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Posted By : painbehindthebadge - 8/29/2007 7:59 AM
I just had an appointment with a neurosurgeon. He wants to fuse L4 and L5. Has ne one had the procedure or know someone who has had it? It is a workers comp case so everything moves real slow. (I hurt my back while arresting someone). One more question ne one know where I can get stats and recovery, side effects, and such. Thanks.

Posted By : painKILLER - 8/29/2007 8:20 AM
Hi pain, All that I can give is anecdotal evidence that the fusion should not be undertaken. My father, at 45, underwent the fusion surgery in the same exact place as you. I remember helping him when he came home from the hospital. He was in constant, severe pain from the surgery and because of the pain medication, he also had other side effects like dehydration and constipation which made things very difficult for awhile. You will be unable to really do anything besides rest and relaxation. Thats immediately after the surgery. In my dad's case, a few years later, the hardware that was implanted in his spine to fuse the disks began to cause problems themselves. Pieces of it broke apart, and also, large amounts of scar tissue formed. Anyone who has had scar tissue can tell you that by itself, it causes severe pain, never mind the original reason you had the surgery. It is in the surgeon's best interest to do the surgery, as it is upwards of $100,000 to do. I'm sorry if I sound cynical, but fusion for me or any surgery would be the absolute last thing that I tried. If I were you, I would get a referral from your workman's comp doctor to a pain management physician. These doctors are specially trained in alternatives to complicated, expensive surgery. They may employ pain medications, steroid and trigger point injections, radio frequency lesioning to name a few. They also work in conjunction with psychologists and chiropractors to provide an alternative treatment to the physical symptoms of pain. Also, I would suggest a second surgical opinion. Hope this helps. Good luck officer!

Posted By : Chutz - 8/29/2007 9:44 AM
Hi Paininthe... and welcome! If you're worried then get a second or third opinion. Some people do get relief from this type of surgery and others don't. about the only way you'll know is to keep checking until you're comfortable. If you can get to a university/teaching hospital for a second opinion it would be best. They are on the cutting edge of technology. Just a thought...

Take your time and I would suggest not do the surgery unless you're ready and sure you want it. It can help some but like all surgeries there are risks.


Co-Mod Fibromyalgia & Chronic Pain Forums
Fibromyalgia, Ulcerative Colitis, Insulin dependent diabetic, collapsed disk, dermatitis herpetiformus, osteo arthritis in spine and other locations.

The only difference between genius and stupidity is that genius has it's limits. Albert Einstein: (1879-1955)

