Case of Retrolisthesis

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neo301

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Hello Physicians,

I am an MD.The patient is my grandmother. Her MRI reports showed Lurabar spondylosis with degenerative disc disease & Grade 1 anterolisthesis of L4 on L5 with posterior disc protrusion & ligamentum flavum hypertrophy causing LUrabAR CANAL STENOSIS, which is responsible for tingling nurabness in bilateral lower lirabs & weakness in left leg.the condition has now been present since 4-5years.not significantly progressive.her age is 75 years.Spine surgeons here advised open surgery lest she shall have progressive involvement & get wheel chair bound with bladder involvement in over 6 months.he said we'll perform a laminectomy; correct the anterior displacement,releaving the lurabar canal stenosis; fixing the vertebral bodies by screws & bone graft.I think he was talking about Transforaminal Lurabar Interbody Fusion(TLIF).Any suggestions will be valuable as she is a little apprehensive about surgery at her age & the ensuing physiotherapy to be followed after surgery.Can any spine surgeon tell me the rough success rate of such a surgery?How strongly should we consider surgery?How are the outcomes of minimally invasive procedures performed on patients of her age?
at present she is undergoing physiotherapy & on Calcium tabs,strontium granules, meganeuron.

Thank you.Looking forward to a reply.
Anupam
 
I'm not a physician. Most of us on this board are mostly people who experience back problems - not really a forum for physicians to comment. But I can tell you that surgery at her age is a viable option if she is otherwise healthy. I do think she could progress with further decline due to the spinal problems if she does not do a TILF.

Unrelated...but my father had a total hip replacement last year at age 81. At first some surgeons didn't want to do the surgery based on his age. But I coached him and once he told them that he walks daily, is very active, has no significant health issues they agreed that even at his "advanced age" he was a good candidate. It was a tough recovery but he is so glad he did it, and is back to walking at least a mile a day. On the other side my grandmother was told at 78 to do a knee replacement and she refused, figuring she would not live long, she did live into her mid-90's and later said "I should have done a knee replacement...it would have made the last 15 years so much more comfortable".
 
I'm not sure how a PLIF could be considered a minimally invasive surgery. Maybe others can chime in on this one. My surgeon told me the sucess rate of my fusion is an 80% success rate. Now that I am worse off after the surgery(pain wise and with mobility), I have found out through other surgeons and medical articles that the sucess rate is as follows: 30% sucessful outcome, 30% stay the same, and 30% of patients get worse. Mind you, the more levels that are fused, the lesser sucess rate. I've had this surgery twice, once @ the age of 16, and again @ the age of 46. Both times the recovery period was brutal and very long-up to a year. Please ask your grandma's surgeons more questions including how many levels will be fused. And do your own research. Best Wishes--janiee08.
 
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