Back Surgery - Yes or No?

[ChrisDDD]

I've never posted here but am a regular visitor at another forum at MedHelp.  Since that forum is so helpful, I thought, why not ask my questions here?  I developed sudden, severe low back pain in August of '06 from bending and lifting stuff that wasn't very heavy.  I have tried physical therapy (too painful), a kinesiologist, massage therapy, chiropractor, and 10 days ago had a spinal block with relief for 3-4 days.  My MRI shows degenerative discs from L1 to S1, with L4-5 discs almost completely gone.  It was the L4-5 area that received transforaminal injections, and asymmetry was noted.  I have a good friend who works for a neurosurgeon, and she said she would never undergo back surgery from anyone but a neurosurgeon.  I visited a physician assistant at the office she works for, and they recommend physical therapy and acupuncture.  The orthopedic surgeon who ordered the MRI is recommending fusion at the L4-5 level.  I want the fusion because I want my life back, and I know several people who've had fusions and had excellent results.  Any advice?  Thanks.

[BOLD FOR JESUS]

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[ChrisDDD]

Thanks for all of your help.  After reading these posts, I'm going to see three more neurosurgeons and take my MRI films and report with me.  It's just that I don't know anyone who had back surgery among my friends, acquaintances, etc. who didn't have a good outcome.  They all did very well and are glad they did it, so I don't understand why my friend is telling me to just "live with it".  I'll let you know what I find out.

[Joface]

I also agree with ValveJob.....a laminectomy in that area (which is what I had recently) can be every bit as effective as a fusion.  Something I learned when exploring surgery was that every doctor has "a" procedure they are most comfortable with and it is up to the patient to decide not only which surgeon to choose, but which procedure.  Two years ago, I went for four opinions on my cervical situation.....doctor #1 said posterior laminectomy; doctor #2 said laminoplasty; doctor #3 said fusion and doctor #4 said both posterior and anterior laminectomy and corpectomy with instrumentation.  Yikes!! In the end....I chose the most conservative neurosurgeon and the most conservative, safest procedure - the laminoplasty - 5 levels - and I've not ever been sorry.  The point is....just proceed cautiously and ask a lot of questions along the way.  You can't "un-do" spinal surgery, so you want to hopefully get it right the first time around.  Good luck - keep us up to date on what you decide!  Jo

[ValveJob]

In 1984 I had surgery for severe sciatica.  It was done by the Chief of Surgery of the Montreal Neurological Institute.  However, it was not a fusion.  He removed the part of the disk which was herniated (it was fragmented as well).  It is now over 23 years later, and although I have minor aches and pains in the back, the surgery gave me back my life!!

[Joface]

I tend to agree with your friend as far as going to a neurosurgeon in most circumstances - especially if there are any nerves involved...I would go to an orthopedic surgeon for a broken leg or broken arm or even a rotator cuff...but when it is my back, my spine and it's the only one I have, no one will touch it but a neurosurgeon (and a GOOD one, at that.)

I received 4 neurosurgical opinions before choosing one to do my cervical and lumbar surgeries. There may be circumstances where fusions are called for, but think about it....when you fuse two levels of anything together and make it immobile, you put additional stress on the level above and the level below where the fusion occurred, making it more likely that you could have troubles at those levels in the future.  You might not, but why take that chance if it isn't specifically indicated?  At the very least, take your MRI and get a couple of other opinions before proceeding.  Fusions aren't always successful.  Just go to the neurology forum and see what people there have to say about them.  Good luck!  Jo

[re448]

I had back surgery for a herniated disc in november of this year...........i thought i had made a big mistake about 2 weeks after my surgery because i was in so much pain.....but now i know i did the right thing. i had very bad leg pain from the herniated disc. they called it sciatica. i couldnt hardly walk or drive....it basically controlled my life. so i say if it is controlling your life do something about it. some people say they wouldnt do it but i am so glad i did. i feel like i have my life back . good luck ...hope this helps

[ChrisDDD]

P.S.  The physician assistant is at the office of the neurosurgeon my friend works for, so that's the conflicting advice I'm getting.  I was able to go horseback riding, sail, ski, rode my bicycle 4 miles per day, all of which I've been unable to do since this pain started.  It's very depressing.  Thanks.