Posted By : TDoern - 8/29/2007 10:58 AM
Pain - I think the best decision you can make is to decide whether or not you are willing without having TRIED the surgery.
I woke up the morning of Oct 22, 2000 feeling like someone had taken a sledgehammer to my lower back. I (then) laid on my back to sleep, at the time, everytime I tried to move my legs, toes, anything below my bellybutton, had sharp shooting pain down both of my legs to about mid-thigh. At the time, I did what I'd done with every other little injury, I tried to walk it off. I went to work, came home in tears at night, not knowing what the heck was going on. Finally, my husband (who I'd married 5 days before the pain started) said either I went in willingly, or he was dragging me in with his platoon (he was in the army) kicking and screaming.
I go in, and they have me move certain ways the PA could feel my back spasming, and me jerking from trying to do things that caused extreme pain. By then the pain was regularly down into my ankle on the left, and knee area on the right. The PA leaves, comes back with a doctor who has me do a few more things. He leaves and comes back with that area of the militarys clinic's head doctor, he has 4 or 5 people with him. HE has me do stuff, the chat in whispers I'm thinking omg I'm dying. He tells me it appears I have done something to my spine, and there is redicalapathy on both sides. (not sure how to spell that). Again, my thoughts are I'm dying. So I look him in the face, and ask him to explain that in english, so one of the students (the 4 or 5 of his entourage) leave and come back with a little spine statue and who me, that he thinks somehow something in my back has moved and is putting pressure on the nerves.
I get sent to physical therapy every day for awhile, then this, then that, finally (the military has it's hoops you have to jump through) I get an MRI done, and it comes back I've ruptured my L4-L5-S1 and show signs of degenerative disc disease. The neuro that I saw that told this too me explained that, there are many treatments availible, to try this and that and this first. So I went to pain management and was on 10 different medications one was a muscle relaxer, the other a skeletal muscle relaxer, a pain pill, a nerve pain pill, an anti-inflammitory, and so on. Hubby gets out of the military... and due to (IMO) civillian doctors being so afraid of treating you, the pain got worse. Eventually it got so bad I had to quit working, my life sucked. I was in pain 24/7. My husband ended up in Iraq, and I made the decision I at least needed to fight to get my life back.
I went to my PCP who at the time was giving me 1 percocet 3x a day for pain. Without issue. Told him I NEEDED a fix. He sent me to Dr. Robert Allen in Raleigh NC. Dr. Allen ran a ton of tests before he'd even consider the surgery. He said he always prefers to avoid the surgery if possible. Because without surgery you always have another option, with surgery, you become limited in what can be done. There's also the risk of infection, stuff coming undone, it not working at all, things being made worse, paralysis, blood clots, stuff like that. So we tried specific PT and some other meds, nothing worked, so I made the decision that if I was going to be miserable for the rest of my life, or die, at least I was going to die trying.
My surgery was on Oct 20, 2003. I woke up with nerve damage in my left thigh, basically an area about as big as a hand I couldn't feel a darn thing. BUT I was laying on my back AND the pain wasn't shooting everywhere. That afternoon their physical therapist comes in to show me how to sit up, and I demand to walk. I took about a step before I couldn't do it anymore. BUT something felt different. I had a low grade fever they couldn't get to stay down for 2 days, then finally it went away for 3, and I was released. I DID develop and infection at the incision site the day they took my staples out of my back. I was in the hospital 5 days extra for that.
Life after surgery for me was rough for awhile. I HATED car rides as they were horrible pain wise. Not being able to bend at all was a problem. I went from wanna be superwoman to just plain dependant on others for about a month. That Christmas I was at my moms, and she mentioned to me how I was running up and down the stairs, moving all over. To me, and my family the surgery was a success.
In Nov. 2005 the pain started coming back. They do xrays, MRI's, everything and can't figure out whats going on. The pain is steadly getting worse, I'm now using a cane to walk. I can't find a decent pain doctor to save my life. The one I was referred to first, loaded me up with drugs, I objected to taking then a year later wants me to do suboxone treatment for the drugs he told me to take. I'd already hated the meds so much I had stopped taking them, so I told him where he could go. I find a new doctor who sends me to a very nice, understanding pain doctor, who ONLY specializes in treating pain with injections, which didn't work. This pain doc feels that my problems are scar tissue related, and he warned me if they suggest surgery to realize that all another one will do is create more scar tissue. So I'm heading back to my primary care doctor to be referred to another pain doctor. Hopefully one who will realize PT, shots, injections, chiropractic dont work.

That should show some of the good, the bad, and the ugly. First thing I would do is try alternative methods of treatment, anything other than just surgery. See if you can live without it, and if not, then when you've exhausted other options try for surgery.

Do I consider my surgery a success? YES. For 2 years I had my life back. I went back to work. Do regret the surgery? NO. If I had to go back would I do it again? YES.

BUT it's not without it's risks, or it's complications. It's a very personal decision.

IF You decide to opt for surgery, I would look long and hard at your doctor. Call the BBB ask if he has any complaints. Ask to speak to prior patients. Ask for HIS stats on doing this operation, compare them to the national average. Ask about the mortality rate. Ask what your alternatives are. Ask how he knows that fusion WILL help your pain? Ask him how many patients in your situation end up with the pain coming back. How many have the pins/screws coming undone? Develop infection? Have complications during surgery? End up full/partially paralyzed. If he refuses to answer any of these questions, find another doctor. Also find out how quickly he will respond if you have to call him in the middle of the night (like I did when my wound started dripping fluid, my doc was up at 2 am calling me back, and at the hospital less than hour later). Make sure this is whats right for YOU. Some people tell me the surgery couldn't have been worth it. for me, it was.

I hope some of this helps, sorry it's so long.

