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Fusion Surgery?

Turkishexpress

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Hello fellow PM'ers who may have dealt with a similar situation. I figured I would field this question here since we share a common passion that we know we can't live without and I've recently been recommended lumbar fusion surgery (L5-S1) by the first neurosurgeon I consulted with for my sciatica.

I got sciatica for the first time in my life November of last year and it has been getting progressively worse. I'm basically in pain all day long unless I'm lying down. Walking and working out have both become incredibly hard and painful. The sciatica affects my left leg only. It feels like I have knives stabbing me all the way from my back down my glute, hamstring, calf, all the way down to my heel. Tried PT for about two months on top of my usual workout routines and core exercises. I got epidural done as well as cortisone shots outside of the area to no avail. I do not deadlift or squat due to the problem and the few times I've tried with light weights, the situation has gotten worse. Got my MRI done and I have a degenerated disk at L5 S1. The doctor said that the degeneration is moderate and would be non symptomatic for most people. However he said, I have some of the largest nerves he has seen and it's being crushed by my vertebrae (L5 S1). He said there is nothing he can do in terms of a non invasive or non-hardware procedure. I'm down to about 260lbs and tend to stay around a comfortable 13-15% BF and according to the MRI my other disks are in excellent order with no sign of any degeneration.

I've set up a second opinion with a much more renowned surgeon here at Northwestern University Hospital in Chicago and will find out what he will say.

I wanted to see if any of you have faced a similar situation and have gotten a fusion or TDR (total disk replacement)? What was your fusion like? How was the recovery? Did the surgery affect your overall performance after your recovery etc...? I've read and watched videos online of the average joes out there but as we know, we're a bit different. We demand a higher level of performance from our bodies. I would appreciate your experiences and advice. Thanks in advance!
 

buck

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Laminectomy and had L4-5 fused. And some of my Spondylolisthesis fixed. Many here have gone through the same. Definitely get a second opinion from a Dr that deals with pro athletes. Had the surgery in the afternoon and was home the next morning. No real pain or discomfort. Off meds after 5 days as i didn't need them and made my lethargic with no appetite. Back in the gym and work within 10 days later with DR approval. Moving less then warm up weights on machines that caused no discomfort. 25# restriction from DR. As long as back was supported he was fine with everything. Kept food under control to not turn into a fat bastard.
 

Bio

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Five levels of my cervical spine are fused and two levels of my lumbar spine are fused, L4-5 and L5-s1. You won't notice any type of limitation from an L5-s1 fusion. Once it's healed you won't know the difference. Good luck with the surgery! Feel free to message me if you have any questions.
 

rAJJIN

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Did it happen from an accident or do you know when it happened?

I had it bad (sciatica) from a deadlifting injury. So bad I had drop foot for a short time. Fortunately I did not have to have surgery but I sure thought for a few months life as I knew it was over .
Now I’m not 100% but I’m 90-95 % better.
I did a lot of stretching, praying, and stayed moving to keep my mind from playing tricks. Some days it felt like cement blocks attached to my work boots.
 

CONTRACTOR 47

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Defiantly get a second opinion. But back fusion surgery is in a class of it's own.
Course your talking one section but fusion is a long recovery no matter if it's one or more sections. They all heal at the same rate.
Had L1-S2 done 11 months ago, besides the ever lasting pain I have to use a pole grabber to dress myself. You shouldn't have
that problem though.
 

FrancisK

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@Fatboy3580

Redeem all your stupid ass self serving threads and see if you can help someone for the first time ever…
 

Turkishexpress

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Did it happen from an accident or do you know when it happened?

I had it bad (sciatica) from a deadlifting injury. So bad I had drop foot for a short time. Fortunately I did not have to have surgery but I sure thought for a few months life as I knew it was over .
Now I’m not 100% but I’m 90-95 % better.
I did a lot of stretching, praying, and stayed moving to keep my mind from playing tricks. Some days it felt like cement blocks attached to my work boots.

Honestly I don't know. In my 42 years, I've had two major accidents and they were both motorcycle related. One of which did result in a sore back and 2 broken ribs in the rear and 2 in the front along with a bunch of other issues that put me in the hospital for 12 days. I assume that could have been a factor. In terms of working out however, I always thought I kept my back safe in terms of technique.

