Spine Scheduling a L5-S1 fusion tomorrow

Boy, Carol….I’m not that familiar with back issues, so I also don’t have any specific questions to ask. But just be sure that you completely understand what the problem is (have the surgeon show you on the imaging), that he explains the possible options (both surgical and non-surgical), and what improvements can be expected. Once we know that, it may be possible for us to formulate some additional questions to assist you. You’ve been through so much. I hope and pray that you’ll have an option that will work for you.
 
Hello,
Thank you everyone for your advice and support. I had an appointment last week with my Orthopedic surgeon who said I definitely need a fusion at L5-S-1 and surprisingly L2-L3 based on the Spec CT. He’s ordered a CT without contrast. He’s booked out for 3 months and I don’t have it scheduled yet. I might look at Neurosurgeons as suggested. Using TENS and Advil, swimming and stretching to get by because I have to work 18 more months before I can retire. Please let me know more about your fusions if anyone has had them. I saw some mixed opinions. Thanks again!
 
@Cjackso21 Let's trying tagging the members whose recovery threads I shared with you above.

@NightQuilter @AussieRodney @WillB @Elf1

Although none of them has been active on the Forum this year, they might still be receiving notifications.
Unfortunately, when I search here I don't see anyone who is currently an active BoneSmart member who has been through this surgery. However, as you read through these threads, you might try tagging someone as I've done above.
 
I do think it would be good to get a second opinion from a neurosurgeon, if for no other reason than to confirm what your current surgeon has proposed. I hope you will consider doing this.
 
Hello, seems time flies when you’re working and trying to schedule a fusion back surgery. The list of prerequisites before they will even schedule is daunting. Fortunately I have a nice nurse helping me, FYI for those who don’t know, here’s the list: 6 weeks of PT in the last 6 mos with PT notes, a physical and EKG, a Discogram with pain management (next week) then I can make an appointment to discuss surgery and I hope schedule surgery. The vascular surgeon that is also needed, is booked out 3-4 months as well as my Orthopedic surgeon. Fortunately I spoke to a friend who had this surgery and it worked. But she said I should use a different orthopedic surgeon who I’ve never been to who is better than my current orthopedic surgeon. Will try to contact him but I’ve been going to my doctor for many years. Welcome any advice or other folks experiences with this. Thanks, Carol
 
FYI for those who don’t know, here’s the list: 6 weeks of PT in the last 6 mos with PT notes, a physical and EKG, a Discogram with pain management (next week) then I can make an appointment to discuss surgery and I hope schedule surgery. The vascular surgeon that is also needed, is booked out 3-4 months as well as my Orthopedic surgeon.

Thanks so much for sharing these details, @Cjackso21. I had no idea of the protocol and I'm sure other members who are considering this surgery will find your post informative. Please continue to keep us posted on your progress through all these steps.
 
@Cjackso21 Hi Carol! Sorry I hadn't seen this earlier. Was busy getting my PT set up prior to my hip replacement and getting my husband in to see and get treated by my neurosurgeon for his spine.

Just me personally, I would try to get a consult with a neurosurgeon that specializes in spines. As someone once explained to me, true or not, always take a bit of salt with all outside opinions, but they compared orthopaedic surgeons to carpenters and neurosurgeons to working on finely tuned equipment. I will say that my orthopedic surgeon that replaced my knee was also seeing my husband and did eventually recommend he see a neurosurgeon and just happened to recommend/refer him to the one who did my L5/S1 spinal fusion. And this Ortho has worked with Bone Smart for many years so definitely trust his opinions.

Realize you have faith in your current Ortho but this may be out of his normal range of procedures. Plus, did your friend say why her Ortho is better? I would definitely want to know that at the very least. And, is your Ortho an Orthopedic Spine Surgeon? My Ortho specializes in hips and knees and some shoulder work but doesn't touch spines.

Sounds like some of those requirements they are asking for may be insurance driven. I know when I was pending my spine surgery the office called me and confirmed that I had previously been to PT. They knew that I had been to pain management for injections as they sent a very detailed report to my Primary to include when he sent my referral to the surgeon.

What is the Vascular Surgeon for, the disco gram maybe? I'm not exactly sure why they want to do this. I'm no doctor or any other type medical person but to me that seems like a diagnostic type procedure.

As far as the actual fusion went (L5/S1) it was pretty straightforward surgery as best I know. One of my big problems was when I moved, in any direction, my disc kept slipping and pinching the nerve causing major pain. Doc said he could stabilize the disc to keep it from pinching and possibly severing the nerve eventually. He didn't promise that he could take away all of my pain. He couldn't straighten my spine perfectly without possibly causing more problems but did the best he could.

