OT Lumbar Fusion

[buddybikes]

Originally Posted by StayingUpright

This seems like the place to ask: does anyone have anecdotal or secondhand knowledge of spinal cord stimulators? Saw my chronic pain doc the other day and he said we’re out of conservative options for the damaged L4 nerve root. His suggestion was to start the process for a spinal cord stimulator. Thanks again for everyone’s thoughtful input.

I went through a review of spinal cord stimulator. There are a lot of them in my case they wanted a high frequency one (newest model) to aid neuropathy. BUT, I had a MRI of T levels of spine and there wouldn't be enough room for the electrodes. Bummer... Make sure you have a top notch pain doc who will due such detailed review.

[Spoker]

Originally Posted by mdeeds71

Actually nearly 1 inch taller given how compressed that disk was. 7mm space to 27mm now.

Encouraging to read how much that helped you.
Are you sure about the 27 mm though? That sounds way too much.

[.RJ]

Originally Posted by ridethecliche

There's a 100% chance that I'll push for an ALIF (or related) vs a posterior approach

From what I remember, this approach for sure is better but it will involve a longer hospital stay - they dont let you leave until your bowels are working.

[buddybikes]

ALIF are lot more complex, they may need multiple surgeons in the OR - perhaps a cardio and gastro.

[ridethecliche]

Originally Posted by .RJ

From what I remember, this approach for sure is better but it will involve a longer hospital stay - they dont let you leave until your bowels are working.

Taking a bit for your GI function to come back fully online is pretty common after anesthesia and pain meds as well. I'd rather they not have to cut/dissect through the muscles in my spine.

Depends on age/fitness etc. I've seen great outcomes for ALIF with younger folks.

I'm thankfully not there yet, but i don't love the idea of long term whack a mole from fusions. You get significant adjacent level disease over time by virtue of losing motion at the fused site.

Originally Posted by buddybikes

ALIF are lot more complex, they may need multiple surgeons in the OR - perhaps a cardio and gastro.

Yeah, CT-surg often needs to be available in house. Things get exciting when you have to move the aorta out of the way to get access.

I've seen gensurg do the approach for ortho.

Full disclosure: I'm not a surgeon, but did outcomes research at a reasonable hospital in boston before going to grad school. One could say that said institution likes to think that it's man's greatest hospital

[htwoopup]

Originally Posted by StayingUpright

This seems like the place to ask: does anyone have anecdotal or secondhand knowledge of spinal cord stimulators? Saw my chronic pain doc the other day and he said we’re out of conservative options for the damaged L4 nerve root. His suggestion was to start the process for a spinal cord stimulator. Thanks again for everyone’s thoughtful input.

I don’t have experience with this, but following this thread and researching elsewhere as this will be an issue in my future.

Came across this article that may help you answer your question…scroll down towards the end of it as it is the third subject they looked at…
https://www.nytimes.com/2024/09/14/h...smid=url-share

[StayingUpright]

Originally Posted by htwoopup

I don’t have experience with this, but following this thread and researching elsewhere as this will be an issue in my future.

Came across this article that may help you answer your question…scroll down towards the end of it as it is the third subject they looked at…
https://www.nytimes.com/2024/09/14/h...smid=url-share

Thank you!