Five levels of my cervical spine are fused and two levels of my lumbar spine are fused, L4-5 and L5-s1. You won't notice any type of limitation from an L5-s1 fusion. Once it's healed you won't know the difference. Good luck with the surgery! Feel free to message me if you have any questions.

Man, that makes me feel a little better. I might take you on that offer. Thanks!
 

Pericles

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Find someone very well versed in active release treatment and dry needling. You can search your zip code on their website. Surgery should NOT even be on the table.
 

heavyhitter

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Honestly I don't know. In my 42 years, I've had two major accidents and they were both motorcycle related. One of which did result in a sore back and 2 broken ribs in the rear and 2 in the front along with a bunch of other issues that put me in the hospital for 12 days. I assume that could have been a factor. In terms of working out however, I always thought I kept my back safe in terms of technique.



Man, that makes me feel a little better. I might take you on that offer. Thanks!
Herniated my l5s1 in a motorcycle accident at 19. Had horrible drop foot due to nerve impingement that required a brace to keep my foot from dragging. Had to have my mom tie my shoes so I could go to work. I actually considered killing myself after almost a year of this. A total of 7 epidural injections and physical therapy that led to 20 years of weight training got me back to 90-95 percent better. Most days it doesn’t bother me and usually if I injure it again it’s from sleeping weird
 

lookslikesausage

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I'm honestly surprised anyone has talked surgery with you. I have a worse MRI report (bulges and herniations at multiple levels) and all but one doctor has recommended surgery (ALIF fusion). I've been in pain for over ten years and epidurals have been the only thing to help substantially although I'm still not comfortable very often for long periods. Nerve ablation has been mentioned and again, I'm surprised this wasn't mentioned to you too. I am very curious to see more comments in this thread. Good luck and please keep updating this thread with your experience.
 

Canuck54

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A fusion for what is on your MRI is way overkill. I would definitely get a 2nd opinion.
I second this. After cervical and lower back disc bulges, T7 thoracic compression fracture, stenosis, schmorles nodes and more, I still haven’t had back surgery. It isn’t about being tough though, it’s about pain management, and finding a good massage therapist, chiropractor, and some lifestyle/diet changes will help. Try everything you can first. Once they open your back up, it is never guaranteed. Also check out Stu McGill and Brian Carroll. Don’t forget to keep a positive mindset, pain clouds everything.
 

FartJohnson

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A fusion for what is on your MRI is way overkill. I would definitely get a 2nd opinion.
progressive radiculopathy refractory to non-surgical interventions sounds like a possible surgery candidate to me. If you let it go untreated for too long, the damage to the nerves can become permanent.

Of course, if you're holding a hammer everything looks like a nail (w regards to the nsgn). OP was the PT not effective? Would weight loss or downsizing be an option? 260 is pretty big and 20-30 lbs weight loss can make a world of difference to your body. Yoga helps many (we're all too inflexible) but you may want medical clearance first.

If you can't manage it in any other way, get the surgery. But do your body a favor and exhaust every other option first.
 

maldorf

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I'm honestly surprised anyone has talked surgery with you. I have a worse MRI report (bulges and herniations at multiple levels) and all but one doctor has recommended surgery (ALIF fusion). I've been in pain for over ten years and epidurals have been the only thing to help substantially although I'm still not comfortable very often for long periods. Nerve ablation has been mentioned and again, I'm surprised this wasn't mentioned to you too. I am very curious to see more comments in this thread. Good luck and please keep updating this thread with your experience.
My neighbor is in his mid 60s now and had to have a bunch of his lumbar vertebrae fused. He also has a stimulator implanted in him somewhere that constantly applies an electrical stimulation to his back. Somehow that helps him quite a bit with pain. He has to charge the battery once a day or so. I asked him how he feels about it and he is glad he got it.
 

Turkishexpress

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I'm honestly surprised anyone has talked surgery with you. I have a worse MRI report (bulges and herniations at multiple levels) and all but one doctor has recommended surgery (ALIF fusion). I've been in pain for over ten years and epidurals have been the only thing to help substantially although I'm still not comfortable very often for long periods. Nerve ablation has been mentioned and again, I'm surprised this wasn't mentioned to you too. I am very curious to see more comments in this thread. Good luck and please keep updating this thread with your experience.
A fusion for what is on your MRI is way overkill. I would definitely get a 2nd opinion.

