Degenerative Diseases Community
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Avatar universal

spinal fusion

I have severe degenerative disc disease at L4-L5 and L5 - S1.  All conservative treatments have failed.  I had a minidiscectomy about 10 years ago for herniated discs in those locations which was successful.  I have had S1 radiculopathy for the past 2 and 1/2 years.  The neurosurgeon recommends spinal fusions at both levels.  After questioning him re MIS, he didn't think i was a candidate as it involved 2 discs and i had a previous surgery.  I am going to an orthopedic surgeon soon for a second opinion.  How does one decide to use a neurosurgeon or an orthopedic surgeon for this procedure, and is it the right option.  I am not a smoker, nor overweight.
4 Responses
874521 tn?1424120397
sorry for the pain and failed attempts..that is most frustrating for all of us to hear!
I suffer from similar pain and haven't attempted any surgery thus far, I survive on pain meds.
In my own opinion if I were to attempt surgery on such a sensitive area as the spine I would have it done by a neurosurgeon who specializes in the nervous system and not only the bones...
good luck
Avatar universal
I  have  smiilar issues and  also  had  to  decide between  ortho  and  neuro surgeons.  I  personally had  a  neuro  only  because  they  specialize  with  spinal  cord , nerves etc  ?getting  a second  opinion   from  the  other wouldnt hurt  and I  would  highly recommend you  do so.!  there is  also "spine specialist you  could  look  into  as  well?  Good luck to you *
3112530 tn?1434035633
I have had surgeries on my spine due to degenerate joint/disk disease. I have been to many a doctor. The neurologists I have been to, I did not feel confident with. They understand the nerves but treatment varies according to the doctor. Most of the neurologists I have been to, rely on mediation to calm the nerves.
The orthopedic surgeon I went to (after years of research and going to hundreds of doctors), agreed to do my surgery with out the 'threat of paralysis'. Every other doctor I had been to, advised me there was a chance for paralysis.
The orthopedic surgeon I went to specialized in my area of pain. First he did a surgery on my neck for spinal stenosis. He replaced the diseased area with cadaver bones. Two weeks after that surgery, he did my spine. I had a spinal fusion done. Later on, he had to implant rods in my back to help the bones. 5 years down the road, he had to remove the rods due to nerve impingement. I trust my surgeon for all the work he has done. He was knowledgeable and talked to me with xrays and mri's to explain what needed to be done.
One side effect, I developed from the surgery was scar tissue. That is normal for the surgeries he has done. My pain issues are substantially better since the surgeries but I trusted an orthopedic surgeon to do this procedure because he specialized in the bone structure. Since my surgeries, I am walking again for the first time in 5 years.
It took A LOT of researching and education to understand my condition. Finding a doctor who specializes in this area is part of the education of the patient. The more you learn, the more you understand what the doctor expects to accomplish, but don't expect miracles. Many doctors do not want to do surgery to the spine. Find a doctor you feel comfortable with, who explains his/her specialty and what he/she can do for you.
I know all this sounds scary but fear of the unknown is normal. Don't let the fear overtake you. Educating yourself will help eliminate some of the fear. Finding a doctor who will help with you issue was more fear for me than the doctor itself. Once I found a specialist, my fears subsided.
I am no longer taking pain medication and exercise when I can. That is part of the healing process so good luck in your research and stay informed!
Avatar universal
Given the date of Susie's post (2009) I am sharing my view on this question.

Both my sister and I have suffered with severe spinal stenosis, wich caused terrible sciatica and back pain. Both of us have severe osteoarthritis, disk degeneration, spondylolisthesis and even intradural synovial cysts. She is 69' I am 63.

My sister never had any physical therapy, nor had any doctor even suggested she try an epidural shot in her lumbar spine prior to surgery. I thought that odd. But, then, I have an HMO provider that has patients go through both before referring them to a surgeon.

So... my sister had surgery (a laminectomy with fusion at L4-5) 1 1/2 years ago; her doctor was an orthopedic surgeon. (Since her insurance allows her to use any doctor, she chose one her son had gone to for an industrial accident.) Sis had some surgical complications, including an accidental puncture--with bleeding--of the dura (the protective covering of the contents of the spinal canal) and an infection.  Her recovery took months, nearly a year. Of course, her longer recovery was likely due to the fusion; also, she's 69 (6 years older than me), so age may have been a factor. Her surgeon thought physical therapy "might help" her recovery, but the provider he suggested specialized in rehabilitation for sports injuries, and didn't have a clue what she needed or could even do. So she ended up doing "exercises that had helped" following her knee replacement.

My surgery--a laminectomy (without fusion)--was a year later, performed by a wonderful neurosurgeon. My recovery was weeks, not months. My surgeon explained every step, would take calls about any questions or concern, no matter how small. While I didn't ask for him (since specialists are usually assigned to you), I soon found out that he is the very best neurosurgeon in my area. It was my other specialists--a neurologist and a rheumatologist along with my primary care doctor--who all raved about him. It was very reassuring! Perhaps I was just lucky? I never before had any doctor so straightforward and honest, yet caring and patient.

When I first explored this question--as to which surgical specialty is best for delicate spine operations--there was an excellent response by a doctor on the spine-health site, who felt that: if the surgery was primarily intended to fix or repair nervous system problems (such as entrapment)), a neurosurgeon would be his first choice, but if the main problems involved were caused by primary bone disease, degeneration or trauma, he'd coose an orthopedic surgeon. That sure made sense to me.

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