OT Lumbar Fusion

[Alistair]

My dad (76yo) had spinal fusion about a month ago. Don't recall which area beyond "lower back". This was after years of worsening pain that impacted his sleep and ability to function outside the house.

They went in from the back. Procedure time isn't too bad, but depending on exact location and severity, they might keep you for 2-3 nights at the hospital. Dad was in for 2 nights, I think.

He did have a complication, in that he took a bad fall the night he returned home. Got up to pee in the middle of the night, passed out (not sure if a blood pressure drop or what), and fell backwards over the edge of the tub (while we was mid-urination). Broke two ribs and a different vertebrae. And obviously went back into the hospital for another few nights. Definitely not common, but do be careful those first few nights back home - don't try to sneak around at 3am and avoid waking your partner - wake them up and ask for help!

He's recovering fine now, and walking around much better than prior to surgery. It had gotten bad enough that even a quick walk up the block wasn't doable. He probably should have had it fixed surgically 3-4 years ago.

[buddybikes]

Savior for me was/is walking sticks. First surgery went from walker (used religiously for first days) to bit of cane, then quickly to walking sticks.

I remember doing .6 mile walk with my walker up our street few days after getting home from surgery.

Don't be bashful of using walker or other device!

[.RJ]

Originally Posted by Fat Cat

Just do a search. There are a bazillion horror stories.

Or you could share. We only have a sample size of 2 in my own house, but no ill effects. And I know one other person that used it to control cramps on long (multi-day) events.

[benb]

Scary thread.. my mother is scheduled for this..but she has such bad Osteoporosis she's gotta take some drugs for a while first (which she has been on/off for 20 years already).

I think she's having 3 vertebrae fused and 2 discs worked on. She can barely walk right now, her leg goes numb. She hasn't been able to ride a bike for a long time already. My dad had gotten her a tricycle and they even sold that this year, she couldn't even ride that anymore.

In her case it was partly her being scared of surgery. Not doctors pushing her off.

I hope everyone here who is facing this has a good outcome and quick recovery.

[Plum Hill]

Had L2 through L5 fused in January. Walked three miles eight days after surgery. Still have some minor back pain issues but biggest issue is muscles that are constantly tight. Never been able to figure that out. Deep tissue massage or stretching works for about an hour and then muscles are tight enough to tune.

Always preferred upright position on bike. Still running 6cm of drop.

Physiatrist prescribed Lyrica years ago. It’s now listed as an allergy on my records. People noticed a change in me. Living alone, I didn’t notice anything until I received Payment Past Due notices. I completely failed to pay bills while on it, so it must have messed up what’s upstairs.

[StayingUpright]

For those who have had multiple fusions, how long were you enjoying life before the next joint needed attention? I’ve been told the answer to my issue is eventual fusion, but too young (late 40s). They don’t want to chase joints up the back.

[buddybikes]

Originally Posted by StayingUpright

For those who have had multiple fusions, how long were you enjoying life before the next joint needed attention? I’ve been told the answer to my issue is eventual fusion, but too young (late 40s). They don’t want to chase joints up the back.

Sample size of 3, myself every 3 years after last one. two other friends with 2 level initial fusion, both doing fine years after. One is retired but maintaining multiple houses, wood stove, and antique cars. Non stop...

[.RJ]

Originally Posted by StayingUpright

For those who have had multiple fusions, how long were you enjoying life before the next joint needed attention? I’ve been told the answer to my issue is eventual fusion, but too young (late 40s). They don’t want to chase joints up the back.

Unless there are structural problems in the adjacent joints I dont know why it would cause more fusions.

And in your 40's, you have easily 30-40 more years active if you're fit and riding a lot now and thats too long to put off not being in pain or limiting yourself IMO.

[rnhood]

Any surgery on the back should be the option of last resort. The truth is, even with the best surgeons operation success runs about 50%. A year post surgery, these 50% are happy and living life like they should. The other 50% needs further surgery, to remove scar tissue, to trim other vertebra bones or discs, more fusion, etc. In other words, one surgery leads to another.

[Onno]

Originally Posted by rnhood

Any surgery on the back should be the option of last resort. The truth is, even with the best surgeons operation success runs about 50%. A year post surgery, these 50% are happy and living life like they should. The other 50% needs further surgery, to remove scar tissue, to trim other vertebra bones or discs, more fusion, etc. In other words, one surgery leads to another.

Source? I've certainly talked to people who had unsuccessful back surgery, and that made me very wary. But the surgeon who did my back fusion (the head of the Yale Spine Center), told me his success rate was about 80%. He also told me that he was relatively conservative, not recommending surgery unless he felt there was a very strong chance of success. I suppose he could have been making up his data, but he certainly gave the impression of being a very honest and extremely competent surgeon.