The first week or so were kind of rough, part of that had to do with the pain meds he prescribed. Luckily my pain management doc had prescribed me meds prior to surgery to get me through and in the event the Neurosurgeon didn't give me a long enough prescription. Once I switched to meds that worked and that I could function on life was much better. Hadn't learned how wonderful ice was at that time unfortunately. I was good enough to drive myself to my 2 week follow-up and get my infusion checked. I still had a few months of recovery but felt quite a bit better everyday. Was out of work day before Thanksgiving till the week after New Years. Could have gone back earlier if I really wanted but doc said sitting all day (I was admin and did teleconferences) was one of the worst things for me.

Went to my husband's first appointment with Doc and he kept looking at me and I said you did my surgery in 2015. He went I knew I knew you! Well, seems like its working for you.

Having two levels done may be a bit more pain, a bit more downtime but wouldn't think that much. Most of these surgeons are doing as minimally invasive as possible now. I think my incision was maybe an inch or two long, can't even really see it anymore. Sorry for the book, just wanted to share as much as I thought might be helpful. Will try to update my profile to email me if I get tagged so know to come here and check. Good luck and keep me posted if you don't mind.
 
Carol, I’ll second the suggestion that you at least consult with a neurosurgeon for any spine surgery. Years ago our GP advised this for my husband’s back surgery and I believe it made a huge difference in his outcome. After all, these are the guys who are skilled enough to do brain surgery and they frequently do a lot of very intricate procedures, where an orthopedic spine surgeon may not. When nerves are involved, skill with this can make a big difference.
 
Hello,
It’s been a few months and I’ve finally completed all required testing and will be scheduling my S1L5 fusion surgery. My Doctor, who is an Orthopedic Doctor, Dr. Robert Eastlack, is also a Spine Surgeon specialist. I feel very comfortable with the care from his whole staff. The friend who recommended him has said recently her friend used another surgeon she said was better and recommended I use him. But it would likely mean 6-12 months delay. The pain is now most of the day and evening so not sure I can wait for that. I do have another disc L2-3 that they said has problems but I don’t have pain. We finally decided to only do the lower discs but I’m now rethinking that. What do you think? Thanks again…Carol
 
Well done for getting through the tests and finding someone you are happy with. Thank you for updating us. Feeling confident with your consultant and team is a huge part for anyone undertaking major surgery and recovery. Perhaps you can ask your team again about the other disc? Only you know the toll the pain takes on you and if you could wait longer. You’ve also had a lot of surgery, and are experienced in the whole process. What is your body and gut telling you?
We all get told stories (sometimes tall ones) of better recoveries, surgeons and more, (and not all of them are helpful) however it’s our body, and our decision as to who we go to for help, (unless there’s no other option) and only we can ever really know what we feel and what is the best option available to us at the time.
Please keep us posted.
 
My Doctor, who is an Orthopedic Doctor, Dr. Robert Eastlack, is also a Spine Surgeon specialist. I feel very comfortable with the care from his whole staff. The friend who recommended him has said recently her friend used another surgeon she said was better and recommended I use him. But it would likely mean 6-12 months delay.
Only you can make this decision. But, as Legseleven says, if you feel confident about your current spine specialist, why wait? With a new surgeon, you'd have to start the entire process over. Do you know why your friend thinks this other doctor is "better"? Is he better qualified? Does he do more of this surgery? Or could it just be that her friend likes the other surgeon's personality more?


I do have another disc L2-3 that they said has problems but I don’t have pain. We finally decided to only do the lower discs but I’m now rethinking that.
If it was me, I'd just do the fusion on S1L5. I know you are thinking that you want to avoid another back surgery down the road. But if L2-3 isn't causing pain, I'm not sure it makes sense to fuse them now. It possible that it won't ever give you problems. Again, only you can decide what's best for you.

Feel free to share more of your thoughts and concerns. Perhaps taking about it with us will help you decide what's best for you.

Sending hugs :console2:
 
I agree with @benne68 about the additional fusions. What did your surgeon recommend? He would be the final say about what is best for you. To me, the “no pain right now” would be reason enough for me not to do that additional fusions.

Many times with spine issues, the fusion fixes the immediate problem, but living your life causes issues to appear farther up the spine. My question to the surgeon would be, if you were to fuse the upper level now even though it’s not giving you pain, would that prevent this advance for a while, or would it be more likely to move up higher in the coming years? What I’m thinking is that the lower fusion might just be enough to delay additional problems above the fusion.
 

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