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please help - Dr says cervical AND lumbar fusion!
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please help - Dr says cervical AND lumbar fusion!

Hi all,

I have a dilemma. In short, I want to hear from others who have had both a cervical fusion AND/or lumbar fusion. I have had 2 laminectomies on my L5-S1. I was pain free for 2 full years after the first one before the pain slowly came back. I waiting 7 years before having my second surgery. The second surgery was a nightmare! I was a 20 on the pain scale of 1-10 and had to use a walker for months. I never got better and truthfully am worse. I was told by my doctor 8 months after that surgery and another Dr (for a second opinion) I then needed lumbar fusion. I turned to pain management to avoid another surgery. It's been another year of pain, 11 injections, PT, and hydrocodone - but still in so much pain daily.  

My pain Dr sent me for MRI's and then to a neurosurgeon for consult. My MRI read I had excessive scarring from previous surgery, herniations at L3. L4. and L5 - my S1 nerve is encased in scar tissue, and nerve clumping L4, L5 suggestive of arachnoid scarring. I now also have  large 7mm herniations in 2 levels in my neck (C5-6 and C6-7) in addition to all my back and leg pain.

The neurosurgeon said I need one level fusion at L4 L5, and 2 levels fused in my neck. He told me to stop PT, especially for the neck for fear of further damage. He is sending me to an ortho spine Dr for a second opinion since they would be doing the surgery together (I have already seen the ortho he is sending me to and the ortho had also recommended fusion when I saw him 8 months after 2nd surgery. I did tell the neuro about this.)

My neuro said the fusion in my neck would be easy... with only a sore throat afterwards. he did say the lumbar fusion (with spacer) would be harder and it would only take care of my back pain, not my leg pain. I asked him about the arachnoid scarring and the extensive scar tissue at L5 and he said he didn't think all my pain was from that. (although he did admit my symptoms were the same as arachnoiditis, he said the previous Dr would have had to nick the thecal sac or I would have had an infection for that to be true. Not sure how he can assume the thecal sac had not been nicked during surgery and I have had infections since surgery and antibiotics)

My pain level is pretty bad. It's certainly very distracting. Some days I walk with a cane..and I'm only 45. I have also been prescribed Lrica and just took my first dose tonight. I had been too afraid to take it (read about the side effects and the many comments from people who had them) but the pain is just too bad - I have to do something.

If you have had a fusion, are you glad you did it? Did you have the fusion knowing it would not address all your pain? Are you in more pain now? Did you have scar tissue prior to the fusion?

Should I even bother with the fusion if it's not going to adress all my pain? I will still need pain management anyway...

Please help, what should I do? I am so afraid I am going to end up with the same pain or worse afterwards.... I don't know what I would do if it got any worse....

Thanks in advance for your comments - I really need your opinions on this. Only you (friends here in on this webpage) have been through this.... I just don't feel comfortable with the advise from people who (although have my best interest at heart) have no idea what it's like to live in constant pain and think you will be magically fixed if you have surgery.
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8 Comments Post a Comment
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Avatar_m_tn
I don’t think you’re going too find many people on this board that think surgery is some kind of magical cure, matter of fact I think we have the opposite problem of people being scared to have surgery because of the horror stories they read here. You know as well as I do that a lot of these surgery are necessary and do have positive results. The problem is that those people don’t post on boards like these so we get a much distorted view of the results.

I had a PLIF at L4-5 about 8 years ago, and I was in so much pain that I didn’t even care if it took away all the pain, as long as it got rid of some of it. The Surgeon said it probably wouldn’t take away all pain, but like I said, I didn’t care. The outcome was great. It took almost an entire year to recover, but aside from some permanent numbness in my leg, I haven’t had a low back or leg problem since. No adjacent segment disease or anything.

My ACDF at C6-7 is a completely different story. That surgeon told me that the surgery would take away all my pain, and that I might have occasional tingling in my arm, total bs. That idiot basically botched my diagnosis. I presented with 3 disc herniations in the cervical spine, the worse being at C6-7, the surgeon felt that the other ones weren’t severe enough to worry about at that time. When my recovery pretty much stalled I saw 2 other surgeons that said I need a fusion at C4-5, this was 5 years ago. At that time there was no way I could have gone through another procedure physically or emotionally. The experience made me very cynical and distrusting of the medical establishment as a whole, and I though maybe if I gave it a little time I might feel better, no such luck. I’ve been dealing with chronic pain ever since. I’ve finally made up my mind that I need to have this fusion done, will it take all my pain away, I doubt it but I don’t care. Anything is preferable to the way I’m living now.

Having surgery is really a decision you have to make for yourself, intractable pain or serious neurological problems are usually the determining factors. Sounds like you’re in pretty bad shape. With help from Pain Management, do you feel that you can function and live  the rest of your life the way you are now? That’s an important question.

You didn’t say much about your neck problems, have you had a previous neck surgery? The procedure might be easy for the surgeon, but let me caution you, the recovery can be pretty rough.