"When we come to the edge of the light we know, and are about to step off into the darkness of the unknown, of one thing we can be sure; either God will provide something solid to stand on... or we will be taught to fly.'"

"Cause when push comes to shove You taste what you're made of, You might bend, till you break Cause its all you can take; On your knees you look up Decide you've had enough, You get mad you get strong Wipe your hands shake it off, Then you Stand" From "Stand" by Rascal Flatts
Dx.: Polycystic Ovarian Syndrome, Ulcerlative Colitis, Chronic Inflammation of the Colon, Ruptured & Fused L4-L5-S1 w/pinched nerves, Degenerative Disc Disease, Chronic Costochondritis, Back Muscle Spasms, Asthma, Benign Tremmors (hands)

Posted By : mexximelt - 8/29/2007 10:59 AM

I had a fusion at L4/L5 in 2002.  I would be more than happy to share the entire experience with you but can you tell me exactly the description of the diagnosis?  MRI results? Extent of injury?



Posted By : painbehindthebadge - 8/29/2007 12:30 PM
I had PT, choroprator, work conditioning, injections, and I even saw a voodoo woman
:-)  . Nothing has worked. I have had 2 MRI's ( 2 1/2 years apart)and they showed little disk degeneraztion. I did a discogram (OUCH) in 05 and I had little evidence that is was from the same disc that was very slowly shrinking. My Dr. doing the Pain management told me I could no longer be a police officer. The city I worked for sent me to get a 2nd opinion. He told me I couldnt be in law enforcement. He recommended me to have another discogram June 07 (OUCH) This time my test was a diffenenent positive. The Dr. commented on having 2 big holes and how impressive they were. Oh yeah I gained 50 pounds along the way. confused   My treating Dr. told me I needed a fusion and sent me to see the neurosurgeon. He and his staff reviewed my case. My options are pain management and living with pain. (I refuse to take ne high dose stuff and only take hydrocodone 10-325 when I am off duty. That makes the pain bareable but does not relieve it.) or surgery. I am tired of being in agony and I am tired of being fat. I am going to have the surgery unless me research scares the poop out of me. I work for the low paying police department and have to work OT just to get by. I had to lie several times about being well so I could come of limited duty to work OT. I need to get back to full duty so I can support my family. This is my last and only option to stay in law enforcement.
My injury occurred when I arrest a p.o.s. who was wanted for rape, kidnapping and armed robbery. I pulled him out of a car and I didnt relize he had his seat belt on. I never considered I violent felon would be wearing his selt. He had a gun on him but the last thing in the world I thought could ever ruin my law enforcement career got me......a freakin seat belt. mad    I guess he figure he 43 years he got sentenced to was bad enough and he didnt want to pay the $50.00 seatbelt fine. Sry for all the typos and misspelling but i cant find a spell check on the forums.

Posted By : TDoern - 8/29/2007 12:57 PM
Pain - have they talked to you about disc replacment? When I was operated on I'd never heard of this, but I hear the technology there is expanding rapidly. You may want to ask about it, just to know if it's even an option.

Thank you for all you've sacrificed for us. I know that is little help when your dealing with the pain you deal with, but thank you anyways.

"When we come to the edge of the light we know, and are about to step off into the darkness of the unknown, of one thing we can be sure; either God will provide something solid to stand on... or we will be taught to fly.'"

"Cause when push comes to shove You taste what you're made of, You might bend, till you break Cause its all you can take; On your knees you look up Decide you've had enough, You get mad you get strong Wipe your hands shake it off, Then you Stand" From "Stand" by Rascal Flatts
Dx.: Polycystic Ovarian Syndrome, Ulcerlative Colitis, Chronic Inflammation of the Colon, Ruptured & Fused L4-L5-S1 w/pinched nerves, Degenerative Disc Disease, Chronic Costochondritis, Back Muscle Spasms, Asthma, Benign Tremmors (hands)

Posted By : mexximelt - 8/29/2007 8:35 PM

Dear pain behind the badge

I can relate to everything you mentioned although I hurt mine lifting weights.  I also went through all the tests  (double ouch) you did and tried everything (except voodoo woman) to relieve the pain and fix the problem.  First let me say the one thing I have learned in the last 7 years since I hurt my back was that you have to make your quality of life #1 and your job second.  Now, I know of what you speak because I was a single mother of 2 when I went through all this.  I went from a $70,000 a year job to now making $38,000 and about to go to no job, no income, and no health insurance due to my back. This forum is full of people who have lost their livelyhood an survive on next to nothing.   If you don't take care of your back you will turn into one grumpy person and your family won't like being around you.  The money is not important.  I thought my life would end with a decrease in salary but trust me , it all works out in the end and you will survive. 

