Spinal fusion - long term results?

[chris2008]

Hi,

DH had spinal fusion surgery + disc replacement on his lower spine 3 years ago due to spondylosis and sliding vertebra.
3 years were alsmost prefect recovery. He did his exercises constantly but very carefully.
Now it seems that the pain is coming back as the parts above and below the fusion get stressed.
All info says that it is not a surprising reaction of the body.

My question: Are there other forum members who have expereienced spinal fusion? How does it work long term for you? What kind of exercises are helpful to you?

Thanks in advance for your input.

 

[braumeister]

Not surprising to me.
Good friend has had two of these procedures already, and is getting ready for a third in a few months.
If it's needed once, odds are that the same conditions will prevail and it will be needed again at another place some time down the road.

Sorry for this pessimistic reply, but my friend has a very matter-of-fact attitude about it.

 

[haha]

Not surprising to me.
Good friend has had two of these procedures already, and is getting ready for a third in a few months.
If it's needed once, odds are that the same conditions will prevail and it will be needed again at another place some time down the road.

Sorry for this pessimistic reply, but my friend has a very matter-of-fact attitude about it.

My friend and old roomate has had 4. It doesn't seem to be a very promising approach, though I suppose there may be no other options.

Ha

 

[chris2008]

Thanks!
Drs have advised to continue with careful exercise and try to postpone a new fusion as long as possible, unless there is some paralysis. If that happens, directly into emergency room.
We are quite realistic about it. There were and are no other options, so it has to be done what has to be done when it has to be done.

I would like to know how much of the body motion the 2rd and 3rd fusion would prohibit. Are your friends still able to do some sports like biking? Do they travel?

 

[braumeister]

My friend has no real problem with travel or normal activities, and has never been into sports. He's just a little stiffer than he used to be (aren't we all?), but at the age of 59, he's doing fine.

 

[grumpy]

Just thought I'd offer another point of view -

45 years ago, at age 18, I was diagnosed with a plum-sized benign tumor within the spinal canal. The surgery to remove it was a laminectomy, from L1 to L4. Apparently in those days a fusion was not done. Being young I healed quickly and was on the golf course three weeks later. For about 15 years I had no pain or physical limitations. Then things started to go south. Due to the structural changes from the surgery and the resulting instability, I began to develop bone spurs that caused pain. The doctors offered me spinal fusion surgery but cautioned that I would likely be in as much pain after that surgery as before. They further said that the bone spurs were the body's way of doing its own fusion and that around age 55 they would likely fuse things on their own.

I elected to rely on all the other treatment options such as PT, exercise, acupuncture, chiropractic treatment, pain meds, etc.

In my mid to late fifties the pain became less severe. I have learned over the years what activities to avoid (e.g. twisting, heavy lifting). I swim a mile every day for exercise as this is the only vigorous thing I can do that doesn't set off the pain. I found a good pain management doctor who prescribed Ultram ER, a synthetic narcotic that works well and, for me, has few side effects.

The doctors continue to offer spinal fusion surgery with rods and screws if the pain becomes more than I can stand. I doubt that I will ever opt for that course.

Now that I'm retired and financially comfortable I hire someone to do the things I can't, like yard work, shoveling snow, etc. Other than that I live a pretty normal life. DW and I travel (we have a western Mediterranean cruise planned in May) and generally enjoy our retirement.

Spinal fusion is not the only way to deal with back issues. If paralysis or severe problems occur, then of course it may be necessary. But I believe it should be a last resort.

 

[ls99]

At the risk of piling on, a BIL two years ago had some very expensive hardware installed on his spine. Post surgery had complications of MRSA. The attempt to cure MRSA resulted in internal chemical burns. Very messy. It was terminal.

 

[Alan]

I had a discectomy on L4/L5 20 years ago and it took a full year before the pain in my leg went away - I used to have to go back for shots every few weeks. I gave up playing all the sports I used to like such as soccer, tennis and raquetball but was able to be a soccer ref with the use of a back brace.

I still wear a back brace today when I do some activities such as playing tennis, which I took up again 5 years ago at age 50, and I still get back pain quite regularly but it is very manageable and often I can get instant relief by gently twisting my back, yoga style, until it "cracks". (DW is amazed when I do this as she can hear it from across the room).

I know that it is not a spinal fusion but thought I would pass on a success story.

 

[tjscott0]

Business has an article on this today.

Doctors Getting Rich With Fusion Surgery Debunked by Studies - BusinessWeek

It is a bit of a hit piece. The title of the piece is:"Doctors getting rich with fusion surgery debunked by studies"

The charges made by the article:

1)Payments by medical-device makers pose an “irresistible” temptation to tailor treatment to more-lucrative procedures, said Eugene Carragee, chief of spine surgery at Stanford University in Palo Alto, California. “There is precious little in human nature to suggest this proposition is unlikely.”

2)Medtronic paid six of the 10 Twin Cities Spine surgeons -- including Transfeldt -- $1.75 million in royalties and consulting fees in the first nine months of this year. It also makes other financial contributions to the firm.

I believe what is important in the article are the studies.

1)In a U.S. study in Spine in 2007, surgeons reported fusion was successful in only 41 percent of 75 patients suffering from lower-back disc degeneration. Success measures included pain reduction. Two years earlier in the same journal, surgeons found a 47 percent success rate among 99 patients, 80 percent of which were taking narcotics for pain two years later. Both studies compared fusion to artificial disc replacement in trials submitted to the FDA

2)Evidence that fusion is better than a simpler procedure called decompression for stenosis is “lacking,” a study in the Journal of the American Medical Association found earlier this year. The study also found that fast-growing complex fusions -- those joining more than three vertebrae -- carried a 5.6 percent risk of life threatening complications, more than double the 2.3 percent rate for decompression, which usually involves cutting away damaged discs or bone pressing on spinal nerves.

I recall an article many years ago about back pain. Doctors blaming ruptured dics in the back for pain. Patient without back were examined & had xrays/or MRIs [I can't remember which] made on their backs. And they also had ruptured discs but no back pain. I just don't think medical science has progressed very far regarding back pain.

I would recommend folks going to their local library to see if they have "Stabbed in the Back: Confronting Back Pain in an Overtreated Society"
Amazon.com: Stabbed in the Back: Confronting Back Pain in an Overtreated Society (9780807833483): Nortin M. Hadler: Books

"Hadler argues that no theory on what causes regional back pain has stood up to scientific testing, and the myriad of treatments do more to sustain an enormous treatment enterprise than ease the pain."