Anterior/Posterior L4-5, L5 S1 Fusion from failed fusion

  • Thread starter Thread starter Larryheadhunter
  • Start date Start date
L

Larryheadhunter

Guest
After 2 back surgeries in the last 2 1/2 years including July 2010 TLIF failed lurabar fusions L4-5, L5 S1, with severe back pain and acute achy legs. After drug eluting coronary stent 3 months ago, I have been cleared for a redo. Orthopedist wants to do 2 phase surgeries, anterior/posterior ALIF and decompression of L3-4. Is this overkill, and I first have to detox from Oxycodone 2 weeks pre surgery.
2 part operation Tues/Thursday, Feb 8 & 10.
All those narcotics caused low testosterone levels, and addiction, and I am scared to death. Is it worth front/back surgery to achieve fusion. Using cadaver and synthetic and my bone this time. Zero fusion last time, is there an easier fusion surgery? I stop Plavix and aspirin 7 days pre surgery.
Bedridden since Aug 2009, even tho I walked, PT, strengthening exercises. Even bone growth stimulator failed to fuse me. How long to recover? Should I insist on only one surgery? I have 5 coronary stents, and am 60 yr old man. I have caregivers and wife to take care of me and provide meRAB. Is this the best fusion surgery?
 
The latest news is that my MRI showed failed back syndrome after July 1, 2010 fusion surgery and I will be undergoing either a one stage or 2 stage, L-3-4 decompression, and A/P fusion of L-4-5, and L-5S1. Since I am in Southern CA, I have seen Dr. Watkins, and now will be seeing Dr. Robert Pashman for another opinion, as I hear that this surgery is quite barbaric, and I am scared out of my mind. I have lower back pain, and achy legs, which leave me mostly bedridden. I was told that I needed to be narcotic free for 2 weeks before surgery, so I will be detoxing in patient next Friday for 10 days, then 2 weeks later undergo this double fusion from one of these 2 docs. Anyone have any ideas, or opinions on pre and post surgery. The one thing the first fusion accomplished was it stopped the shooting pains down my legs, instead they just ache. Help! 2 years bedridden is long enough. The first surgery was a lurabar decompression with excision of a large synovial cyst that returned. Then TLIF fusion, and now the possibility of A/P surgery. Anyone have it done in one surgery, or like Dr. Watkins wants, on a Tues and Thurs. 2 stage surgery.
 
First, welcome to the board. I hope you will find a group of caring people who will attempt to support you and answer your questions.

I searched for the two surgeons you mentioned. Is the Watkins the group with the father and son Roberts? That's who I looked up and who I am basing my comments on....in either case, with either group it would certainly appear that they are well-credentialed and very experienced. At least on paper, it would be hard to find too many better-qualified surgeons. Now you have to go with your personal experiences with them -- who you feel most comfortable with --. We all have certain things we look for in a doctor and I cannot say what is important to you. But, figure that out, and then use those criteria to guide you in your decision. It is always a good idea to gather several opinions. (I consider myself the Queen of second opinions....I perhaps overdo it a bit!!) But to the best of your ability, you want to find the right doctor for the job and you want to be sure your are getting the "right" surgery for your issues. Those two things are the magic corabo for the best chances of a successful fusion. As you well know, there are no guarantees when it comes to spine surgery.

Now, pertaining to what is commonly called a 360 fusion, I would not consider it barbaric. It is the gold standard to guarantee the best chance for a complete fusion. It is used for revision when someone has not fused from a less invasive procedure, but it is also used in many first-time surgeries. It is, in large part, a preference of the surgeon....Oddly enough, recovery time doesn't seem to take much longer than from the standard open posterior interbody fusion.

Keep in mind that when you are consulting with a surgeon that offers a variety of types of fusion, including all the new, current ones like TLIF and minimally invasive, when this surgeon recommenRAB to you a 360, he feels that this surgery stanRAB the best chance of providing you with a successful fusion.

Sometimes the 360 is performed all at one time. They start out on the front, complete that surgery, then flip the patient over and operate from the back. Probably due to your other health problems, the surgeon is electing to give your body a little break in between so you are not under anesthetic for such a long time.

I can imagine how you are reacting to the possibility of what is in reality, two surgeries. I was offered a 360 for my first one level fusion, and I was stunned. At that point I wasn't even convinced I needed any surgery, so this struck me as over-kill. It did seem primitive with all the new advances in spine surgery that are out there. But, keep in mind, this surgery has years and years of statistics behind it, with a proven track record. The same cannot be said for the TLIF, XLIF, etc. You need the surgery that is most appropriate for your specific health issues, spinal problems, etc. regardless of what may be en vogue at the time.

Many people on the board have had fusions, including the 360 and can share tips and advice with you. Please ask if you have specific questions.

Good luck getting off your pain meRAB. Your doctor is insuring that your body will be able to respond to pain medication during and after surgery...so I guess it will be rough on the front end, but you should have excellent relief post surgery.
 
I had the 360 fusion a few years ago and it was one of the easiest recoveries I have had. I am a veteran of 8 lurabar surgeries and have had cages, roRAB, screws, spacers, etc. so I have a variety of experiences with the different types. My 360 was a one-step surgery....I cant think of anyone who has had this done in two steps. I would urge you to do some research and find out how common it is as I would think it is better to go under anesthesia once. I also don't quite understand why you need to go into the hospital for detox unless you are on some very heavy medication, so perhaps you could detail that for us a bit.

I just urge you to research as much as you are able and to ask lots of questions of your doctor. It might also be a good thing to get yet another opinion, perhaps from an orthopedic spine specialist just so you are clear in your mind as to what this entails and which method might be best for you.

Please do stay in touch and let us know how you are doing and ask whatever other questions you might have.

Carol
 
Back
Top