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Thread: Why not go all the way?

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  1. #1
    Join Date
    Jun 2005
    Location
    Bloomfield Hills, Michigan
    Posts
    285

    Why not go all the way?

    Hi all -
    I had surgery in 2000 and I'm fused from T4 to L4, I'm now 62 years old. I have been having excruciating nerve pain in the back and legs, different than the muscle spasms and general soreness I have had since my surgery. After going through all the conservative treatments, none of which helped and actually made it worse, I am now scheduled for a second fusion surgery in August. I have stenosis at L5, and my doctor is planning to clean out the canal, add more screws and rods to the existing hardware, and fuse me to L5. I have some questions:

    If L3-L5 is the most common area for anyone to have back problems, scoliosis or not (according to my surgeon), and if it is already known that the unfused vertebrae take on more more work after a fusion, why would the surgeons leave only one or two vertebrae unfused? Seems to me there's several people on this site who have had to undergo a second surgery just as I have to.

    Second question, which I asked my surgeon, is why doesn't he fuse to the sacrum. He told me they don't do that unless they absolutely have to because it creates more mobility issues and can cause other problems later, including involvement with the SI joint. He also indicated this would be a more serious anterior/posterior surgery.

    Linda, I believe your situation is similar to mine.

    Does anyone have any knowledge, experience, input for me? Am I doing the right thing by only having one more vertebrae fused? Could I be facing yet another surgery in five more years? Anyone have any input on what further mobility issues I'm facing with this additional fusion?

    I apologize for all the questions, but I truly believe experience is the best teacher. And knowledge is power. And that's all the cliches I'm going to toss out today! Thanks!
    TrulyAries

  2. #2
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,797
    Hi Truly...

    I think we're screwed either way. Here's some research on the topic:

    http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15371700
    http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

    Who is your surgeon?

    Regards,
    Linda

  3. #3
    Join Date
    Jun 2005
    Location
    Bloomfield Hills, Michigan
    Posts
    285

    Why not go all the way?

    Ouch ... ouch ... and triple ouch ... you're right - we're screwed.

    My doctor is David Montgomery, Beaumont Hospital, Royal Oak, MI. I saw some comments about him in other posts. He has a reputation as one the best in Michigan for spinal surgery. I don't have any doubt about his surgical skills, but his bedside manner leaves a lot to be desired. I call him Dr. Charm School. (Gee, I hope he doesn't read these posts!) He was quite a bit more pleasant this time around, perhaps because we now have this shared history.

    Once I've gone through this second surgery, do you think if I turn myself over to an experienced physical therapist to get serious about strengthening all my back and leg muscles that it will help? (I have been a bit inconsistent with exercise since my last surgery.) I'm nearing retirement and I was planning lots of vacations and extended car trips and I'm afraid I won't be able to do a thing ...
    Thanks.
    TrulyAries

  4. #4
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,797
    Hi...

    I honestly don't know. The PT that I used to go to believes that, after a long fusion, one should avoid using back muscles at all. She works on strengthening abs, so they can do all of the work. Until last Fall, I was pretty religious about performing my daily exercises, and I have to say that I had a lot less back pain. Unfortunately, I did something to my ribs on the left side and now when I try to lay on the floor, my ribs go into a big, painful spasm.

    Best of luck with your surgery. I'll be anxious to hear how you do.

    Regards,
    Linda

  5. #5
    Join Date
    Jun 2005
    Location
    Austin, TX
    Posts
    96
    My surgeon told me that they were going to decide during my surgery how far down to fuse, but the farther down they went, the more correction I would get but the less mobility I would have. They fused to L-3 giving much more mobility in my lower back. I am glad they stopped there because I think I would have more trouble riding bikes and bending over than I already have.
    Harrington Rods in 1991 at age 15
    Surgery at Scottish Rite in Dallas, TX

    Fused from T-4 to L-3

  6. #6
    Mary Lou Guest
    My daughter is fused from T3-L2 and has a slipped vertebrae below the fusion (I think it is at the L4 or L5 level) which the doctor keeps a very close eye on. I asked him before surgery if he would fuse that area and he said no. He does not like to fuse the Lumbar area, especially very low like that, unless he absolutely has to because you lose too much flexibility. So far, the fusion hasn't caused any problems and the slipped vertebrae has remained unchanged.

    Mary Lou

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