Take Care


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1322157_tn?1279660281
Just want to correct my misspelling of Lyrica. AND that I decided the pain was so bad that I had to start taking it. So far, it's been good! (Crossing my fingers for no side affects and less pain.)
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1322157_tn?1279660281
Thanks for the response. The Dr told me the recovery would e easy. No previous injury or accident. My neck, shoulder and arm just started to hurt when I lowered my head or raised my head. Because I had been there done that - with the herniations in my back, I knew what was coming. Truthfully - even the 7mm herniation in the neck does not bother me as much as my back.

I too, am not emotionally or physically ready for fusions. Still reeling from the last surgery 2 years ago.

I just posted above that I caved and took my first Lyrica last night. So far so good. I can even say the pain is lower today! I would easily stay in pain management if the pain could be controlled. If i could take 2 more hydrocodone a day (take six right now but they only last for 4 hours at best), along with the lyrica, I would be fine.... i could live like this for a while. But getting the Dr to prescribe the 2 extra is probably not in the cards. Sometimes I wonder if they conspire to keep you in pain so that you will continue to have surgery.

There is no doubt in my mind that pain can be controlled - but it's just a matter of finding a Dr who is willing to do it.
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Avatar_m_tn
Your point's taken about the Doctor's prescribing, been down that road. 5 years ago I had a Doctor that gave me the extra 2 pills and everything was fine, until it was flagged by my insurance company and my Doctor didn't want to hassle with them. The Tylenol is not a factor if your taking 10/325's but they don't know that, they have a book of guidelines they go by.

Personally, most of these pain killers, Neurontin, etc have never really done anything for me but take the edge off, no matter how much I was taking. I guess that's why I have to have surgery.

Take Care
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Avatar_f_tn
So sorry to hear of all your going through!!!! *hugs* I had a one level fusion at l5/s1 on feb 22nd of this year. My first spine surgery and my last lol. I had spondylolisthesis which resulted in severe bilateral foraminal stenosis which caused significant bilateral root nerve compression at this level. My symptoms began out of the blue in my legs one day March 21st of last year. Tried everything I could think of to stop the abnormal gait I aquired due to weak leg muscles and the excruciating nerve damage pain in my legs. I had fusion surgery with instrumentation. I get around better now than at the beginning of my surgery. My leg pain and weakness come on here and there, but the main switch off. Is the pain in my lower back. I have much more of that since my surgery and less leg pain and weakness. I'm almost 4 months out. I'm waiting to see before I say my surgery is successful. At night, getting out of bed or rolling over is still painful, but during the day, if I'm up moving around, walking, its so much better. Greates blessings to you:) hi kalvin, good to see u!! *hugs*
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1322157_tn?1279660281
Thank you for your reply. My Dr told me that the fusion would take care of the pain in my back but not the leg pain. I have heard from many people, like you, who say the back pain continues after surgery... I do hav to say, the Lrica has worked a bit with the nerve pain in my legs. The bad part is that m insurance company won't cover it..and it's so terribly exspensive. If I can get pain control with medication, I am going to try to put off the fusions for as long as I can....

Can you feel the hardware in your back when you sit against a chair, for example? I had one person tell me they could and it was uncomfortable.. I once had plates and pins for a bone break - but the Dr's removed them when I was healed saying the pins and plate would weaken the bone. I think of that, too - when I think of the fusion in the spine. Did your Dr tell you anything about what your future holds with a fusion? Possible problems later with the discs above it?

Do you know what cause your spondylolisthesis? Did you fracture your back? Just curious since you say it came on quickly last year and imply you had no previous back problems... I am so, so sorry to hear of your pain. I hope the Dr has good news for you when you see him. Best wishes!!!
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Avatar_n_tn
I have had an acdf c5-7 with c6 corpectomy and am VERY happy wityh the outcome. Sorry that was in july 09.I woke up one day with a sore neck and arm which within days lost all feeling in my right arm. I was back to work as a boat mechanic within 2 weeks with lifting limits. I did a ton of research before the surgery so I kind of new what to expect. On Nov. 30th 2010 I had L4-S1 posterior interbody fusion and the only thing is the nerves "waking" up have been the uncharted waters for me pain wise. Other than that Its just the surgical sight to have some pain. I used to have terrible sciatica with numbness on top of my legs which is all gone already!! So for all the terrible stories you will hear most are from people who had an orthepedic surgeon or just like to eat pain killers.Reasearch NEUROSURGEONS since we are working with nerves here. STAY AWAY from chiropractors -I have a friend who is paralyzed from one who tried to realign his neck and severed nerves. If your physical therapist is still trying to treat you they are using you and you need to ask what exactly they are trying to make better since there is something anatomically wrong and making things flare up just to get thru therapydoesnt make sense. Now dont get me wrong injections and therapy sometimes work but a good neurosurgeon and an mri will help lead you down the right path. Also if you do have either surgery do exactly what they tell you to do. Thats another reason you will hear horror stories about these surgeries is people think they can do more after feeling a little better. GOOD LUCK!!
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Avatar_n_tn
Sorry wasnt back to work in 2 weeks it was 2 months!!
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