What should I know about surgery on L-4-5 and a level farther down?

[Job777]

A surgeon has scheduled surgery on me for July 14, saying that my situation was a "no-brainer."  I've had 23 years of pain in my feet and now, more recently, in my thigh.  Four steroid shots showed conclusively that those two levels in my back and above the coccyx were the culprits.  (1)  What advice or experiences have any of you had with lumbar surgery?  (2)  Why do so many doctors miss the back as the problem when there is pain in a person's feet and thighs?  (Doctors in six states and Canada, all places where I have sought medical help missed the diagnosis until a young pain doctor finally guessed and confirmed that my back was the problem after I retired and moved to Michigan.)  Any thoughts that any of you have would be greatly appreciated!

[Job777]

Thanks for your encouragement!  I do have a rare form of hereditary peripheral neuropathy as well as fibroamyalgia.  But I'm very thankful that God gave me peace about the presence of pain in my life 13 years ago after many, many complaining and confessing prayers (see Philippians 4:6,7), but his peace is not fatalistic.  I hope that the great Surgeon will use my human surgeon to give me some relief, because pain is distracting me more and more.  Again, thanks a lot!  I'll follow the doctor's instructions.  

[pickle28]

I have been through both the cervical surgery 3 discs replaced.  That part is doing great.  But, as for my lower back L4-L5 so far I have had three unsuccessful surgeries.  My pain management Dr. Did another ct/myelogram, and the report is stating surgical defect was noted.  Does anyone have any thoughts on what that could mean?

[bigdonkey1]

Do you have any information about a secondary fusion success rate? I had fusion on 2 levels in 2007 with great results. to good in fact, now I damaged the L2 joint with severe leg pain. I am scheduled for a single lumbar fusion on 6/11/09. But the Dr did say that secondary fusion success rates are lower than primary fusion.
Does that sound right to you? what are the diffferences? I am 48 yr old thin healthy male with a screwed up back. The prognosis is encouraging from the DR but I am really concerned with the fusion success rate. I am confident that if I do successfully fuse that I will achieve stability and reduce my pain. But the fear of not fusing is high. any thoughts to lower my fears?
I have one of the top Neuro Dr's in the country, so I am confident that he will do a good job. my bodies abiltiy to fuse is what worries me. Is there any supplements that I could take to help the fusing occur? Calcium etc?
Any feedback would be appreciated.

[ezlivin]

One huge thing to consider with this surgery is that if you have nerve issues (which it sounds like you do) be VERY careful upon healing.  Be sure to ask your Doctor exactly what you are supposed to do after surgery.  If the Doc tells you to not do anything after surgery, DONT!  I have had 4 surgeries on the same levels:  L4, L5 with stenosis.  I have permanent nerve damage and dengenerative disc disease as well.  

Anyway my point is after my second surgery the Doc told me to take it easy and stay off my feet for 2 weeks.  The day of my two week follow-up, I was feeling great and decided for the first time to just do some dishes before my appointment.  Well, when your nerves are healing they can give out on you completely unexpectedly!  I ended up slamming down on my right hip because my legs gave out before I knew it.  I was then in bed for 8 months with a broken hip!  

Find out if you need to have a walker and if you do, use it even if you feel great!  You never know when the legs are going to give out with nerve damage.  I did not even have time to "catch" myself on the counter because it happened so fast!  Another huge thing for me was to have a medical toilet seat so that I do not have to bend so much while my incision is still healing.  I was also given a long "picker-upper" which is a huge pair of tweezers so that I could pick up things that I dropped, and a long shoe horn by my PT people.  (These were from my last surgery because I had great insurance)

To answer your question about losing the use of a leg, I think that is fairly rare!  I have known many people that have been through this surgery including myself and my father (who has had multiple surgeries as well).  I really think you will be amazed at the relief you will have after the surgery!  Just be sure to follow the Dr.'s orders to the "T"!  Good luck and let us know how things work out!

[Job777]

Thanks for your encouragement.  I met a woman at the local nursing home who lost the use of her right leg with lumbar surgery.  Do you know how often that result happens?

[kittyluv1]

Hard to say why doctors interpret symptoms so differently.  They should be reviewing the same diagnostic tests and arrive at similar conclusions, but as you are finding, that is not always the result.
Thankfully you are on the right path now and surgery will likely improve your condition.
I am assuming you are being scheduled for a lumbar fusion at two levels.  Based on the fact that your symptoms have been present for so many years, it is possible that your nerve recovery will be slow and you may not achieve immediate relief of your pain.
Age and overall health (ie no other major medical problems) will also play a part in your recovery time.
I had cervical fusion C4-C7 done almost four months ago and the majority of my symptoms have resolved.  I still have some minor numbness in one finger, but compared to my pre-op pain and numbness, it is insignificant!
Best wishes on your surgery and I hope you have a successful outcome ---