%, meaning 33% get better, 33% get worse, and 33% have no change. He said this is documented by the Mayo clinic and any doctor that says differently is not giving the facts. So, based on the 33% of getting better, I'm holding off on any surgery until I'm stuck crawling on my hands and knees. So, I'm 66% het to stay the same or get worse....no thanks. Good luck to you.

Really? I think either you might have misunderstood or your doctor is misinformed. I'm not even sure what documented by the mayo clinic means... that they published a study? This is easy to disprove, simply read through the studies online to see the average success rate for lumbar fusion in large patient population is much higher than this. Again a 3 level will have a lower success rate but recent literature should put it at around 70-80% successful fusion with low pain reported.