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Spondylolethesis L5/S1 spinal fusion

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Unread 12-04-2012, 05:44 PM   #1
Bocce Ball
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Unhappy Spondylolethesis L5/S1 spinal fusion

Hi,

I had spinal fusion for Grade II spondylolisthesis back in July 2010 at Massachusetts General Hospital in Boston. Obeyed all the post surgical do's and don'ts until the customary 90 day period when the CTscan was done in October 2010 to determine if the fusion was sucessful. My neurosurgeon sat with me going over the computerized scan and told me I was all set. I trusted him and never asked for the Radiologists printed report. It was only recently, 2 years later when I wanted to pursue more physical therapy because of sciatica nerves symptons that had cropped up again is when I discovered that the fusion was not successful. My new physical therapist had asked me for the results of surgery and I decided to retreive the "written CT report. The Mass. General Hospital provided the radiology report and when I looked it over I was stunned. My PT person confirmed the dread and confusion I felt, reading the report and telling me there was no fusion.
Before I move forward with any greivance filings I really need to find a new neurosurgeon....someone skilled and experienced in spinal fusions....and hopefully straightforward and honest with the results. Anyone with any positive outcomes with neurosurgeons in the greater Boston area, please let me know.
Thanks
Bocce Ball
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Unread 12-05-2012, 05:10 PM   #2
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I'm "bumping" this up so someone might see this. I dont want it lost at the bottom of the "list."
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recovering alcoholic, sober since 7-29-93;severe depression; 2 open spinal surgeries; severe sciatica since 1986; epidurals; trigger points; myelograms; Rhizotomy; Racz procedure; spinal cord stimulator implant (and later removal); morphine pump trial (didn't work);now inoperable; lumpectomy; radiation; breast cancer survivor; heart attack; fibromyalgia; on disability.



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Unread 12-06-2012, 08:58 PM   #3
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Quote:
Originally Posted by Bocce Ball View Post
Hi,

I had spinal fusion for Grade II spondylolisthesis back in July 2010 at Massachusetts General Hospital in Boston. Obeyed all the post surgical do's and don'ts until the customary 90 day period when the CTscan was done in October 2010 to determine if the fusion was sucessful. My neurosurgeon sat with me going over the computerized scan and told me I was all set. I trusted him and never asked for the Radiologists printed report. It was only recently, 2 years later when I wanted to pursue more physical therapy because of sciatica nerves symptons that had cropped up again is when I discovered that the fusion was not successful. My new physical therapist had asked me for the results of surgery and I decided to retreive the "written CT report. The Mass. General Hospital provided the radiology report and when I looked it over I was stunned. My PT person confirmed the dread and confusion I felt, reading the report and telling me there was no fusion.
Before I move forward with any greivance filings I really need to find a new neurosurgeon....someone skilled and experienced in spinal fusions....and hopefully straightforward and honest with the results. Anyone with any positive outcomes with neurosurgeons in the greater Boston area, please let me know.
Thanks
Bocce Ball
Sorry to hear of the confusion. So there was no attempted fusion, or there was and it is a non-union?

If one was not done, I would certainly get a second opinion as it is a HUGE surgery, generally takes about 1 year before you are back to where you were and the few I've seen, patients told me at one year post-surgery they wouldn't have done it knowing what they now know.
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Unread 12-07-2012, 05:03 AM   #4
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Hey Dubious ~ isn't that a "bad" area to fuse in the first place, since there's so much movement? I wouldn't think any doctor would WANT to fuse that area, but I don't know that much about it. I haven't heard of fusions that low before. This is the first, I think, that I've heard of. ????? Can you offer a little more info? Hugs, Lee
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recovering alcoholic, sober since 7-29-93;severe depression; 2 open spinal surgeries; severe sciatica since 1986; epidurals; trigger points; myelograms; Rhizotomy; Racz procedure; spinal cord stimulator implant (and later removal); morphine pump trial (didn't work);now inoperable; lumpectomy; radiation; breast cancer survivor; heart attack; fibromyalgia; on disability.



Often the test of courage is not to die, but to live..
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Unread 12-07-2012, 04:19 PM   #5
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Quote:
Originally Posted by Leesa View Post
Hey Dubious ~ isn't that a "bad" area to fuse in the first place, since there's so much movement? I wouldn't think any doctor would WANT to fuse that area, but I don't know that much about it. I haven't heard of fusions that low before. This is the first, I think, that I've heard of. ????? Can you offer a little more info? Hugs, Lee
Any fusion is "bad" in the first place! But it is really more about stabilizing two motion units and and trying to make a bad situation better. A necessary evil, if you will. As far as prevelance of fusions per level....that's a textbook question but my hunch is that since most disc herniations in the lumbar region occur at L4-L5 and L5-S1 with the majority of those occuring at L5-S1, and since some number of those discectomies will require fusions, I would think that most fusion do occur at those two levels.

Spondy's are different in that they are relatively unstable compared to normal anatomy and when all conservative forms of therapy fail, there is no other way to deal with it other than fusion. But as I mentioned before, it is a huge surgery with questionable outcome so I am not sure it is worth it until you just can't get up from the floor!