Now, about the surgery.  I felt the same as you about taking pain meds but one day woke up and said "hey, I am not addicted to pain killers, I am addicted to not being in pain".  Pain can take you to the lowest spot out there and ruin your life.  Take your meds and don't feel bad about it.  I did lots of research about surgery before considering it.  I was to the point where I could do nothing without wanting to cry anymore.  You just wake up one morning and say "gotta do it".  You will know when you reach that point.  After much research I was accepted into a program in LA involving a trial study of a device called "charite".  It is a disc spacer and very cool.  The recovery time is cut to 1/4 and the success was amazing.  It has been used in Europe for a long time.  Now at the time I had surgery it was not approved here but that was 7 years ago so please check it out.  I had to go to another state to do it and at the last minute (no kidding 14 hours before surgery) my insurance company changed their minds so my doctor went ahead and did a interbody cage fusion with fixation devices.  Again , with much research my doctor consented to go in through the front to take out the effected disc and put cages in then, went into the back with 4 small holes to put in screws and rods.  My fear with research was that when they cut you open in the back and do all the work from there they risk nerve damage and I read many horror stories.  Also, with typical fusions they use bone from another site (hip usually) to pack around the cages so it will fuse properly.  Again through research I found out the recovery from the bone graf is far worse than the actual back surgery soooooo  my doctor used something new that was an artifical protein of some kind that was injected at the fusion site.  I wish I could remember the name of the protein but try to google it.  I am sure it is out there.  Now, I dont think back surgery is worse than any other but for me is was a horror because the first shot of morphine i was given with my own little controlled pump made me throw up and very sick so I had to go through the hardest part with no pain meds.  I remember thinking if I could make it to the window I would jump out but I was at Cedar Sinai hospital where all the movie stars go and I did not want to be on the 6pm news.  Now as for recovery, I was back to work part time in 3 months and full time in 6.  I can almost remember to the day (12 months later) that I woke up and felt like a million bucks and like I could do anything.  It truly took about a year.  Now that was in 2002 and about a year ago I started in with pain again.  I continued and I found out the hard way and have been told by many doctors when you get a fusion at L4/L5 it is wise to also do  the one below and above as that is the major point in your back for stability and because the one above and below has to now work harder those 2 will go bad eventually.  Hindsight I guess but I do suffer with pain and take 3 vicadin a day religiously without guilt.  The best advice I ever got was "keep moving after surgery for the rest of your life".  Right after surgery I started walking 1 mile a day around a track with my unattractive brace on.  I was soon up to 3 miles a day and that is what will heal your back the quickest and make for a good fusion.  I can keep my pain tolerable if I keep moving.  I have chosen jobs that allow me to move constantly.  The worst part is getting up in the morning as the pain is bad but I just have to move around and off I go.  I am sorry to say you will probably have to give up being a cop out there but I am sure there are many options for you in law enforcement that will accomodate your back.  It is not easy to give up what you love but believe me you have to take care of your back to be happy.  I recently hurt my back while working (the first time since surgery) and am looking at changing careers again in order to find something I can actually do.  It is hard to let go of it but I have to be able to smile everyday and love my family and friends.  I am guessing as yours is a workers comp claim they will pay for everything so that is good.  I would think you could get on disability after surgery if you cant perform your police duties?  Don't know much about that as workers comp is new to me also.  Do your research on the surgeons and go to more than one of course to discuss surgery.  Google the "charite" device I mentioned as well as the protein.  For sure if you decide on a surgeon ask for patients that you can talk to that have had the same surgery.  There are plenty of them that don't mind sharing their experience with that surgeon with you.  I don't want to minimize the recovery period.  It is a drag and you need lots of help from your family to get through it.  If you can tolerate the pain with meds and live a good life don't have the surgery.  Use it as a last resort but as I said, you will know the moment you can't take it anymore.  The most important thing for me at the time was to join a pain support group like this.  I truly don't think I could have gotten through it all without the ability to talk to those who have gone through it.  My kids got me through mine but I am sure it got old always listening to my whining.  Let me know if you have any more questions......................we are there for you 