[benb]

Originally Posted by Onno

Source? I've certainly talked to people who had unsuccessful back surgery, and that made me very wary. But the surgeon who did my back fusion (the head of the Yale Spine Center), told me his success rate was about 80%. He also told me that he was relatively conservative, not recommending surgery unless he felt there was a very strong chance of success. I suppose he could have been making up his data, but he certainly gave the impression of being a very honest and extremely competent surgeon.

We have rather world class hospitals/surgeons here in Boston.. my mother was advised to get 2 or 3 opinions even here with regards to these kinds of surgeries.

It makes sense to be extremely cautious. But these surgeries are often for people who are going to end up in a wheelchair without it.

[buddybikes]

When you are in level 8 pain constantly the thought of wait wait wait is massively difficult.

In my case I had Spondylolisthesis is a condition where a vertebra in the spine slips out of place relative to another vertebra. My conservative doc (NE Baptist Boston, head of spine surgery) said cut.

When I couldn't walk down to bench 1/4 mile away without sitting round two I gave in also

[krooj]

Originally Posted by StayingUpright

For those who have had multiple fusions, how long were you enjoying life before the next joint needed attention? I’ve been told the answer to my issue is eventual fusion, but too young (late 40s). They don’t want to chase joints up the back.

Do you know what the exact issue is? I'm younger than you - 40 in December - and had a right-side L4/5 microdecompression at 38. The effect of the surgery was instantaneous insofar as I could feel the ball of my foot and "know" where it was in space again. From what I've read, fusion is reserved for pretty severe cases, like one poster mentioned, where you'd otherwise end up in a wheelchair. So, I'd imagine fusion would be for folks with serious scoliosis, vertebral instability, extreme disc issues where an ADR won't work, etc.

The thing about any spinal surgery is that it's not a magic bullet: you still need to do physical therapy / exercises to keep additional issues at bay and injured nerves do not heal in a linear fashion, which is why even technically successful surgeries still take YEARS of work to heal from.

[.RJ]

Originally Posted by rnhood

Any surgery on the back should be the option of last resort. The truth is, even with the best surgeons operation success runs about 50%. A year post surgery, these 50% are happy and living life like they should. The other 50% needs further surgery, to remove scar tissue, to trim other vertebra bones or discs, more fusion, etc. In other words, one surgery leads to another.

If its anything like what I see in the PT offices, I'm guessing a lot of that data comes from people that dont have active lifestyles.

I went through several PT's before surgery because they didnt know what to do with a younger active person - "you can sit at a desk why are you here?"

[makoti]

I went and saw three spine doctors a few years ago.
Dr 1: You need injections and surgery. Your back is a mess. Schedule on your way out.
Dr 2: Why are you here? You're fine. Stretch, keep working out, I'll probably never see you again. Is your back bad? Sure, if you're over 40, your back is bad. Go home.
Dr 3: We *could* do surgery, but I wouldn't suggest it. Injections? Not until you are really thinking about surgery. The reason for doing them isn't just for pain relief, which may or may not last, but to make sure we know what the problem is before we cut you

I stayed with Dr 3, did do injections, got no relief, so took it as that wasn't actually the problem. Got serious about stretching (5 times a week, if not daily) hamstrings, hip flexors, doing leg workouts to balance muscle strength, and keeping my weight down to a level that works for riding (which is lower than what was suggested to me). So far, a few years in, all is better than it's been in quite a while

Originally Posted by rnhood

Any surgery on the back should be the option of last resort. The truth is, even with the best surgeons operation success runs about 50%. A year post surgery, these 50% are happy and living life like they should. The other 50% needs further surgery, to remove scar tissue, to trim other vertebra bones or discs, more fusion, etc. In other words, one surgery leads to another.

I work in MRI. I see LOTS of the other 50% (the successful ones obviously don't need to see me). So many that it pushed me to find another solution that wasn't surgery and sticking metal in my back. However, most of the ones I see also tell me they are willing to do another surgery because the first helped so much.
I have two friend who don't ride but have had multiple surgeries. One is injury related, the other genetic issues. Both are a mess. I can't imagine how they get through the days. Both were a mess before surgery, too, so I can't blame the surgery.
I had a dog who one day was completely paralyzed. All four legs just quit at once. Rushed to the vet, emergency spinal surgery, amazing recovery. She seemed happy for the rest of her days.
So, I guess it is case by case and what they are trying to fix.
Not much help for all these words, I know.