But you are correct about the amount of motion. AMA Guidelines place maximum combined sum total of flexion plus extension at 15 deg. for any two motion units between L1 and L4, 20 degrees for L4-L5 and 25 degrees for L5-S1.
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Unread 12-08-2012, 09:25 PM   #6
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All I can say, after 8 open spinal surgeries, is welcome to the club. I am not a total moron who is hooked on surgery. Each one involved instability and most were done on an emergency, near emergency basis, symptom wise.

Three surgeries were cervical and I am thrilled to say that my neck remains stable and relative free of pain after 15 years. There are a few arthritic changes but that is predictable and easily managed. The lumbar is another story. The math is simple. Five open lumbar surgeries. Each one at least involved the infamous, ever popular l5-s1. The lumbar is loaded with metal.

Perhaps I have had bad luck but I havent had a spinal surgeon, yet, that I would refer Jack the Ripper to. They had fine reputations, worked out of major teaching hospitals and I got second opinions on everything when possible. I have always been told that every surgery was a flaming success and I was fusing. WRONG. Each one was a little god whose sub specialties were deception, manipulation and intimidation.

Can you tell the weather is terrible and I am in a dreadful pain flare? LOL!!! If it was just the two of you in the room when you discussed the surgical results, you can forget taking action. It's your word against his. I always take a wittness to that special appointment and find they are much more careful in chosing their words, qualifying everything. Even if you have a wittness, good luck finding another doctor to back you up. The good old boy system is alive and well. Best wishes.
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Unread 12-08-2012, 10:55 PM   #7
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Originally Posted by Spiney95 View Post
All I can say, after 8 open spinal surgeries, is welcome to the club. I am not a total moron who is hooked on surgery. Each one involved instability and most were done on an emergency, near emergency basis, symptom wise.

Three surgeries were cervical and I am thrilled to say that my neck remains stable and relative free of pain after 15 years. There are a few arthritic changes but that is predictable and easily managed. The lumbar is another story. The math is simple. Five open lumbar surgeries. Each one at least involved the infamous, ever popular l5-s1. The lumbar is loaded with metal.

Perhaps I have had bad luck but I havent had a spinal surgeon, yet, that I would refer Jack the Ripper to. They had fine reputations, worked out of major teaching hospitals and I got second opinions on everything when possible. I have always been told that every surgery was a flaming success and I was fusing. WRONG. Each one was a little god whose sub specialties were deception, manipulation and intimidation.

Can you tell the weather is terrible and I am in a dreadful pain flare? LOL!!! If it was just the two of you in the room when you discussed the surgical results, you can forget taking action. It's your word against his. I always take a wittness to that special appointment and find they are much more careful in chosing their words, qualifying everything. Even if you have a wittness, good luck finding another doctor to back you up. The good old boy system is alive and well. Best wishes.
Didn't want to say it, but that's how my shoulder surgery wound up.....just like Spiny95's low back....
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Unread 12-09-2012, 04:38 AM   #8
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Are those guidelines AFTER surgery or before or doesn't it matter? Those guidelines are just plain IT, right? Seems like alot of motion to me, but what do I know. LOL
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recovering alcoholic, sober since 7-29-93;severe depression; 2 open spinal surgeries; severe sciatica since 1986; epidurals; trigger points; myelograms; Rhizotomy; Racz procedure; spinal cord stimulator implant (and later removal); morphine pump trial (didn't work);now inoperable; lumpectomy; radiation; breast cancer survivor; heart attack; fibromyalgia; on disability.



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Unread 12-09-2012, 03:49 PM   #9
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Are those guidelines AFTER surgery or before or doesn't it matter? Those guidelines are just plain IT, right? Seems like alot of motion to me, but what do I know. LOL
Yeah....pretty much is what it is. They are from the 5th Ed. of the AMA Guidelines to Permanent Imprairement. Instability is also rated by excessive horizontal motion measured off of flexion, extension and neutral lateral films. The guides originate from original work done by authors Augustus White, MD and Manomar Panjabi, PhD on clinical instability in the 80's.
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Unread 12-10-2012, 10:48 PM   #10
sonup2sondown4
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Frown Still in pain...

In 2010 I began having major back pain all of a sudden. I went to a regular doctor that told me I just had 2 bulging disk. I dealt with the pain for about 6 months and then my regular doctor sent me to a pain specialist. The meds worked great at first then my tolerance grew and they had to keep upping them. Come to find out I had severe Spondylolethesis along with severe sciatica.
I was the GM of a restaurant so I was on my feet all day everyday and the pain just kept getting worse. While going to the pain specialist I endured 12 spinal nerve blocks and 3 RF procedures with no continuing luck. I then decided to give up and just have the surgery. I went in for surgery on June 10 this year to have the l5-s1 fusion. I woke up with my doctor telling me that my l4 had never fused since birth and they removed it and used that bone for the fusion. I have been in pain every since. It did seem to help the sciatica but it is already starting to come back.

On my last visit my doctor told me everything was great and all fused together and released me for all duties. The pain I feel now is worse than before and I am lost at what to do. I work full time, raise 4 boys, and go to school. It is hard to get out of the bed everyday. I do no that I will never have another surgery and if I knew then what I know now I would not have done it to begin with. I am considering going back to the pain specialist. Any other suggestions.
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