That was my initial thought as well since I've never had serious back pain previous to this. However the surgeon seemed to be more worried about permanent nerve damage if I tried to deal with the pain long term. He said that it could come to a stage when even surgery won't help since the nerve will just cause pain non stop. Like I said, he was surprised that I had pain with the the degeneration that he observed until he saw the size of my nerves apparently. He said it's being pinched between the two vertebrae.

Currently I'm on 900mg of Gabapentin and recently the pain clinic put me on Hydrocodone and Meloxicam and they don't do much to help. The pain is pretty severe. I can only stand or walk for short periods of time.

I second this. After cervical and lower back disc bulges, T7 thoracic compression fracture, stenosis, schmorles nodes and more, I still haven’t had back surgery. It isn’t about being tough though, it’s about pain management, and finding a good massage therapist, chiropractor, and some lifestyle/diet changes will help. Try everything you can first. Once they open your back up, it is never guaranteed. Also check out Stu McGill and Brian Carroll. Don’t forget to keep a positive mindset, pain clouds everything.

You said that right. The pain was really what made me consider the surgery so quickly. I have a very high pain tolerance according to everyone around me and this pain is different. When you can't walk from point A to point B without limping and crouching down like a 80 year old man, thoughts definitely change. For the past year, I've been getting weekly massages and physical therapy. Didn't want to go to the chiro since I don't know of any great ones in the area that I trust but I will weigh my options after my second epidural this coming week.

progressive radiculopathy refractory to non-surgical interventions sounds like a possible surgery candidate to me. If you let it go untreated for too long, the damage to the nerves can become permanent.

Of course, if you're holding a hammer everything looks like a nail (w regards to the nsgn). OP was the PT not effective? Would weight loss or downsizing be an option? 260 is pretty big and 20-30 lbs weight loss can make a world of difference to your body. Yoga helps many (we're all too inflexible) but you may want medical clearance first.

If you can't manage it in any other way, get the surgery. But do your body a favor and exhaust every other option first.
I have been losing weight over the last few years. I was a solid 280 for the past five or more years. 290-300 for a few years before then. I just dropped down to 260 during Covid and like it a lot. Plan on going all the way down to 230-240 in the next few years. It's a lot of weight but for someone that's 6', it's not too crazy. Flexibility is definitely an issue, especially now. I can't do a lot of stretches due to immense pain. I will definitely look into some of the methods you mentioned above.
 

TrippplePPP

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progressive radiculopathy refractory to non-surgical interventions sounds like a possible surgery candidate to me. If you let it go untreated for too long, the damage to the nerves can become permanent.

Of course, if you're holding a hammer everything looks like a nail (w regards to the nsgn). OP was the PT not effective? Would weight loss or downsizing be an option? 260 is pretty big and 20-30 lbs weight loss can make a world of difference to your body. Yoga helps many (we're all too inflexible) but you may want medical clearance first.

If you can't manage it in any other way, get the surgery. But do your body a favor and exhaust every other option first.

I agree a patient can be a surgical candidate who has continuing worsening symptoms and exhausted oral meds, at least 1-2x ESIs, physical therapy yet I disagree with the surgeon wanting to do a fusion. With mild and moderate describing his discs and facets in absence of anything hinting of instability I don't see a reason. However, I have not seen the MRI and also many times a surgeon can mention multiple approaches in one conversation and as a patient you are not familiar and only recall a certain percentage of the conversation and then remember key words then leaving with a somewhat skewed idea of what the doctor explained. So the doctor may have mentioned laminectomy or discectomy but the patient remembers fusion only.

And I also agree with exhausting all non-surgical options first.
 

lookslikesausage

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I agree a patient can be a surgical candidate who has continuing worsening symptoms and exhausted oral meds, at least 1-2x ESIs, physical therapy yet I disagree with the surgeon wanting to do a fusion. With mild and moderate describing his discs and facets in absence of anything hinting of instability I don't see a reason. However, I have not seen the MRI and also many times a surgeon can mention multiple approaches in one conversation and as a patient you are not familiar and only recall a certain percentage of the conversation and then remember key words then leaving with a somewhat skewed idea of what the doctor explained. So the doctor may have mentioned laminectomy or discectomy but the patient remembers fusion only.