Posted By : mexximelt - 8/29/2007 8:40 PM

Posted By : CRANKY 1 - 8/29/2007 10:46 PM

Hey Painbehindthebadge,

I'm so sorry you are in such pain, but I can totally identify with your situation.  I have all sorts of problems with my back, especially at S1, L4, L5, C6, and C7.  Both my orthopedist and my pain management doctor agree that I will need to have my lower spine fused at some time, but because I'm only 42, they think I should put it off as long as possible.  If I were to have it done now, I would have to have it redone sometime down the line.  Nobody should have to go through that kind of surgery more than once.  Thus, I'm stuck getting useless epidurals and nerve blocks, and staying in constant pain because nobody wants to put me on any pain meds.  I hope things work out for you.

Leigh Ann cool

Basic info:
  • On Disability for: Chronic Migraines, serious Back and Knee problems (will need surgery eventually), moderate Depression, Anxiety/Panic disorder, TMJ 
  • Divorced, 42, no children
  • Surgeries: Gastric Bypass, Gallbladder Removed (followed by a week in the hospital for a Blood Clot), Kidney Stone Removed, Broken Ankle, Major Dental work(four molars pulled, multiple cavities, root canals) 
  • Current Meds: Lexapro, Klonopin, Wellbutrin, Stadol Nasal Spray, Lortab, Trazadone, Buspar, Nexium, Skelaxin, Tramadol, Phenergan, Chantix PROHIBITED FROM ALL NSAIDS
  • Current Problem: Internal Bleeding, possible ulcer in location of Gastric Bypass
"The weather is here, I wish you were beautiful."
                                             - Jimmy Buffett

Posted By : straydog - 8/30/2007 1:02 AM

Hi Pain Behind the Badge,

I too wanted to welcome you to HW. I am sorry you have to be here, but at least you came to the right place and found us.

I think Mexximelt gave you the best summation I have seen in a long time concerning back surgery.Everything she wrote there is the absolute truth. I worked for attys over 20 yrs,we handled W/C claims and Personal Injury. In my time of working, I saw thousands of neck & back surgeries over the yrs. If I were having back surgery, I would lean more towards a neurosurgeon doing my surgery versus an orthopedic. Why, be cause he is more trained to deal with nerve part of the surgery, that his specialty. I saw many successfull surgeries over the years. The ones that did not do well fell into 2 categories, 1. they didn't have a good dr or 2. they didn't have their head on right having the surgery and made their mind up they would never be able to do anything again. Guess what, they didn't, the dr did his part but the patient did not do his/her part.

Walking after surgery is the best form of exercise you can do. It strengthens you, your back and builds your stamina up. The first 6 weeks are the roughest because you have to be so careful as to not disturb the fusion so it can start becoming solid. Most of the drs here limit riding in the car to coming in for office appts in the begining, don't need to get hit with a soft fusion, no sitting, puts too much strai on the back and fusion. The drs here put you on 6 wks of bedrest except to get up & go to the b/r or to eat.

It does take one year to totally heal and have a full recovery from back surgery. Trying to push things along quicker will only set you back. Yes, you will have some limitations, but look how limited you are now. You might ask your dr to have one of his back surgery patients call you and talk to you about the surgery. They can tell you how he handles his patients.

Educate yourself as much as you can. Asking on forums you are going to get mixed reviews, so really you just have to take it all with a grain of salt. Everyone is different so keep that in mind. Keep us posted on how you do. Susie 
























































































































































































































































































Posted By : painbehindthebadge - 8/31/2007 8:00 AM
TDoern, thank you and your family for your sacrifices. I servered in the U.S. Army 1988-1990 and I know how hard Military life is on a family. If you are married to someone in  the service you make tons of sacrfies. You will live with a poor salary and not see your spouse
do to deployments.

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