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-   -   Anterior & Posterior Fusion Patients...Please Read (http://www.ispine.org/forum/ispine/1138-anterior-posterior-fusion-patients-please-read.html)

Eddie G 11-06-2008 05:07 PM

Anterior & Posterior Fusion Patients...Please Read
 
If you have had fusion from both sides, kindly help me. I already have had disk replacement at L4-L5 with my incision in the front. My latest discogram shows an annular tear at L5-S1. Dr. Goldstein has scheduled me for fusion surgery, operating anterior for graft placement and posterior for pedicle screw placement.
My 1,000,000.000 question is; how bad will my stomach pain be as compared to disk replacement?
My stomach didn't wake up for 3 days after my disk replacement and hurt for months after.
Should I expect the same horrible pain from the anterior fusion?
Dr. Goldstein said they will just use the bottom of my existing stomach scar to enter my body so I think the hole will be smaller than the original hole. It is possible to install the graft through the posterior, but he said the pain would be worse as he is lifting the back muscles out of the way to fit the graft through. I am leaning toward the belly operation but would like to know more about the pain involved from other fusion patients.

Anybody have any thoughts?

chasswen 11-06-2008 05:55 PM

eddie i would think it will be the same as your adr surgery.
hang in there kid
chuck

Eddie G 11-06-2008 06:07 PM

Couldn't you sugar coat it just a little? OUCH!

I also need to find out if I will be given a plastic brace. I didn't get one for ADR but alot of fusion patients get them...

...then there's that lovely catheter...Oh the memories........

mmglobal 11-06-2008 07:17 PM

Wow.

I'm glad that you are moving forward towards a solution, but so sorry that you must consider another surgery.

Does another anterior surgery limit your future options if you need further spine surgery?

Do the posterior elements behind L4/5 look good?

Is he sure that the 4-5 level is not a continuing pain generator? Have you discussed the possibility of 2-level posterior fusion if pain from continued motion at 4-5 is not ruled out?

If anterior is better, has he discussed anterior only with newer cages that include screw fixation instead of needing posterior support?

I have a bunch more questions that are probably best discussed off line... call me.

Mark

Eddie G 11-06-2008 07:38 PM

Excellent points Mark. I will discuss the cage with Dr. Goldstein and with you.

Dr. Goldstein is not 100% that the L5-S1 surgery will solve my problems, but I am pretty sure L5-S1 has been the pain generator all along since the pain never changed even after ADR.

The disk replacement at L4-L5 is slowly fusing so I won't need to do anything there. I wouldn't fuse my Prodisc unless I was 100% positive it was a problem.
Over the past 2 years I have had sooo many treatments that if there were any issues with the L4-L5 they would have been found by now. My leg and hip pain would steer me more towards the L5-S1 as a pain generator rather than the L3-L4 which showed a tear but no reaction during the latest discogram. The L5-S1 reacted twice during this latest discogram and once during the initial discogram 3 years ago.

I just got approval a few minutes ago from worker's comp so I am getting my mind ready. I plan on having fusion in about 3 weeks.

mmglobal 11-06-2008 07:53 PM

Eddie,

Here is a GPN story page with STALIF (Stand Alone Lumbar Interbody Fusion) cage. This eliminated the need for posterior surgery.

GPN story page with STALIF cage

Mark

Eddie G 11-06-2008 08:20 PM

Thanks Mark for taking the time to talk to me. You brought up some good discussion points to talk to Dr. G about. Everyone should have an advocate on their team.


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