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Is fusion a good option?
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Is fusion a good option?


  I am a 35 yo female with history of lumbar back problems.  I had two previous surguries to  remove herniated disc fragment that was "at least the size of an olive" and to open the nerve root openings.  After two years things were improveing and a wrong move sent my symptoms back into play.  I have no ankle jerk reflex anymore and have numbness and tingling in both legs, although left side is predominant and mroe frequent.  I also have difficulty after standing and sitting for any length of time (beyond 10-15 minutes I get uncomfortable and tingling starts).  My left foot is numb almost all the time.  I do not experience any loss of strength that is noticeable.  I have recently seen my neruosurgeon who feels that the problem is predominantly mechanical at this point and is caused by instability of the disc space which is the direct result of the removal of the large disc fragment.  He feels that fusion is the only option to fix this if the pain and symptoms become intractable..  I am on Relafen for the next two months to alleviate the inflammation and help reduce the symptoms.  What are my odds if I opt for the fusion ( with cages, vs. screws, rods, et.al)?  Is there anything else I should be doing to assist in my recovery?  I am walking and doing some exercises recommended by the PT.  Or do I just accept that this is the way it is and get on with life? Thanks for your thoughts on this matter.
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Dear L.,
Your situation is one that may be improved with a fusion.  Chronic back pain can be caused by mechanical movement of one vertebral body on another, especially after multiple procedures to remove herniated discs.  One way to evaluate this is with plain films of the spine in flexion and extension to see how much one vertebral body moves in relation to another during dynamic testing.  If the bones do move significantly, then a fusion may be a good idea.
If a fusion is not done, the bones will eventually fuse on their own, but this may take some time.  The idea with the surgical fusion is to accomplish this more quickly and allow the patient a faster recovery to a functional lifestyle.

Speak to your surgeon about these issues and the risks involved with surgery.
Good luck.






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