And I also agree with exhausting all non-surgical options first.
Disclaimer: I'm not trying to hijack this thread. In my ten years of experience in dealing with my back pain I was kind of hoping i'd meet a surgeon who'd tell me I was a great candidate for discectomy and that he'd done thousands of these surgeries and that my life would go back to how it was when I in my early 20s. Unfortunately, where I live it's very hard to even find and get an appointment with a neurosurgeon who does spines. Only an ALIF fusion was ever mentioned to me and it was because the surgeon believed my pain was due to stenosis which makes him the only doctor in all that I've seen who felt that was the cause. Another thought it was my facet joints and that nerve ablation was the answer. A pain specialist I saw tried trigger point injections. They did nothing and next on the list was nerve ablation or epidural (again). So far, epidurals have helped more than anything else.

Also, I can never get a good answer about this but I'll ask anyway. McGill's method revolves around strengthening the core. So let's say you already have a strong core but still have back pain. What will McGill Method bring to the table at that point? I've read so many testimonials about success with his method but I've never read how his method actually deals with pain related to bulging or herniated disc pain. Strengthening one's core and even stretching won't get that disc back in place or get it off the nerve to my knowledge, or at least I've never read anything that suggests so. Please correct me if I'm wrong. I'm disappointed that Stu McGill has never discussed in all of his talks and/or videos. How does his method actually deal with a disc that is misplaced?

Also, to Turkish Express: I have seen a video where McGill does talk about when there is an annular tear, he says that the nerves around the spine can actually grow in size and that is how a person's pain can become intensified. I found this very interesting. I wonder if this could be you.
 

TrippplePPP

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Disclaimer: I'm not trying to hijack this thread. In my ten years of experience in dealing with my back pain I was kind of hoping i'd meet a surgeon who'd tell me I was a great candidate for discectomy and that he'd done thousands of these surgeries and that my life would go back to how it was when I in my early 20s. Unfortunately, where I live it's very hard to even find and get an appointment with a neurosurgeon who does spines. Only an ALIF fusion was ever mentioned to me and it was because the surgeon believed my pain was due to stenosis which makes him the only doctor in all that I've seen who felt that was the cause. Another thought it was my facet joints and that nerve ablation was the answer. A pain specialist I saw tried trigger point injections. They did nothing and next on the list was nerve ablation or epidural (again). So far, epidurals have helped more than anything else.

Also, I can never get a good answer about this but I'll ask anyway. McGill's method revolves around strengthening the core. So let's say you already have a strong core but still have back pain. What will McGill Method bring to the table at that point? I've read so many testimonials about success with his method but I've never read how his method actually deals with pain related to bulging or herniated disc pain. Strengthening one's core and even stretching won't get that disc back in place or get it off the nerve to my knowledge, or at least I've never read anything that suggests so. Please correct me if I'm wrong. I'm disappointed that Stu McGill has never discussed in all of his talks and/or videos. How does his method actually deal with a disc that is misplaced?

Also, to Turkish Express: I have seen a video where McGill does talk about when there is an annular tear, he says that the nerves around the spine can actually grow in size and that is how a person's pain can become intensified. I found this very interesting. I wonder if this could be you.
Its hard to explain for me with text only as a verbal conversation would be best for me to describe but back pain/radiating pain can sometimes be dynamic and so can its treatment. I constantly say a person's outcome can sometimes be changed by a good conversation. Terminology can sometimes skew a person't perception when you look up diagnosis's and anatomy. But the phenomenon of spine pain is a cascade events of multiple area degenerating and therefor all treatments could be useful at different times.

Shots are like looking to pour water on the largest fire and then look for the next largest fire to try and extinguish. So different shots can be useful at different times. And a knowledgable doctor should be able to best figure what would work best for different situations yet medicine is educated guessing. If ESIs are working now, use them until you are able to start doing physical therapy again.

As far as you core, if you are having enough forces travel through your body for it to degenerate in one spot worse than the rest of you than their is a weak link in your core somewhere as it takes time and reaction to forces for your body to degenerate. Thats what a good physical therapist is for, to see what you are missing. I'm not familiar with McGill but I have learned about plenty of different techniques on PT. Again, a good PT is able to blend different techniques for different people with different issues like a MMA fighter mixing different styles for accomplish a task.

I really don't think a person can have large nerve nor would an angular tear enlarge a nerve. An angular tear my create sporadic and sometimes constant irritant creating inflammation of a nerve. But generally as we age nerves shrink in size and elderly people with stenosis that progresses slow enough can have nerve shrink and never have issues as the nerves somehow adapt to the tightened nerve portals.
 

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