Hey guys,

I will be scheduling a fusion of my l4/l5 and l5/s1 joints soon. I live in Dallas.

I've leaned that orthopedic surgeons and neurosurgeons can both do this procedure.

I wanted to see if anybody had experience or reasons for going with one over the other.


Any other advice or info that you guys have related to this procedure is greatly appreciated.


Thanks!
Craig '01

For right or wrong. I went with a neurosurgeon because my fusion dealt with nerves.

Only advice I have is to get yourself a good recliner before your surgery. I don't know what I would have done if I didn't have mine. The bed was a big no go for me. Instant pain from muscle spasms trying to lay in that thing.

Thanks for the reply. That is great advice on the recliner. Any advice on what type? did you need motorized functions on it?

Would be grateful for anything else you'd be willing to share on your experience. Anything you wish you would have done differently? Tips on recovery process?

I don't have any advice, but obviously surgery on your back is a big big deal. I would always recommend trying everything you can before going that route.

I actually just listened to a really fascinating podcast with Dr. Stuart McGill today. He talked about doing virtual surgery on patients. It is a gimmick but basically he said he tells patients to act like they just had surgery and follow all the recovery protocol. He said it is an amazing amount of patients who do well just following the recovery procedures from surgery .

McGill is fantastic. Guy spent his entire career focused on back issues. His book, The Back Mechanic should be the first stop for anyone who is experiencing any sort of back pain.

Are you not a candidate for disc replacement surgery? I assume you tried physical therapy without success?

I definitely had a motorized one. Only advice I have on a brand is to make sure it's comfortable enough for you to sleep on. I spent several weeks sleeping on it instead of the bed.

Make sure you have some laxatives on hand. Something about being under screws up your digestive system. Took me several days after the surgery before I got over that bit of fun.

Pain wasn't too bad for me. Mostly it was a different kind of pain compared to my spondy. Wish I'd done it sooner instead of suffering from the constant pain of my vertebrae shifting.

That said, my wife recently had a disk replacement surgery for her neck. If I had that option back then, I would have to sought it out. Seems like more natural fix to the problem.

aggiederelict said:

---

Are you not a candidate for disc replacement surgery? I assume you tried physical therapy without success?

---

The feedback I have received is I am not a good candidate for disc replacement surgery. However, that may be coming from doctors that do not do this surgery. I had also heard that the disc replacement was promising when it first came out but the data didn't present all that well after it has been around a good 10+ years.

I have been bone on bone in L5/S1 since at least 2011. This has been the main problem for years. But now this has lead to a really bad disc at L5/L4 at present. This disc is really deteriorated and bulged into the spinal cord aggressively. Causing all the issues down the legs.

Did a lot of physical therapy over the last several years to delay surgery. I think the scales have finally tilted in favor of surgery. And, to be honest, I'm a bit relieved there could be some relief in sight.

Philip J Fry said:

---

I definitely had a motorized one. Only advice I have on a brand is to make sure it's comfortable enough for you to sleep on. I spent several weeks sleeping on it instead of the bed.

Make sure you have some laxatives on hand. Something about being under screws up your digestive system. Took me several days after the surgery before I got over that bit of fun.

Pain wasn't too bad for me. Mostly it was a different kind of pain compared to my spondy. Wish I'd done it sooner instead of suffering from the constant pain of my vertebrae shifting.

That said, my wife recently had a disk replacement surgery for her neck. If I had that option back then, I would have to sought it out. Seems like more natural fix to the problem.

---

Do you know much about disc replacement for the lumbar spine? Would you mind sending me the name of the exact procedure she had (if there is a medical term for it).

Thanks!

Here is my MRI. These are the 2 problem discs. The lowest one has been bone on bone for a good 13 years. Considering a fusion of those 2 discs. (Disclaimer: I'm lucky to be in a big city and have access to great doctors. Just looking for other input from folks with experience, etc.)

I think the simple term is disc replacement. Wife had a cervical disc replaced.

thank you.

My recommendation is nuerosugeon route. I also wonder if Regenex would help.

I have had 2 disc replacements and one fusion in my neck.

My understanding is that in the lower back, the "natural" movement allowed by artificial discs can allow facet movement. This facet movement can cause a lot of back pain.

I'm probably having a spacer with a fusion (screws and small rods) installed at L4-L5 in the next month or so. Not looking forward to it.

Texas Back Institute is great in Plano for disc replacement. I send my patients there if they don't want to do fusion. I always send my patients locally to a neurosurgeon here locally in Austin if they are considering a fusion.

thanks for the continued input guys. it's helpful and i appreciate it.

aggiederelict said:

---

Texas Back Institute is great in Plano for disc replacement. I send my patients there if they don't want to do fusion. I always send my patients locally to a neurosurgeon here locally in Austin if they are considering a fusion.

---

I have had laminectomy-discectomy there by Dr. Guyer twice. He's great. No complaints, aside from having to have the surgery done a second time five years later.


Interestingly, he went on to perform back surgery on Tiger Woods, who then went on to win his most recent Masters. So I guess that's a good sign.